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6 The initial history should cover menstrual history, timing and frequency of intercourse, previous use of contraception, previous pregnancies and outcomes, pelvic infections, medication use, occupational exposures, substance abuse, alcohol intake, tobacco use, and previous surgery on reproductive organs. In theory, it is possible to conceive on any of these 6 days that occur before and during ovulation. Surgical procedure to conserve the uterus for future pregnancy in patients suffering from massive adenomyosis.(PDF, 958 KB) Reproductive BioMedicine Online, 2010. A defect in any of these sperm structures may result in infertility that will not be detected by semen analysis.[60] Antisperm antibodies cause immune infertility.[23][24] Cystic fibrosis can lead to infertility in men. Article Sections Infertility is defined as the inability to achieve pregnancy after one year of regular, unprotected intercourse.

Blood, urine, and imaging tests can be done to discover why you are having trouble getting pregnant. Broekmans FJ, Kwee J, Hendriks DJ, Mol BW, Lambalk CB. Vascular injuries can result in hemorrhage that may be life-threatening. Successful Autotransplantation of an Intra-abdominal Testis to the Scrotum by Microvascular Technique. (PDF, 11 MB) The Journal of Urology, 1976. Tourism[edit] Fertility tourism is the practice of traveling to another country for fertility treatments.[68] It may be regarded as a form of medical tourism. Ejaculatory duct obstruction Complete and partial ejaculatory duct obstruction has been implicated as a cause of 1-5% of patients with male infertility.

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Medical treatment for minimal to mild disease has not been shown to be of benefit. The sperm is washed in a fluid and the best specimens are selected.

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Men with Infertility Caused by AZFc Deletion can Produce Sons by Intracytoplasmic Sperm Injection, but are Likely to Transmit the Deletion and Infertility. (PDF, 102 KB) Human Reproduction, 1999. Other causes of ovulation disorders include ovarian insufficiency and hypothalamic amenorrhea. 21,22 Evaluation of Women Jump to section + The etiology of female infertility can be broken down into ovulation disorders, uterine abnormalities, tubal obstruction, and peritoneal factors. A blood test done on days 21 or 22 of a normal 28-day menstrual cycle can be used to test whether ovulation has occurred by measuring the progesterone level.

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Vause TD, Cheung AP, Sierra S, et al.; Society of Obstetricians and Gynecologists of Canada. Large submucosal uterine fibroids may make the uterus' cavity bigger, increasing the distance the sperm has to travel. In many instances, more than one hysteroscopy is required for total resection. Physical exam A directed physical exam that may include a pelvic ultrasound should be performed. In women whose ovulation is suppressed by hyperprolactinemia (high blood levels of the pituitary hormone prolactin), ovulation may be induced with prolactin-suppressing drugs. Hypogonadism Hypogonadism is an abnormally low level of testosterone, the male sex hormone involved in making sperm. Histologic endometrial dating is not considered reliable nor is it predictive of fertility. Also, polymorphisms in folate pathway genes could be one reason for fertility complications in some women with unexplained infertility.[62] However, a growing body of evidence suggests that epigenetic modifications in sperm may be partially responsible.[63][64] Diagnosis[edit] If both partners are young and healthy and have been trying to conceive for one year without success, a visit to a physician or women's health nurse practitioner (WHNP) could help to highlight potential medical problems earlier rather than later.