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Abnormal sperm: The sperm may have an unusual shape, making it harder to move and fertilize an egg. Ageing ” population ... chronic & degenerative diseases Multiple health problems are common in elderly people THE ... A routine part of the initial evaluation is testing of specific serum hormone levels, which usually includes FSH, LH, testosterone, and prolactin. As the rate of getting spontaneous pregnancy among infertile or subfertile couples is lower than that among normal fertile population, it is recommended to carry out the following diagnostic, evidence-based, work-up to detect any hidden treatable cause. Surgery for epididymal blockage: A blocked epididymis can be surgically repaired.

Causes of this kind of infertility include: Retrograde ejaculation. Intrauterine insemination (IUI): At the time of ovulation, a fine catheter is inserted through the cervix into the uterus to place a sperm sample directly into the uterus. In some couples who have been unable to reproduce, tests fail to find the cause of infertility.

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Although sperm quality deteriorates as men age, this does not create a problem until after the age of 60. Investigations Infertile couples are usually adviced to start their investigations after 12 months of trying to conceive or after 6 months if the female partner is more than 35 years old or immediately if there is an obvious cause for their infertility or subfertility [16]. Several methods are available to detect antisperm antibodies, such as radioimmunoassay and enzyme-linked immunosorbent assay, but the most specific test is the immunobead test. Extra Renal Function in Patients with Duplication Anomaly: Obligatory and Compensatory Renal Growth. (PDF, 1 MB) The Journal of Urology, 1974. Microsurgical Aspects of Varicocele. (PDF, 9 MB) Fertility and Sterility, 1979.

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Histologic endometrial dating is not considered reliable nor is it predictive of fertility. An abnormal semen analysis warrants a further evaluation usually by a reproductive urologist. About 85 percent of male-female couples will be able to get pregnant within 12 months of trying. Requirements for Female Fertility (Continued) Other requirements for female fertility include: Adequate sexual drive and sexual function to permit coitus.

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Endometriosis is usually more common in women in their mid-twenties and older, especially when postponed childbirth has taken place.[55] Another major cause of infertility in women may be the inability to ovulate. Perfect Anatomical Reconstruction of Vas Deferens with a new Microscopic Surgical Technique. (PDF, 19 MB)Fertility and Sterility, 1977. This may partly be due to the fact that the average age at which women give birth to their first child also keeps rising because of occupational preferences and longer periods of education. The laboratory evaluation begins with a semen analysis. Reversal of Vasectomy and the Treatment of Male Infertility. (PDF, 4 MB) Journal of Andrology, 1980. In some cases, the egg may have matured properly, but the follicle may have failed to burst (or the follicle may have burst without releasing the egg). Although relatively uncommon, eating disorders can negatively affect menstruation, fertility, and maternal and fetal well-being. It also gives them more options in dealing with unexpected adverse events (e.g., uncontrolled bleeding) that may otherwise require creating a much larger incision and converting to a fully open surgical procedure.[5] Conceptually, the laparoscopic approach is intended to minimise post-operative pain and speed up recovery times, while maintaining an enhanced visual field for surgeons. The substances are preferentially used at the beginning of the cycle. This should be followed by documentation of ovulation via serum progesterone. The treating doctor may feel inadequacy and the trust between the doctor and patient breaks down [43]. Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility. Some causes are more common in some countries than others, such as pelvic inflammatory diseases (PID) and sexually transmitted infections (STI) in Africa [10].