Infertility

Causes of Infertility in Females

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By 2014, over 5 million people had been born after being conceived through IVF. A doctor injects sperm directly into the egg in a dish and then places it into your uterus. Other conditions that affect the quality and quantity of sperm include: Primary testicular failure.

For example, endometriosis can cause infertility with the growth of endometrial tissue in the Fallopian tubes or around the ovaries. Approximately 4 million (9%) men aged 25–44 years reported that they or their partner had consulted a doctor for advice, testing, or treatment for infertility during their lifetime (4). As the major causes of infertility are sperm abnormalities, ovulation dysfunction, and fallopian tube obstruction, the preliminary adviced investigations for the infertile couple should be focused on semen analysis (to be compared with the WHO reference values [27]), detection of ovarian function by hormonal assay (early follicular FSH and LH levels, and mid-luteal progesterone), and evaluation of tubal patency by hysterosalpingography (HSG) [17-32], (Appendix 3).

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Nonchromosomal testicular failure Testicular failure that is nonchromosomal in origin may be idiopathic or acquired by gonadotoxic drugs, radiation, orchitis, trauma, or torsion. When anatomic variance or obstruction is suspected, referral for surgical evaluation and treatment is appropriate. Blood, urine, and imaging tests can be done to discover why you are having trouble getting pregnant.

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If a deficit of greater than 1 L is recorded, the procedure should be terminated, and, preferably, the myomectomy should be completed in a second hysteroscopic attempt. Patients with severe ovarian hyperstimulation syndrome are often hospitalized and confined to bed, with strict control of fluid intake and output. 6,23 Anovulatory women should have further investigation to determine treatable causes such as thyroid disorders or hyperprolactinemia based on symptoms. The quality and quantity of eggs begin to decline by the early 30s and drop even further as a woman approaches the age of 40. Effect of metformin on ovulation and reproductive outcomes in women with polycystic ovary syndrome: a meta-analysis of randomized controlled trials.

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Microsurgery for Vasectomy Reversal and Vasoepididymostomy. (PDF, 13 MB) Urology, 1984. To verify azoospermia, the semen should be centrifuged and evaluated under a light microscope for the presence of sperm. Passing very dark, old blood at the beginning of a period can also be a sign of endometriosis. A complete pelvic exam should reveal any uterine hypoplasia, fibroids, adnexal tumors or cervical lesions and should indicate whether dyspareunia may be a problem. If the woman is aged over 35 years, the couple may wish to see a doctor earlier, because fertility testing can take time, and female fertility starts to drop when a woman is in her 30s. Ectopic pregnancy This is when a fertilized egg implants outside the womb, usually in a fallopian tube. Medication. If you have ovulation problems, you may be prescribed drugs such as clomiphene citrate (Clomid, Serophene), gonadotropins (such as Gonal-F, Follistim, Humegon and Pregnyl), or letrozole. 8,26,27 As opposed to laparoscopy or hysteroscopy, hysterosalpingography is a minimally invasive procedure with potentially therapeutic effects and should be considered before more invasive methods of assessing tubal patency. Clinical diagnostic testing for the cytogenetic and molecular causes of male infertility: the Mayo Clinic experience. Microcirugía y fertilición in vitro para la azoospermia obstructiva. (PDF, 5 MB) Chapter 14 from textbook, Avances en reproducción asistida, 1992.


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See also
Infertility Treatment Egg Donation
Infertility Treatment Steps
Female Infertility Tests and Diagnosis