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The problem is getting the sperm where they need to go. In vitro fertilization[edit] IVF is the most commonly used ART. 34 Although intrauterine insemination has been shown to be equally effective as timed intercourse in unstimulated cycles, there is a modest increase in live birth rates when combined with ovarian stimulation.

The patients are prepared in a similar way to in-vitro fertilization, firstly with ovarian stimulation and follicle puncture. Many infertile couples have had some previous assessment for their infertility and this data should be cautiously reviewed. No Differences in Outcome after Intracytoplasmic Sperm Injection with Fresh or with Frozen-thawed Epididymal Spermatozoa. (PDF, 66 KB) Human Reproduction, 1999.

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Several studies have demonstrated that an increase in BMI is correlated with a decrease in sperm concentration, a decrease in motility and an increase DNA damage in sperm. This indicates whether the fallopian tubes are open or blocked. If pregnancy has not been established within a reasonable time, further evaluation and/or an alternative treatment plan should be considered. Common causes of infertility of females include: ovulation problems (e.g. polycystic ovarian syndrome, PCOS, the leading reason why women present to fertility clinics due to anovulatory infertility.[58]) tubal blockage pelvic inflammatory disease caused by infections like tuberculosis age-related factors uterine problems previous tubal ligation endometriosis advanced maternal age immune infertility Males[edit] The main cause of male infertility is low semen quality. Surgical Management of Male Infertility. (PDF, 2 MB) Chapter 12 from textbook, Male Infertility, 1992. Predominantly anovulation is caused by hormonal imbalances such as Polycystic Ovarian Syndrome (PCOS) but ovarian scarring and premature menopause can also result in failure to ovulate. • Tubal disease, comprising anything from mild adhesions to complete blockage of the fallopian tubes, prevents fertilised eggs from travelling from the site of fertilisation to the uterus.

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Many of these treatment options may have harmful or unpleasant side effects such as nausea, headaches and weight gain. Computer-aided semen analysis (CASA) Introduced in the late 1980s, CASA uses a video camera and computer to visualize and analyze sperm concentration and movement.

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Aromatase inhibitors Aromatase inhibitors (letrozole, anastrozole) inhibit the action of the enzyme aromatase, which converts androgens into estrogens by a process called aromatization. She records this temperature on a sheet of graph paper. Suspect antisperm antibodies when semen analysis reveals abnormal clumping, agglutination, unexplained decreased motility, or an abnormal postcoital test result. Sperm are then collected, washed, and added to the eggs in the dish. If the sperm are of good quality and the mechanics of the woman's reproductive structures are good (patent fallopian tubes, no adhesions or scarring), a course of ovulation induction maybe used. 38,39 Family physicians may choose to attempt ovulation induction in anovulatory women (WHO group II) with clomiphene. 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.