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The woman may be given a low dose of ovary stimulating hormones. Conventional IVF vs ICSI (Intra Cytoplasmic Sperm Injection) for Patients Requiring Microsurgical Epididymal Sperm Aspiration (MESA). (PDF, 4 MB) Chapter from textbook, Frontiers in Endocrinology: Perspectives on Assisted Reproduction, 1994.

The medicalization of infertility has unwittingly led to a disregard for the emotional responses that couples experience, which include distress, loss of control, stigmatization, and a disruption in the developmental trajectory of adulthood.[16] Infertility may have psychological effects. Women in group III can conceive only with oocyte donation and in vitro fertilization. In women, both smoking and alcohol use are associated with lower rates of conception and increased rates of spontaneous abortion. MESA or TESA? (PDF, 115 KB) Human Reproduction, 1996. If too many embryos develop, one or more can be removed. The Disappearing Male. (PDF, 1 MB) From Towards Reproductive Certainty, 1999.

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A defect in any of these sperm structures may result in infertility that will not be detected by semen analysis.[60] Antisperm antibodies cause immune infertility.[23][24] Cystic fibrosis can lead to infertility in men. Normal uterine implantation can therefore not occur. Because 85% of couples conceive spontaneously within 12 months if having intercourse regularly,5 it is important to identify those who will benefit from infertility evaluation. These endometrial cells can extend as far as the outside of the fallopian tubes, the ovaries and the bladder. In addition, her reproductive tract must allow the eggs and sperm to pass into her fallopian tubes to become fertilized and implanted in the uterus.

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As the rate of getting spontaneous pregnancy among infertile or subfertile couples is lower than that among normal fertile population, it is recommended to carry out the following diagnostic, evidence-based, work-up to detect any hidden treatable cause. Just before those eggs would otherwise be ovulated, they are retrieved under mild anesthesia in an operating room. Endometriosis can be treated with hormones that suppress the displaced endometrial tissue or the tissue can be removed by a surgical procedure. IUI is more commonly done when the man has a low sperm count, decreased sperm motility, or when infertility does not have an identifiable cause. Diverse Spermatogenic Defects in Humans Caused by Y Chromosome Deletions Encompassing a Novel RNA-binding Protein Gene. (PDF, 2 MB) Human Reproduction, 1996. Less common factors The following other factors may also be responsible for infertility in a smaller proportion of cases: • Genetic abnormalities within eggs, sperm or both • An abnormal uterine cavity, including the presence of fibroids or polyps • Immunological infertility, whereby either the male or female partner produces anti-bodies against sperm cells or implantation of an embryo • Abnormal cervical mucus which hinders the passage of sperm to the uterus and fallopian tubes Unexplained infertility Even when investigations have been extensive, some couples will have no reason with which to explain their infertility.

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These numbers are comparable to those of other industrialized nations. Several days later, embryos -- or fertilized eggs -- get put back into your uterus with a device called an intrauterine insemination catheter. Infertility may be caused by blockage of the Fallopian tube due to malformations, infections such as chlamydia or scar tissue. However, until approximately age 64, a man’s age does not affect sperm or the ability to fertilize eggs. The fertilized egg is then placed back into the uterus. Semen analysis – The semen analysis is the main test to evaluate the male partner. With the fast progression in reproductive medicine and the experiences gained through infertility management, a wider range of treatment options have become available to infertile couples [17-19,21-26,31,36], (Appendix 4). Vasectomy. (PDF, 5 MB) From the Encyclopedia of Reproduction, 1999.