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Generally, evaluation should be offered to couples who have not conceived after one year of unprotected vaginal intercourse. Fertility may improve after adopting a gluten-free diet.Infertility: Introduction Infertility is a significant social and medical problem affecting couples worldwide. In humans, infertility is the inability to become pregnant after one year of intercourse without contraception involving a male and female partner.[2] There are many causes of infertility, including some that medical intervention can treat.[3] Estimates from 1997 suggest that worldwide about five percent of all heterosexual couples have an unresolved problem with infertility. The medicalization of infertility has unwittingly led to a disregard for the emotional responses that couples experience, which include distress, loss of control, stigmatization, and a disruption in the developmental trajectory of adulthood.[16] Infertility may have psychological effects.

Hypogonadotropic Hypopituitarism: Low pituitary gland output of LH and FSH.  This condition arrests sperm development and causes the progressive loss of germ cells from the testes and causes the seminiferous tubules and Leydig (testosterone producing) cells to deteriorate.  May be treated with the drug Serophene.  However, if all germ cells are destroyed before treatment commences, the male may be permanently infertile. The final third may be due to a combination of both, other factors, or unknown causes. The predictive value of hysterosalpingography for tubal and peritoneal infertility factors. M. genitalium infection is associated with increased risk of infertility.[25][26] Genetic[edit] A Robertsonian translocation in either partner may cause recurrent spontaneous abortions or complete infertility.[citation needed] Mutations to NR5A1 gene encoding Steroidogenic Factor-1 (SF-1) have been found in a small subset of men with non-obstructive male factor infertility where the cause is unknown.

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Undescended testicles During fetal development one or both testicles may fail to descend from the abdomen into the sac that normally contains the testicles. Problems in the uterus or fallopian tubes can prevent the egg from traveling from the ovary to the uterus, or womb. Normal cervical mucus to allow passage of the sperm to the upper genital tract. 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. Gynecological history, including operations and medical treatment.

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Blood tests Depending on the individual couple's situation, various blood tests on either the female or the male may be needed. For conception, sperm must reach the cervix, penetrate the cervical mucus, migrate up the uterus to the fallopian tube, undergo capacitation and the acrosome reaction to digest the zona pellucida of the oocyte, attach to the inner membrane, and release its genetic contents within the egg. Treatment of Female Infertility: Assisted Reproductive Technology (ART) Assisted Reproductive Technology (ART) is a term used to collectively describe a number of noncoital methods of conception that treat causes of infertility not responsive to conventional methods. Minimal Ovarian Stimulation (mini-IVF) for IVF Utilizing Vitrification and Cryopreserved Embryo Transfer. (PDF, 406 KB) Reproductive BioMedicine Online, 2010. The fluid comes from the prostate gland, the seminal vesicle, and other sex glands.

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In-vitro fertilization (IVF): Sperm are placed with unfertilized eggs in a petri dish, where fertilization can take place. Effects[edit] Psychological[edit] The consequences of infertility are manifold and can include societal repercussions and personal suffering. Tests such as semen analysis, hormone testing, transrectal and scrotal ultrasound may also be performed. The idea is that for women beyond age 35, every month counts and if made to wait another six months to prove the necessity of medical intervention, the problem could become worse. Surgical procedures are now rarely used because of the high success rate of other infertility treatments.  IUI: Fertility doctors may also recommend intrauterine insemination or IUI. Many countries have special frameworks for dealing with the ethical and social issues around fertility treatment.