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Patients who do not achieve ovulation after three to six cycles should be referred to an infertility specialist for further treatment. Causes include: Surgery: Pelvic surgery can sometimes cause scarring or damage to the fallopian tubes.

WHO categorizes ovulatory disorders into three groups: group I is caused by hypothalamic pituitary failure (10%), group II results from dysfunction of hypothalamic-pituitary-ovarian axis (85%), and group III is caused by ovarian failure (5%). Hormonal analysis reveals increased gonadotropin levels, while 60% have decreased testosterone levels. Specialized semen analysis, including genetic testing of the sperm (looking for the presence of antibodies) and evaluation of immobile sperm (to see if they are dead or alive).

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Ovarian hyperstimulation syndrome is self-limited, and the symptoms subside within 2-6 weeks. [198] Patients with mild and moderate ovarian hyperstimulation syndrome are treated at home with bedrest and strict control of fluid intake and output. A bicornuate uterus can be associated with a history of recurrent miscarriages, and its repair is indicated only if other etiologies for the miscarriage have been excluded (see Surgical intervention below). Practice Committee of American Society for Reproductive Medicine. 6,8 It is important for primary care physicians to be familiar with the workup and prognosis for infertile couples.

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Ovary Transplantation for Fertility Preservation in Cancer Patients: Fresh and Frozen. (PDF, 1 MB) Chapter 42 from textbook Clinial Infertility, 2010. Broekmans FJ, Kwee J, Hendriks DJ, Mol BW, Lambalk CB. Evaluation may be initiated sooner in patients who have risk factors for infertility or if the female partner is older than 35 years. Mental stress: Stress can be a factor, especially if it leads to reduced sexual activity. Optimizing natural fertility: a committee opinion.

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Grading is as follows: Grade 0 – No movement Grade 1 – Sluggish movement Grade 2 – Slow movement in a poorly defined direction Grade 3 – Slow or curved forward movement Grade 4 – Fast movement straight forward  Patients with abnormal sperm motility should be evaluated for the following: Pyospermia Antisperm antibodies Varicocele Sperm ultrastructural abnormalities Partial ductal obstruction Sperm morphology The head, acrosome, mid piece, and tail of individual spermatozoa are analyzed with phase-contrast microscopy after fixation with Papanicolaou stain. The volume provides clear guidelines and a logical sequence of steps which will quickly lead the clinician or physician to an accurate diagnosis of the underlying cause of infertility. Low testosterone (male hypogonadism) and other hormonal problems have a number of possible underlying causes. ICSI with Epididymal and Testicular Sperm in Azoospermic Men. (PDF, 2 MB) From Treatment of Infertility: The New Frontiers, 1998. FSH and LH are released into the systemic circulation and exert their effect by binding to plasma membrane receptors of the target cells. Success rates reported by various practices that offer ICSI range from 15% to 30% per egg retrieval. After in vitro fertilization, your doctor transfers the fertilized eggs into your uterus.Male infertility isn't something you hear much about on the news, so you may be surprised to know that male infertility is almost as likely as female infertility to be involved in a couple's inability to achieve pregnancy. Cystic Fibrosis and Infertility Caused by Congenital Bilateral Absence of the Vas Deferens and Related Clinical Entities. (PDF, 2 MB) Human Reproduction, 1996.