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Poor egg quality: Eggs that are damaged or develop genetic abnormalities cannot sustain a pregnancy. Sperm or egg donation: If necessary, sperm or eggs can be received from a donor. This is called luteinised unruptured follicle syndrome (LUFS). If a couple has never produced a pregnancy, it is defined as primary infertility.

It is usually not the natural state of a healthy adult, except notably among certain eusocial species (mostly haplodiploid insects). Distribution of Spermatogenesis in the Testicles of Azoospermic Men: The Presence of Spermatids in the Testes of Men with Germinal Failure. (PDF, 295 KB) Human Reproduction, 1997. Therefore, this problem must be corrected first or concomitantly to obtain an ovulatory response. Because of a defect in the dynein arms, spokes, or microtubule doublet, cilia in the respiratory tract and in sperm do not function properly.

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However, about one in five cases of infertility has no clear diagnosed cause.[73] In Britain, male factor infertility accounts for 25% of infertile couples, while 25% remain unexplained. The Relationship of Abnormal Semen Parameters to Male Fertility. (PDF, 4 MB) Human Reproduction, 1989. They include: Clomifene (Clomid, Serophene): This encourages ovulation in those who ovulate either irregularly or not at all, because of PCOS or another disorder.

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Although obesity is well known to be associated with insulin resistance, women with PCOS are even more resistant to insulin than other patients who are obese. Counseling about options should be offered to couples who are not physically able to conceive (i.e., same-sex couples or persons lacking reproductive organs).

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In some cases, the reproductive urologist can improve semen function by recommending certain lifestyle changes, by hormonal treatments, or by surgery. This hormone then binds to another area of the brain called the pituitary gland and leads to the release of FSH (follicle stimulating hormone), a hormone that directly binds to cells in the ovary, leading to egg growth and maturation. Other factors, such as luteal phase defect or production of anti-sperm antibodies. The Varicocele Dilemma. (PDF, 139 KB) Human Reproduction, 2001. Spermatid Conception. (PDF, 1 MB) Human Reproduction, 1998. In patients with varicocele, there is insufficient evidence to suggest corrective surgery will increase live birth rates, despite improvement in semen analysis results. It is specially oriented for cancer patients, whose sperm is destroyed due to the gonadotoxic treatment they are submitted to.[70] Ovaric stem cells: it is thought that women have a finite number of follicles from the very beginning. 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. Myotonic dystrophy This is an autosomal dominant defect in the dystrophin gene that causes a delay in muscle relaxation after contraction. Some facts about conception and fertility A doctor can give advice and carry out some preliminary assessments. Clinical Characterization of 42 Oligospermic or Azoospermic Men with Microdeletion of the AZFc Region of the Y Chromosome, and of 18 Children Conceived via ICSI. (PDF, 606 KB) Human Reproduction, 2002. The facilities available and the skills of personnel are the major determining factors for the success rate.