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However, further testing may include: A general physical exam by a urologist. VITRIKAS, MD, David Grant Medical Center Family Medicine Residency, Travis Air Force Base, California Am Fam Physician. 2015 Mar 1;91(5):308-314.   Patient information: See related handout on infertility, written by the authors of this article.   Related letter: Natural Procreative Technology for Treating Infertility This clinical content conforms to AAFP criteria for continuing medical education (CME). Ultrastructure of Human Sperm in Men with Congenital Absence of the Vas Deferens: Clinical Implications. (PDF, 2 MB) Fertility and Sterility, 1992. Experts then assess your sperm count, their shape, movement, and other variables. “Generally, a higher number of normal-shaped sperm means higher fertility,” says Shaban. Laparoscopy with hydrotubation - if the clinical situation suggests this is required . Arcuate uterus In general, an arcuate uterus does not cause infertility.

6,8 It is important for primary care physicians to be familiar with the workup and prognosis for infertile couples. Demographic definitions of infertility An inability of those of reproductive age (15-49 years) to become or remain pregnant within five years of exposure to pregnancy. (DHS2) An inability to become pregnant with a live birth, within five years of exposure based upon a consistent union status, lack of contraceptive use, non-lactating and maintaining a desire for a child. (Trends in prevalence4). Reversal of Vasectomy and the Treatment of Male Infertility. (PDF, 4 MB) Urologic Clinics of North America, 1981. While chromosomal failure is usually caused by abnormalities of the sex chromosomes, autosomal disorders are also observed. History-taking Couples with infertility problem should be interviewed separately as well as together, to bring out important facts that one partner might not wish to disclose to the other. Symptoms include: bloating constipation dark urine diarrhea nausea abdominal pain vomiting They are usually mild and easy to treat.

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One of the best known is the HFEA – The UK's regulator for fertility treatment and embryo research. Once eggs and sperm are collected, the actual process of injecting a single sperm into the egg is carried out in a laboratory using a petri dish or a glass slide with a well in the center. Studies have shown that psychological issues contribute to reducing the sperm quality.

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It is important to undergo a thorough fertility evaluation to determine the problem. A specific portion of the androgen receptor gene, exon 1, has been studied in infertile males and a meta-analysis that involved males with idiopathic infertility and fertile controls found that infertility was directly correlated with the length of CAG repeats in this exon.[23] Y chromosome microdeletion syndrome The long arm of the Y chromosome (Yq) is considered critical for fertility, especially Yq11. Coutifaris C, Myers ER, Guzick DS, et al.; NICHD National Cooperative Reproductive Medicine Network. Large submucosal uterine fibroids may make the uterus' cavity bigger, increasing the distance the sperm has to travel.

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Judaism and Repoductive Technology. (PDF, 160 KB) 2003. WHO Manual for the Standardized Investigation and Diagnosis of the Infertile Couple. Adding recombinant human FSH to HCG has been shown to be effective in achieving spermatogenesis in most patients.[18] Select patients with adult-onset idiopathic hypogonadotropic hypogonadism may respond to clomiphene citrate therapy.[19] Prader-Willi syndrome Patients have characteristic obesity, mental retardation, small hands and feet, and hypogonadotropic hypogonadism due to a GnRH deficiency. Transvaginal ultrasound – Ultrasound is an important tool in evaluating the structure of the uterus, tubes, and ovaries. Epidemiological definition of infertility (for monitoring and surveillance) Women of reproductive age (15–49 years) at risk of becoming pregnant (not pregnant, sexually active, not using contraception and not lactating) who report trying unsuccessfully for a pregnancy for two years or more. (Reproductive Health Indicators) Infertility as a disability Disability: Infertility generates disability (an impairment of function), and thus access to health care falls under the Convention on the Rights of Persons with Disability. Embryos transfer is performed in the office under abdominal ultrasound guidance using a small, soft, sterile and flexible catheter. Abnormal sperm: The sperm may have an unusual shape, making it harder to move and fertilize an egg. Small or firm testicles could indicate potential issues that should be explored by a medical practitioner. Lifestyle and environmental factors such as smoking, alcohol and drugs, poor eating habits, exposure to increases in testicular temperature (for example, in professions where the worker spends many hours sitting down) and exposure to toxins are factors that compromise semen quality.


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See also
Infertility Treatments Risks
Infertility Test Kit
Who Infertility Classification