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Low sperm mobility (motility): The sperm cannot "swim" as well as they should to reach the egg. Malformation of the eggs themselves may complicate conception. Maternal age Infertility due to age is one of the most common causes of female infertility. Women attempting pregnancy at age 40 or older have a 50% decreased fertility rate and a two-fold to three-fold increased risk of spontaneous abortion compared with younger women. The initial dosage of clomiphene is 50 mg daily for five days starting on day 3 to 5 of the menstrual cycle. Testosterone therapy may allow patients to achieve normal height but does not improve spermatogenesis.

37,38 The addition of 1,500 to 1,700 mg of metformin (Glucophage) daily may increase ovulation and pregnancy rates, but it does not significantly improve live birth rates over clomiphene alone. Causes in women Infertility in women can also have a range of causes. Patients who are suffering from Stein-Leventhal syndrome (also referred to as polycystic ovary syndrome, or PCOS) can also suffer from anovulation.[3] Up to 90% of cases of anovulation are caused by PCOS; this syndrome is usually hereditary.[4][5] Weight loss or anorexia can also cause hormonal imbalance, leading to irregular ovulation (dysovulation). Techniques for the Resolution of Testicular Obstruction. (PDF, 8 MB) Chapter 78 from textbook, Reconstructive Urology, 1992. Key to the diagnosis of male infertility is a semen analysis, which assesses primarily sperm numbers, sperm movement and sperm form.

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Infertility is defined as the inability to become pregnant after 12 months of regular, unprotected intercourse. Abnormalities may be a sign of a primary hypothalamic, pituitary, or testicular problem.Causes Causes generally can be divided into pretesticular, testicular, and post-testicular.

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Recent research carried out in Sweden covering stress markers in saliva demonstrated that patients who are stressed have a greater number of reproduction issues. Women receiving fertility treatment have a slightly higher risk of an ectopic pregnancy. Scrotal surgery, including vasectomy, hydrocelectomy (5-6%), and spermatocelectomy (up to 17%), may lead to epididymal injury and subsequent obstruction.[30] Antisperm antibodies Antisperm antibodies bind to sperm, impair motility, and lead to clumping, impairing movement through the female reproductive tract and interaction with the oocyte. Vasectomy Reversal. (PDF, 733 KB) The New England Journal of Medicine, 1977. If the urinary output remains low, albumin 25% (50 mL/h IV for 4 h) has been effective in promoting diuresis. Ovulation of the egg occurs approximately 2 weeks before the start of the next period.

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Poor egg quality: Eggs that are damaged or develop genetic abnormalities cannot sustain a pregnancy. Illegal drugs: Some women who use marijuana or cocaine may have fertility problems. In closed social groups, a degree of rejection (or a sense of being rejected by the couple) may cause considerable anxiety and disappointment. In theory, it is possible to conceive on any of these 6 days that occur before and during ovulation. Lack of estrogen brings about decreased spinnbarkeit of the cervical mucus. Infertility and impaired fecundity in the United States, 1982–2010: data from the National Survey of Family Growth. 6-Mb Deletion of the Human Y Chromosome Persists Through Balance Between Recurrent Mutation and Haploid Selection. (PDF, 295 KB) Nature Genetics, 2003. Primary infertility is when a couple has not conceived after trying for at least 12 months without using birth control Secondary infertility is when they have previously conceived but are no longer able to. Allocation of medical resources that could be used elsewhere The legal status of embryos fertilized in vitro and not transferred in vivo. (See also beginning of pregnancy controversy). Government, the Department of Defense, or the Department of the Air Force.