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Management of the infertile couple: an evidence-based protocol. Paternal age > or = 40 years: an important risk factor for infertility. Reversal of Vasectomy and the Treatment of Male Infertility. (PDF, 4 MB) Urologic Clinics of North America, 1981.

Although obesity is well known to be associated with insulin resistance, women with PCOS are even more resistant to insulin than other patients who are obese. When it is possible to find the cause, treatments may include medicines, surgery, or assisted reproductive technology. In 30% of all cases, the cause is in both partners: combined sterility.

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The woman may be given a low dose of ovary stimulating hormones. Surgical procedures for women If the fallopian tubes are blocked or scarred, surgical repair may make it easier for eggs to pass through.

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GIFT (gamete intrafallopian tube transfer) and ZIFT (zygote intrafallopian transfer).  Like IVF, these procedures involve retrieving an egg, combining it with sperm in a lab, and then transferring it back to your body. Factors effecting normal expectancy of conception. Programming of Ovarian Stimulation with Norethindrone Acetate in IVF/GIFT Cycles. (PDF, 2 MB) Human Reproduction, 1989. In such cases, OPKs and those fertility monitors which are based on LH may show false results, with an increased number of false positives or false negatives. If oligospermia or azoospermia is noted, hypogonadism should be suspected. According to the Office on Women's Health, about a third of issues with infertility comes from women, and another third starts with men.

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Abnormalities of sperm may be treated with gonadotropin therapy, intrauterine insemination, or in vitro fertilization. Round Spermatid Injection. (PDF, 422 KB) Fertility and Sterility, 2000. 18  If the semen analysis result is abnormal, further evaluation is indicated (Table 36–8,10,19,20). M. genitalium infection is associated with increased risk of infertility.[25][26] Genetic[edit] A Robertsonian translocation in either partner may cause recurrent spontaneous abortions or complete infertility.[citation needed] Mutations to NR5A1 gene encoding Steroidogenic Factor-1 (SF-1) have been found in a small subset of men with non-obstructive male factor infertility where the cause is unknown. Other tests include: ovarian reserve testing, to find out how effective the eggs are after ovulation genetic testing, to see if a genetic abnormality is interfering with fertility pelvic ultrasound, to produce an image of the uterus, fallopian tubes, and ovaries Chlamydia test, which may indicate the need for antibiotic treatment thyroid function test, as this may affect the hormonal balance Complications Some complications can result from infertility and its treatment. The pulsatile nature of GnRH is essential to normal gonadotropin release; a continuous stimulation inhibits their secretion. Surgery for epididymal blockage: A blocked epididymis can be surgically repaired. 6) Surgery – After a thorough history, physical examination, and ultrasound are performed, your doctor may recommend surgery to correct and abnormality. Hysterosalpingography: Fluid is injected into the woman's uterus and X-rays are taken to determine whether the fluid travels properly out of the uterus and into the fallopian tubes. 34 Although intrauterine insemination has been shown to be equally effective as timed intercourse in unstimulated cycles, there is a modest increase in live birth rates when combined with ovarian stimulation. The embryo is then placed in the uterus to begin a pregnancy. Endometriosis is usually more common in women in their mid-twenties and older, especially when postponed childbirth has taken place.[55] Another major cause of infertility in women may be the inability to ovulate.