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8 If a woman has irregular cycles, the testing should be conducted later in the cycle, starting seven days before presumed onset of menses, and repeated weekly until menses. Smoking during pregnancy increases the chance of pregnancy loss. Obese women have a higher rate of recurrent, early miscarriage compared to non-obese women.

8,33,35,36 Lastly, in vitro fertilization, with or without intracytoplasmic sperm injection, is the mainstay of assisted reproductive technology for male factor infertility. 17 Evaluation of male infertility starts with a history and physical examination focusing on previous fertility, pelvic or inguinal surgeries, systemic diseases, and exposures. Gracia CR, Sammel MD, Coutifaris C, Guzick DS, Barnhart KT. Peritubaric adhesions can be caused by endometriosis. The fertilized egg is then implanted in the uterus.

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Men should undergo evaluation with a semen analysis. This can be done by a urine test, basal body temperature chart, progesterone test and/or endometrial biopsy. Other factors that can affect a woman's chances of conceiving include being overweight or underweight,[56] or her age as female fertility declines after the age of 30.[57] Sometimes it can be a combination of factors, and sometimes a clear cause is never established.

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A postoperative HSG should be performed 2 months later. If your cycles are infrequent or irregular, your doctor will examine you and perform the appropriate testing to discover which problem you may have and present the appropriate treatment options. Moderate alcohol consumption has not been shown to lower fertility in most men, but it may affect those who already have a low sperm count. Clinical Characterization of 42 Oligospermic or Azoospermic Men with Microdeletion of the AZFc Region of the Y Chromosome, and of 18 Children Conceived via ICSI. (PDF, 606 KB) Human Reproduction, 2002. Blood, urine, and imaging tests can be done to discover why you are having trouble getting pregnant.

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Irregular periods The average woman’s cycle is 28 days long. Examples of such health issues include infections, endometriosis, and fibroids. Sertoli Cell only Revisited. (PDF, 1 MB) Human Reproduction, 1995. Age: Male fertility starts to fall after 40 years. This sterile needle is attached to sterile suction tubing and a collecting vial. Classic Klinefelter syndrome has a 47, XXY karyotype and is caused by a nondisjunction during the first meiotic division, more commonly of maternal origin; mosaic forms are due to nondisjunction following fertilization. Their cumulative probabilities of conception are 60% within the first 6 months, 84% within the first year, and 92% within the second year of regular fertility-focused sexual activity. Congenital Adrenal Hyperplasia: Occurs when the pituitary is suppressed by increased levels of adrenal androgens.  Symptoms include low sperm count, an increased number of immature sperm cells, and low sperm cell motility.  Is treated with cortisone replacement therapy.  This condition is found in only 1 percent of infertile men. Ross says it might suggest a blockage in the “plumbing” that can be corrected with surgery. More than 60% of sperm should be normal, and less than 2-3% should be immature. Cervical stenosis (a narrowed cervix) or the lack of cervical mucus often make it harder for sperm to travel through the cervix into the uterus. Hysteroscopy is the inspection of the uterine cavity through the cervix by a hysteroscope attached to a camera which projects to a screen. Your doctor will analyze your semen analysis carefully and help you decide if ICSI is an appropriate treatment for you. Abnormalities of sperm may be treated with gonadotropin therapy, intrauterine insemination, or in vitro fertilization. 30–32 Other treatment options include antiestrogens and gonadotropin therapy, which showed a trend toward increased live birth rates in a Cochrane review.