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According to the literature survey, the most common causes of infertility are: male factor [5,7-9,13-15] such as sperm abnormalities [9,13,15], female factor [7-9,14-16] such as ovulation dysfunction [7,8] and tubal pathology [7-9], combined male and female factors [7,9,14,15] and unexplained infertility; where no obvious cause could be detected [7-9]. Weight loss in obese infertile women results in improvement in reproductive outcome for all forms of fertility treatment. Twelve months is the lower reference limit for Time to Pregnancy (TTP) by the World Health Organization.[7] a woman over 35 has not conceived after six months of contraceptive-free sexual intercourse.

Chronic conditions: These include AIDS or cancer. Endometriosis can be treated with hormones that suppress the displaced endometrial tissue or the tissue can be removed by a surgical procedure. The initial result of the procedure is not detected before 3 months because spermatogenesis takes 72 days.

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The physician or WHNP may also suggest using a conception cap cervical cap, which the patient uses at home by placing the sperm inside the cap and putting the conception device on the cervix, or intrauterine insemination (IUI), in which the doctor or WHNP introduces sperm into the uterus during ovulation, via a catheter. The main approach to correcting or removing these uterine abnormalities is by hysteroscopy, a surgical method by which a narrow scope with a camera is placed within the uterine cavity. Known male factor semen abnormalities: If a male partner has a history of infertility with a prior partner, or if there are abnormalities on his semen analysis, then we advise earlier fertility evaluation, ideally within 6 months of attempting pregnancy.

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Medical management: - Men with hypogonadotrophic hypogonadism should be offered gonadotrophin drugs. - Men with idiopathic semen abnormalities should not be offered anti-oestrogens, gonadotrophins, androgens, bromocriptine or kinin-enhancing drugs. Intrauterine insemination 33. Consider unstimulated intrauterine insemination as a treatment option in the following groups as an alternative to vaginal sexual intercourse: - people who are unable to, or would find it very difficult to, have vaginal intercourse - people with conditions that require specific consideration in relation to methods of conception (for example, after sperm washing where the man is HIV positive) - people in same-sex relationships Do not offer IUI for people with unexplained infertility, mild endometriosis or mild male factor. Always take in consideration the ages of the couple. Therefore, pelvic ultrasonography is required before CC is initiated. [207] Pure FSH treatment for ovulation induction is another alternative for patients with PCOS who are clomiphene resistant.

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Reproductive Biology. (PDF, 147 KB) The Scientist, 1996. Some couples experience pressure from society, parents and family, who expect that they wish to have children. Obesity can increase the risk for other conditions that may impact a man's fertility such as sperm quality and sexual dysfunction. This should be followed by documentation of ovulation via serum progesterone. Chronic conditions: These include AIDS or cancer. Ovulation induction agents increase the risk of multiple pregnancy, ovarian hyperstimulation syndrome, and thrombosis, and they may increase the risk of ovarian cancer in women who remain nulliparous. The treating doctor may feel inadequacy and the trust between the doctor and patient breaks down [43]. Patients who do not ovulate because of a fault in the pituitary gland may receive this drug as an injection. Adolescents with a varicocele and testicular atrophy or lack of growth should similarly consider repair. Assisted hatching: The embryologist opens a small hole in the outer membrane of the embryo, known as the zona pellucid.