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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. Debate over whether health insurance companies (e.g. in the US) should be required to cover infertility treatment.

PPT Presentation Summary : Evaluation of Fertility: A Cornerstone to Improved Reproductive Health for Women Overview. Ultrasound: This may reveal issues such as ejaculatory duct obstruction or retrograde ejaculation. In GIFT, the sperm and eggs are mixed together before a doctor inserts them.

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WHO Manual for the Standardized Investigation and Diagnosis of the Infertile Couple. However, these tests have only poor to moderate predictive value despite widespread use. This may reflect an unknown immunological incompatibility or other unknown problem with fertilization or implantation.

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Anabolic steroids: Popular with bodybuilders and athletes, long-term use can seriously reduce sperm count and mobility. Search dates: January 6, 2014; January 28, 2014; February 5, 2014; and November 18, 2014. The impact of fibroids located elsewhere in the uterus are controversial and do not always require surgery.

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Large polyps or multiple polyps can impact fertility by interfering with the ability of embryo to implant and should be removed. Overheated testicles: Causes include an undescended testicle, a varicocele, or varicose vein in the scrotum, the use of saunas or hot tubs, wearing tight clothes, and working in hot environments. This is where no cause can be identified in either the woman or man. Conventional In-vitro Fertilization vs Intracytoplasmic Sperm Injection for Patients Requiring Microsurgical Sperm Aspiration. (PDF, 3 MB) Human Reproduction, 1994. Primary testicular causes of infertility Primary testicular problems may be chromosomal or nonchromosomal in nature. The pregnancy rate fluctuates from 20-35%, and the expected ectopic pregnancy rate is as high as 20%. An estimated 34 million women, predominantly from developing countries, have infertility which resulted from maternal sepsis and unsafe abortion (long term maternal morbidity resulting in a disability). Apparent Fertility of Human Spermatozoa from the Caput Epididymidis. (PDF, 4 MB) Journal of Andrology, 1989. Obesity may also lead to less frequent ovulation or to less frequent intercourse, thereby contributing to fertility problems. Experts differ as to when genetic tests should be done.