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Ectopic pregnancy This is when a fertilized egg implants outside the womb, usually in a fallopian tube. Successful Pregnancy after Microsurgical Transplantation of an Intact Ovary. (PDF, 438 KB) The New England Journal of Medicine, 2008.

Obesity and increased risk for oligozoospermia and azoospermia. When Predictions Don’t Predict. (PDF, 549 KB) The Australian and New Zealand Journal of Obstetrics and Gynaecology, 1991.

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Endometriosis: Cells that normally occur within the lining of the uterus start growing elsewhere in the body. Sperm retrieval for azoospermia and intracytoplasmic sperm injection success rates – A personal overview. (PDF, 1 MB) Human Fertility, 2010. Renal Transplantation Between Adults and Children. (PDF, 1 MB) Journal of the American Medical Association, 1974.

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The incidence varies in different populations, in some areas approaching 40%. The only known risk factor for Klinefelter syndrome is advanced maternal age. Some diseases: Conditions that are sometimes linked to lower fertility in males are anemia, Cushing's syndrome, diabetes, and thyroid disease. The patients are prepared in a similar way to in-vitro fertilization, firstly with ovarian stimulation and follicle puncture. The incidence of congenital malformation in IVF babies ranges between 2% and 3% worldwide and is similar to that in babies conceived naturally [45].

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In reproductive medicine, the most common surgical procedures are laparoscopy, hysteroscopy, and abdominal myomectomy (removal of uterine fibroids). The extra heat caused by the vein can lead to low sperm count and impaired sperm movement. They're then stored inside yards of “plumbing” called the epididymis, which lies on top of each testicle. Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility. However, its value has been questioned because some studies have found no correlation between the presence or absence of viable sperm in the mucus and subsequent fertility. Ovulation problems can be a result of:  polycystic ovary syndrome (PCOS) thyroid problems – both an overactive thyroid gland and an underactive thyroid gland can prevent ovulation premature ovarian failure – where a woman's ovaries stop working before the age of 40 Scarring from surgery Pelvic surgery can damage and scar the fallopian tubes, which link the ovaries to the womb. Abdominal myomectomy is a surgical procedure performed through a very low horizontal abdominal incision allowing access to the uterus for removal of fibroids. Surgical sperm aspiration: The sperm is removed from part of the male reproductive tract, such as the vas deferens, testicle, or epididymis. Genetics of Male Infertility: Evolution of the X and Y Chromosome and Transmission of Male Infertility to Future Generations. (PDF, 10 MB) Chapter 5 from Essential IVF, 2004. Symptoms If a couple doesn't get pregnant after a year of unprotected intercourse, both the man and woman should be evaluated.