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To assist in the luteal phase, the patient is given beta-HCG or progesterone. Many more couples, however, experience involuntary childlessness for at least one year: estimates range from 12% to 28%.[4] Male infertility is responsible for 20–30% of infertility cases, while 20–35% are due to female infertility, and 25–40% are due to combined problems in both parts.[2][5] In 10–20% of cases, no cause is found.[5] The most common cause of female infertility is ovulatory problems, which generally manifest themselves by sparse or absent menstrual periods.[6] Male infertility is most commonly due to deficiencies in the semen, and semen quality is used as a surrogate measure of male fecundity.[7] Women who are fertile experience a natural period of fertility before and during ovulation, and they are naturally infertile for the rest of the menstrual cycle.

In addition, antibodies are present in 35% of patients with CBAVD. There are four parameters analyzed: 1) semen volume – should be at least 1. Testis Biopsy and the Infertile Male. (PDF, 20 MB) Chapter 15 from textbook Office Andrology, 2005. A history of pelvic infections or sexually transmitted diseases: Sexually transmitted infections, such as chlamydia or gonorrhea, can cause inflammation and permanent scarring of the fallopian tubes. Although many of these can be treated through surgery or hormonal substitutions, some may be indefinite.[59] Infertility associated with viable, but immotile sperm may be caused by primary ciliary dyskinesia.

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If a tube is blocked and filled with fluid (called a hydrosalpinx), then minimally invasive surgery (laparoscopy or hysteroscopy) to either remove the tube or block/separate it from the uterus prior to any fertility treatments is recommended. There are three types of fibroids: 1) subserosal, or fibroids that extend more than 50% outside of the uterus; 2) intramural, where the majority of the fibroid is within the muscle of the uterus without any indentation of the uterine cavity; and 3) submucosal, or fibroids the project into the uterine cavity.

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This procedure is performed in the outpatient setting. Often, but not always, submucosal fibroids can cause heavy periods, or bleeding between periods. Debate: Are Spermatid Injections of any Clinical Value? (PDF, 6 MB) Human Reproduction, 1998. Submucosal fibroids are the type if fibroid that has clearly been demonstrated to reduce pregnancy rate, roughly by 50%, and removal of which will double pregnancy rate. Immunohistochemical stains are performed if more than 5-10 round cells/HPF are present.  Other tests Semen may be analyzed for levels of zinc, citric acid, acid phosphatase, and alpha-glucosidase. Role of Epididymis in Sperm Maturation. (PDF, 3 MB) Urology, 1989.

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Fertilizing Capacity of Epididymal and Testicular Sperm with ICSI. (PDF, 5 MB) Frontiers in Endocrinology, 1995. Microscopic Vasovasostomy and Spermatogenesis. (PDF, 1 MB) The Journal of Urology, 1977. 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%). Understanding male infertility: Sex Ed 101 To better understand infertility, here's a refresher course on the birds and the bees. (Anyone caught giggling will have to stay after class.) Sperm are made in the testicles. Povey AC, Clyma JA, McNamee R, et al.; Participating Centres of Chaps-UK. Intracytoplasmic sperm injection[edit] ICSI technique is used in case of poor semen quality, low sperm count or failed fertilization attempts during prior IVF cycles. Women with anovulation may be treated in the primary care setting with clomiphene to induce ovulation.