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By 2014, over 5 million people had been born after being conceived through IVF. 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. Clinical Characterization of 42 Oligospermic or Azoospermic Men with Microdeletion of the AZFc Region of the Y Chromosome, and of 18 Children Conceived via ICSI. (PDF, 606 KB) Human Reproduction, 2002.

For example, a woman who has a 33-day cycle one month, a 31-day cycle the next, and a 35-day cycle after that, is probably having “normal” periods. For this reason, it is less likely to adversely affect the endometrium and cervical mucus. Refinements in the Methodology of Injection for Transvaginal Gamete Intra-Fallopian Transfer. (PDF, 2 MB) Human Reproduction, 1994. Enzymatic Digestion of Testicular Tissue May Rescue the Intracytoplasmic Sperm Injection Cycle in Some Patients with Non-obstructive Azoospermia. (PDF, 66 KB) Human Reproduction, 1998. The Effect of Female Age and Ovarian Reserve on Pregnancy Rate in Male Infertility: Treatment of Azoospermia with Sperm Retrieval and Intracytoplasmic Sperm Injection. (PDF, 66 KB) Human Reproduction, 1997. Women attempting pregnancy at age 40 or older have a 50% decreased fertility rate and a two-fold to three-fold increased risk of spontaneous abortion compared with younger women.

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Reduced secretion of cervical mucus due to destruction of the endocervical glands by previous cervical conization, freezing, or laser vaporization responds poorly to low-dose estrogen therapy. 0.[44] Environmental factors Toxins such as glues, volatile organic solvents or silicones, physical agents, chemical dusts, and pesticides.[45][46] Tobacco smokers are 60% more likely to be infertile than non-smokers.[47] German scientists have reported that a virus called adeno-associated virus might have a role in male infertility,[48] though it is otherwise not harmful.[49] Other diseases such as chlamydia, and gonorrhea can also cause infertility, due to internal scarring (fallopian tube obstruction).[50][51][52] Alimentary habits[53] Obesity: The obesity epidemic has recently become is a serious issue, particularly in industrialized nations. Just before those eggs would otherwise be ovulated, they are retrieved under mild anesthesia in an operating room. Chromosomal Abnormalities in Embryos Derived from Testicular Sperm Extraction. (PDF, 324 KB) Fertility and Sterility, 2003. Vasectomy and its Microsurgical Reversal. (PDF, 17 MB) Urologic Clinics of North America, 1978. Continued First, sperm are collected either from ejaculated semen or by a needle from the testicle.

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A Physical Map of the Human Y Chromosome. (PDF, 160 KB) Nature, 2001. 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. This process bypasses the normal fertilization process, which may be compromised due to poor sperm function.

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Coutifaris C, Myers ER, Guzick DS, et al.; NICHD National Cooperative Reproductive Medicine Network. Role of Epididymis in Sperm Maturation. (PDF, 3 MB) Urology, 1989. Antisperm antibodies may form when the blood-testis barrier is breached because of infection, vasectomy, testicular torsion, cryptorchidism, or testicular trauma. This is obviously extremely distressing for the couples involved. Couples may decide to go ahead regardless if the desire to become pregnant is very strong.