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World Health Organization[edit] The World Health Organization defines infertility as follows:[10] United States[edit] One definition of infertility that is frequently used in the United States by reproductive endocrinologists, doctors who specialize in infertility, to consider a couple eligible for treatment is: a woman under 35 has not conceived after 12 months of contraceptive-free intercourse. Ongoing Pregnancies and Birth after Intracytoplasmic Sperm Injection with Frozen-thawed Epididymal Spermatozoa. (PDF, 442 KB) Human Reproduction, 1995. This can result from: A medical condition: This could be a testicular infection, cancer, or surgery. We generally recommend seeking the help of a reproductive endocrinologist if conception has not occurred within 12 months. Antisperm antibody test Sperm contain unique antigens that are not recognized as self by the body's immune system because of the blood-testis barrier.

Severe ovarian hyperstimulation syndrome is characterized by easily palpable ovaries, severe ascites, nausea, vomiting, diarrhea, shortness of breath, hydrothorax, peripheral edema, oliguria, hemoconcentration (eg, hematocrit level >48% and hemoglobin level >16 g), and creatinine level greater than 1. Microsurgical Reversal of Tubal Sterilization: Factors Affecting Pregnancy Rate, with Long-term Follow-up. (PDF, 2 MB) Obstetrics & Gynecology, 1984. Pregnancy After Testicular Transplant: Importance of Treating the Couple. (PDF, 5 MB) Fertility and Sterility, 1980.

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Also, polymorphisms in folate pathway genes could be one reason for fertility complications in some women with unexplained infertility.[62] However, a growing body of evidence suggests that epigenetic modifications in sperm may be partially responsible.[63][64] Diagnosis[edit] If both partners are young and healthy and have been trying to conceive for one year without success, a visit to a physician or women's health nurse practitioner (WHNP) could help to highlight potential medical problems earlier rather than later. Kallmann syndrome has been described in both familial (X-linked and autosomal) and sporadic forms, and its incidence is estimated as 1 case per 10,000-60,000 births. Thus women whose pregnancy spontaneously miscarries, or whose pregnancy results in a still born child, without ever having had a live birth would present with primarily infertility. (Trends in prevalence4). These are agents that support the follicular maturation and the secretion of gonadotropins. Sherban and his staff are the most amazing, compassionate, and supportive people.

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When Predictions Don’t Predict. (PDF, 549 KB) The Australian and New Zealand Journal of Obstetrics and Gynaecology, 1991. Your doctor will analyze your semen analysis carefully and help you decide if ICSI is an appropriate treatment for you. Microsurgery Successful in Vasectomy Reversals. (PDF, 156 KB) The New York Times, 1975. 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. Prolonged anestrus may be congenital or acquired. The following problems are possible: Low sperm count: The man ejaculates a low number of sperm.

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For example, for a woman who ovulates sporadically, the quality of her partner's ejaculate and the frequency of love-making can worsen or improve her prognosis. Omitting unnecessary investigations, in particular couples, could reduce total cost of their infertility management without compromising their success rate. The doctor may ask about the couple's sexual habits and make recommendations regarding these. Pregnancy After Testicular Transplant: Importance of Treating the Couple. (PDF, 5 MB) Fertility and Sterility, 1980. 30–32 Other treatment options include antiestrogens and gonadotropin therapy, which showed a trend toward increased live birth rates in a Cochrane review. 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. Also possible is increased body mass and facial hair, which is relatively easy to treat, and is often associated with PCOS, or polycystic ovary syndrome. Causes of infertility include male factors, ovulatory dysfunction, uterine abnormalities, tubal obstruction, peritoneal factors, or cervical factors.