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It is more successful in women who have previously been pregnant. Oocyte Vitrification – Women’s Emancipation Set in Stone. (PDF, 70 KB) Fertility and Sterility, 2008. Symptoms include: bloating constipation dark urine diarrhea nausea abdominal pain vomiting They are usually mild and easy to treat. Surprisingly, most patients have normal libido, erections, and orgasms, so testosterone therapy has only a limited role; exogenous testosterone may also suppress any underlying sperm production. 25 Women with no clear risk of tubal obstruction should be offered hysterosalpingography to screen for tubal occlusion and structural uterine abnormalities. Normal Fertilization of Human Oocytes after Testicular Sperm Extraction and Intracytoplasmic Sperm Injection.(PDF, 2 MB) Fertility and Sterility, 1994.

For women, being underweight and having extremely low amounts of body fat are associated with ovarian dysfunction and infertility and they have a higher risk for preterm birth. Techniques for the Resolution of Testicular Obstruction. (PDF, 8 MB) Chapter 78 from textbook, Reconstructive Urology, 1992. Large submucosal uterine fibroids may make the uterus' cavity bigger, increasing the distance the sperm has to travel. Small, firm testicles The testes house a man’s sperm, so testicle health is paramount to male fertility. The most common disorders impacting ovulation include polycystic ovary syndrome (PCOS), hypogonadotropic hypogonadism (from signaling problems in the brain), and ovarian insufficiency (from problems of the ovary). 6,23 Anovulatory women should have further investigation to determine treatable causes such as thyroid disorders or hyperprolactinemia based on symptoms.

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Factors Affecting Fertility: Timing of Intercourse Intercourse prior to ovulation is key to maximizing the chance of pregnancy. Secondary fertility involves one or both partners who have conceived previously, but are now unable to do so because of a possible physical or medical condition impairing fertility. After ruling out female infertility concerns, tests for male infertility may be needed. IVF and other fertility treatments have resulted in an increase in multiple births, provoking ethical analysis because of the link between multiple pregnancies, premature birth, and a host of health problems.

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The idea is that for women beyond age 35, every month counts and if made to wait another six months to prove the necessity of medical intervention, the problem could become worse. The male partner can be evaluated for infertility or subfertility using a variety of clinical interventions, and also from a laboratory evaluation of semen.” (Semen manual, 5th Edition3). Ovarian hyperstimulation syndrome (OHSS) usually results from taking medications to stimulate the ovaries, such as clomifene and gonadotrophins. Cystic Fibrosis and Infertility Caused by Congenital Bilateral Absence of the Vas Deferens and Related Clinical Entities. (PDF, 2 MB) Human Reproduction, 1996.

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In some women, and especially with age, the membrane becomes harder. In some cases, the egg may have matured properly, but the follicle may have failed to burst (or the follicle may have burst without releasing the egg). Psychic causes are possible in women just like they are in men. Delayed conception and active and passive smoking. The testicular-epididymal component includes sperm and comprises about 5% of the ejaculate volume. 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). Sexually transmitted infections (STIs): Chlamydia can damage the fallopian tubes in a woman and cause inflammation in a man's scrotum. Rarely, a blood clot may develop in an artery or vein, liver or kidney problems can arise, and respiratory distress may develop. She will also undergo a gynecologic examination and a number of tests: Laparoscopy involves inserting a thin tube with a camera on to investigate and possibly remove unwanted tissue. Chlamydia test: Chlamydia can affect fertility, but antibiotics can treat it. Immunohistochemical stains are performed if more than 5-10 round cells/HPF are present.  Other tests Semen may be analyzed for levels of zinc, citric acid, acid phosphatase, and alpha-glucosidase. The Male-specific Region of the Human Y Chromsome is a Mosaic of Discrete Sequence Classes. (PDF, 754 KB) Nature, 2003. It varies with the age (the optimal female age is between 23 and 39 years) and with body weight (the ideal body mass index is between 19 and 30).