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The sperm can either be mixed with the eggs to allow normal fertilization (conventional insemination) or by injecting one sperm into each mature egg (ICSI). Today, many patients do not receive the recommended medical care that based on the best available evidence [5]. Low weight: Obesity is not the only way in which weight can impact fertility. Conception and Fertility The chance of conceiving in any given menstrual cycle is less than 20% in a woman of reproductive age. It is increasingly recognized that egg quality is of critical importance and women of advanced maternal age have eggs of reduced capacity for normal and successful fertilization. A high serum estradiol level (greater than 60 to 80 pg per mL [220 to 294 pmol per L]) in conjunction with a normal FSH level has also been associated with lower pregnancy rates.

25 Women with no clear risk of tubal obstruction should be offered hysterosalpingography to screen for tubal occlusion and structural uterine abnormalities. The predictive value of hysterosalpingography for tubal and peritoneal infertility factors. These men are at a higher risk for breast cancer, leukemia, diabetes, empty sella syndrome, and pituitary tumors. Testicular Neoplasm in Father and Son. (PDF, 561 KB) The Journal of Urology, 1972. Laparoscopy: A thin, flexible tube with a camera at the end is inserted into the abdomen and pelvis, allowing a doctor to look at the fallopian tubes, uterus, and ovaries.

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Endometriosis causes infertility by producing inflammation and scarring, which can result in not only pain but also potentially detrimental effects on egg, sperm or embryo. Microsurgery of the Male Genitalia for Infertility. (PDF, 8 MB) Chapter 59 from Reconstructive Urologic Surgery, 1994. Testis Biopsy and the Infertile Male. (PDF, 20 MB) Chapter 15 from textbook Office Andrology, 2005. On Regenerating the Ovary and Generating Controversy. (PDF, 37 KB) Cell, 2005. Normal Pregnancies Resulting from Testicular Sperm Extraction and Intracytoplasmic Sperm Injection for Azoospermia Due to Maturation Arrest. (PDF, 6 MB) Fertility and Sterility, 1996.

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Surgical ablation: - In minimal or mild endometriosis; surgical ablation or resection of endometriosis plus laparoscopic adhesiolysis improves the chance of pregnancy. - Laparoscopic resection of endometriomas may be beneficial, however recent RCTs suggest intervention only in endometriomas > 4cm. - In moderate or sever endometriosis; surgical treatment should be offered. (Debatable) - Post-operative medical treatment does not improve pregnancy rates. Not getting pregnant The primary sign of infertility is not getting pregnant after trying for a certain length of time. B.: No role for basal body temperature charts) Basic Work-up for Infertility 14. Ovarian reserve -More important in >35 years old, suspected ovarian failure and to detect response to ovulation induction. Bushnik T, Cook JL, Yuzpe AA, Tough S, Collins J. Coital frequency is positively correlated with pregnancy rates. Surgical sperm aspiration: The sperm is removed from part of the male reproductive tract, such as the vas deferens, testicle, or epididymis.

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Spermatid Conception. (PDF, 1 MB) Human Reproduction, 1998. If a woman has an ovulation disorder, she may ovulate infrequently or not all. If the egg does not travel, it can be harder to conceive naturally. In general, infertility is defined as the inability of couples to achieve pregnancy after ≥1 year of trying (1). There are three main types of sperm antibodies: Immunoglobulin G (IgG) Immunoglobulin A (IgA) Immunoglobulin M(IgM). Macroscopic deletions of Yq11 are often observed in patients with azoospermia, although many new microdeletions have been implicated as a significant cause of infertility. Diagnosis and Management of Hypogonadism, Infertility, and Impotence. (PDF, 13 MB) Chapter 22 of textbook,Male Reproductive Dysfunction, 1986. Therefore, data estimating the prevalence of infertility cited by various sources differs significantly.[8] A couple that tries unsuccessfully to have a child after a certain period of time (often a short period, but definitions vary) is sometimes said to be subfertile, meaning less fertile than a typical couple. Diagnosis Male infertility is usually diagnosed by a semen analysis.