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About one-third of infertility cases are caused by fertility problems in men and another one-third of fertility problems are due to fertility problems in women. Investigations Infertile couples are usually adviced to start their investigations after 12 months of trying to conceive or after 6 months if the female partner is more than 35 years old or immediately if there is an obvious cause for their infertility or subfertility [16]. It stimulates the ovaries to mature egg follicles. However, the presence of fibroids alone doesn’t necessarily cause infertility or predispose a woman to pregnancy loss.

Physical Problems A variety of physical problems can cause male infertility.  These problems either interfere with the sperm production process or disrupt the pathway down which sperm travel from the testes to the tip of the penis.  These problems are usually characterized by a low sperm count and/or abnormal sperm morphology.  The following is a list of the most common physical problems that cause male infertility: Variocoele: A varicocele is an enlargement of the internal spermatic veins that drain blood from the testicle to the abdomen (back to the heart) and are present in 15% of the general male population and 40% of infertile men.  These images show what a variocoele looks like externally and internally.  A varicocele develops when the one way valves in these spermatic veins are damaged causing an abnormal back flow of blood from the abdomen into the scrotum creating a hostile environment for sperm development.  Varicocoeles may cause reduced sperm count and abnormal sperm morphology which cause infertility.  Variococles can usually be diagnosed by a physical examination of the scrotum which can be aided by the Doppler stethoscope and scrotal ultrasound.  Varicocoele can be treated in many ways (see treatment section), but the most successful treatments involve corrective surgery. Prevalence of Premature Ovarian Failure in Monozygotic and Dizygotic Twins. (PDF, 90 KB) Human Reproduction, 2007.

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Congenital Absence of the Vas Deferens: The Fertilizing Capacity of Human Epididymal Sperm. (PDF, 3 MB) New England Journal of Medicine, 1990. Options for Male Infertility Treatment Some causes of male infertility are treatable or correctable through surgery. Fertilizing Capacity of Epididymal and Testicular Sperm with ICSI. (PDF, 5 MB) Frontiers in Endocrinology, 1995. Other hormones including inhibin B and leptin, may also be affected by obesity. Leptin is a hormone associated with numerous effects including appetite control, inflammation, and decreased insulin secretion, according to many studies.

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8 These studies are more sensitive and may delineate an abnormally formed uterus or structural problems, such as fibroids. 0 Definition of Sterility and Infertility With regard to terminology, infertility has to be distinguished from sterility.

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An estimated 34 million women, predominantly from developing countries, have infertility which resulted from maternal sepsis and unsafe abortion (long term maternal morbidity resulting in a disability). Laparotomy with histopathology is usually indicated, because medical attempts at inducing ovulation (human chorionic gonadotropin, FSH, GnRH) are usually unrewarding. Sperm are then collected, washed, and added to the eggs in the dish. If a deficit of greater than 1 L is recorded, the procedure should be terminated, and, preferably, the myomectomy should be completed in a second hysteroscopic attempt. Ideally, the test should be performed at least twice to confirm results. Used by some clinicians to evaluate the motility of the sperm and its ability to travel through the cervical mucus. ARTICLES FROM THE 2010s Ovarian Function 6 Years after Cryopreservation and Transplantation of Whole Sheep Ovaries. (PDF, 496 KB)Reproductive BioMedicine Online, 2010. Successful Pregnancy after Microsurgical Transplantation of an Intact Ovary. (PDF, 438 KB) The New England Journal of Medicine, 2008.