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10 Data Sources: A PubMed search was completed using the key terms infertility, subfertility, treatment, etiology, and diagnosis. Most couples (about 84%) who have regular sexual intercourse (that is, every two to three days) and who do not use contraception get pregnant within a year. ICSI with Epididymal and Testicular Sperm in Azoospermic Men. (PDF, 2 MB) From Treatment of Infertility: The New Frontiers, 1998. Factors affecting Fertility Frequency/Timing of sexual intercourse: - Every 2 to 3 days optimises the chance of pregnancy Obesity: - Women who have BMI of over 30 should be informed that they are likely to take longer to conceive and will affect treatment success rates. The fluid comes from the prostate gland, the seminal vesicle, and other sex glands. Reifenstein syndrome in males involves partial androgen insensitivity in males and presents as a spectrum of abnormal external genitalia and infertility.[22] Because cells inadequately respond to androgen stimulation, spermatogenesis is impaired.

The fertilized embryo is then transferred to womb. A bicornuate uterus can be associated with a history of recurrent miscarriages, and its repair is indicated only if other etiologies for the miscarriage have been excluded (see Surgical intervention below). Endometrial polyps Endometrial polyps are removed through operative hysteroscopy associated with a dilatation and curettage, if necessary. Fertility is not an issue for some patients affected by DES, and they remain undiagnosed until they have an abnormal Papanicolaou test result.

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Chemotherapy: Some chemotherapy drugs can result in ovarian failure. The diagnosis of congenital anestrus is based on the age of the animal and exclusion of all other possible causes (including chromosomal defects, endocrine disorders, and previous oophorectomy). If necessary, they refer patients to a fertility clinic or local hospital for more specialized tests. BMI (body mass index) may be a significant factor in fertility, as an increase in BMI in the male by as little as three units can be associated with infertility.

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Postcoital testing and antisperm antibody testing are no longer considered useful in this evaluation. Diverse Spermatogenic Defects in Humans Caused by Y Chromosome Deletions Encompassing a Novel RNA-binding Protein Gene. (PDF, 7 MB) Nature Genetics, 1995.

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The Varicocele Dilemma. (PDF, 139 KB) Human Reproduction, 2001. When the eggs are mature, your doctor collects them with a device called a vaginal ultrasound probe. 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). The predictive value of hysterosalpingography for tubal and peritoneal infertility factors. The Varicocele Dilemma. (PDF, 139 KB) Human Reproduction, 2001.