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Abnormal semen may not be able to carry the sperm effectively. Hofherr SE, Wiktor AE, Kipp BR, Dawson DB, Van Dyke DL. 6,23 Anovulatory women should have further investigation to determine treatable causes such as thyroid disorders or hyperprolactinemia based on symptoms. It is further sub-divided into primary and secondary sterility.

Obesity can increase the risk for other conditions that may impact a man's fertility such as sperm quality and sexual dysfunction. Undescended testicles During fetal development one or both testicles may fail to descend from the abdomen into the sac that normally contains the testicles.

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Generally, evaluation should be offered to couples who have not conceived after one year of unprotected vaginal intercourse. Epidemiology[edit] Prevalence of infertility varies depending on the definition, i.e. on the time span involved in the failure to conceive. It has been suggested that infertility be classified as a form of disability.[22] Causes[edit] Immune infertility[edit] Antisperm antibodies (ASA) have been considered as infertility cause in around 10–30% of infertile couples.[23] In both men and women, ASA production are directed against surface antigens on sperm, which can interfere with sperm motility and transport through the female reproductive tract, inhibiting capacitation and acrosome reaction, impaired fertilization, influence on the implantation process, and impaired growth and development of the embryo.

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A sperm count of under 15 million is considered low. Legal, cultural and religious inquiries have limited the available choices in some countries, such as the use of donor sperms or oocytes. Ovarian Transplantation between Monozygotic Twins Discordant for Premature Ovarian Failure. (PDF, 315 KB) The New England Journal of Medicine, 2005.

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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. 0.[44] Environmental factors Toxins such as glues, volatile organic solvents or silicones, physical agents, chemical dusts, and pesticides.[45][46] Tobacco smokers are 60% more likely to be infertile than non-smokers.[47] German scientists have reported that a virus called adeno-associated virus might have a role in male infertility,[48] though it is otherwise not harmful.[49] Other diseases such as chlamydia, and gonorrhea can also cause infertility, due to internal scarring (fallopian tube obstruction).[50][51][52] Alimentary habits[53] Obesity: The obesity epidemic has recently become is a serious issue, particularly in industrialized nations. Fibroids that distort the uterine cavity have an impact on the ability of an embryo to implant and should be removed surgically. Surgeons must use tools to interact with tissue rather than manipulate it directly with their hands. Females[edit] The following causes of infertility may only be found in females. Treatment of tubal obstruction generally requires referral for subspecialty care. The results of these tests help determine the best fertility treatment.