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Female and male factors are equally responsible for infertility, about 30% to 40% each, and in 20% of the cases, there is a combination of both. Surgical treatment of myomas is indicated in cases of abnormal uterine bleeding, when the myoma is implicated in recurrent miscarriages or when it is thought to interfere with embryo implantation. Algorithm for infertility evaluation. (ART = assisted reproductive technology.) Lifestyle Factors Jump to section + All couples should be counseled to abstain from tobacco use, limit alcohol consumption, and aim for a body mass index less than 30 kg per m2 to improve their chances of natural conception or using assisted reproductive technology. World Health Organization reference values for human semen characteristics. Vitrification of oocytes from endangered Mexican gray wolves (Canis lupus baileyi). (PDF, 319 KB) Theriogenology, 2010.

Idiopathic Hypercalciuria. (PDF, 1 MB) New England Journal of Medicine, 1971. Which drug can be used for induction of ovulation? Assessment of ovarian reserve This is a very important assessment of a woman's remaining egg supply It is done with blood testing and ultrasound: Blood - day 3 FSH, LH and estradiol hormone testing and AMH hormone levels Ultrasound - assessment of ovarian volume and antral follicle counts Assessment of adequate ovulation This can be done in a variety of ways. Other causes may include: Genetic factors: A man should have an X and Y chromosome. Bladder neck closure during ejaculation is vital to ensure antegrade ejaculation. American Urological Association Education and Research, Inc.

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Obesity and increased risk for oligozoospermia and azoospermia. Endometriosis Endometriosis is when the tissue of the uterine lining grows outside of the uterus. Blood, urine, and imaging tests can be done to discover why you are having trouble getting pregnant.

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If a blockage is present, surgery may be necessary. Close Common Causes of Female Sterility The most common causes of female sterility include: Fallopian tube damage or blockage Ovulation disorders Polycystic ovary syndrome (PCOS) Endometriosis Early menopause Pelvic adhesions Benign uterine fibroids Close Help for Sterility Sexual problems such as impotence or premature ejaculation should be addressed. GnRH travels down the portal system to the anterior pituitary, located on a stalk in the sella turcica, to stimulate the release of the gonadotropins, luteinizing hormone (LH), and follicle-stimulating hormone (FSH).

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A treatment plan should be generated according to the diagnosis, duration of infertility, and the woman's age. The initial result of the procedure is not detected before 3 months because spermatogenesis takes 72 days. In addition, infertility is considered also a public problem. A review of systems and physical examination of the endocrine and gynecologic systems should be performed. Evaluation of the Female Partner: Other Tests Other tests to evaluate a woman’s fertility include: Hysterosalpinogram (HSG). Microsurgery for the Undescended Testicle. (PDF, 5 MB) Urologic Clinics of North America, 1982. Our miscarriage clinic can help investigate these issues and attempt to help couples with any future pregnancy. They can be blocked due to numerous causes, including infections,  trauma or abnormal development, such as with cystic fibrosis or similar inherited conditions. As the major causes of infertility are sperm abnormalities, ovulation dysfunction, and fallopian tube obstruction, the preliminary adviced investigations for the infertile couple should be focused on semen analysis (to be compared with the WHO reference values [27]), detection of ovarian function by hormonal assay (early follicular FSH and LH levels, and mid-luteal progesterone), and evaluation of tubal patency by hysterosalpingography (HSG) [17-32], (Appendix 3). Factors Affecting Fertility: Timing of Intercourse Intercourse prior to ovulation is key to maximizing the chance of pregnancy. Charting of the menstrual cycle may be done by hand, or with the aid of various fertility monitors. If necessary, they refer patients to a fertility clinic or local hospital for more specialized tests.