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Fertility Evaluation: General and Sexual History A detailed history includes: General history  This includes occupation and background, use of tobacco, alcohol and drugs, earlier diseases, history of abdominal surgery and earlier infections. Obese women have a higher rate of recurrent, early miscarriage compared to non-obese women. Symptoms depend on what is causing the infertility. Therefore, it is particularly important to evaluate both partners when investigating infertility. However, the optimal dosage and length of administration is under investigation. [170, 171] Aromatase inhibitors are generally well tolerated. Varicocele A varicocele is a swelling of the veins that drain the testicle, which can impact sperm quality.

Common causes of infertility of females include: ovulation problems (e.g. polycystic ovarian syndrome, PCOS, the leading reason why women present to fertility clinics due to anovulatory infertility.[58]) tubal blockage pelvic inflammatory disease caused by infections like tuberculosis age-related factors uterine problems previous tubal ligation endometriosis advanced maternal age immune infertility Males[edit] The main cause of male infertility is low semen quality. 48 However, there is no firm evidence that preconception counseling leads to increased live birth rates, in part because no studies on this topic have been performed. Microsurgical Epididymal Sperm Aspiration and Assisted Reproductive Techniques. (PDF, 4 MB) Frontiers in Human Reproduction, 1991.

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On the contrary to women, in which is the issue can more commonly be detected, most male fertility issues, other than those caused by infections, are unexplained. If the epididymis is blocked, sperm may not be ejaculated properly. Infertility tests for women A woman will undergo a general physical examination, and the doctor will ask about her medical history, medications, menstruation cycle, and sexual habits. The stimulation of follicular maturation is continued with HMG or FSH. Showell MG, Brown J, Yazdani A, Stankiewicz MT, Hart RJ.

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Although the sperm count may be slightly decreased by an intercourse frequency of once per day or once every other day, the motility and number of sperm in the healthy male would be sufficient to achieve pregnancy. The fluid comes from the prostate gland, the seminal vesicle, and other sex glands. Microscopic Vasectomy Reversal. (PDF, 31 MB) Fertility and Sterility, 1977. Pregnancy Caused by Sperm from Vasa Efferentia. (PDF, 1 MB) Fertility and Sterility, 1988. More than 60% of sperm should be normal, and less than 2-3% should be immature.

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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). The principal indications for CC use are oligomenorrhea, especially polycystic ovarian syndrome (PCOS), and for patients with slight menstrual irregularities. There are many disorders that may impact the ability for a woman to ovulate normally. Therefore, data estimating the prevalence of infertility cited by various sources differs significantly.[8] A couple that tries unsuccessfully to have a child after a certain period of time (often a short period, but definitions vary) is sometimes said to be subfertile, meaning less fertile than a typical couple. Mental stress: This may affect female ovulation and male sperm production and can lead to reduced sexual activity. 6 mg SC q4wk for 6 months) GnRHa therapy can be administered along with cyclic or continuous progestins or with cyclic or continuous estrogen and progestins in cases of severe hot flashes. [145, 152] Combined therapy Medical and surgical treatments are usually combined for the treatment of severe endometriosis.