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Women with regular menstrual cycles are likely to be ovulating and should be offered serum progesterone testing at day 21 to confirm ovulation. Unexplained infertility[edit] In the US, up to 20% of infertile couples have unexplained infertility.[61] In these cases abnormalities are likely to be present but not detected by current methods. Other considerations include preconception screening and vaccination for preventable diseases such as rubella and varicella, sexually transmitted infections, and cervical cancer, based on appropriate guidelines and risk. Possible problems could be that the egg is not released at the optimum time for fertilization, that it may not enter the fallopian tube, sperm may not be able to reach the egg, fertilization may fail to occur, transport of the zygote may be disturbed, or implantation fails. Chemotherapy: Some types may significantly reduce sperm count.

Several studies have reported different causes of infertility [7-9]. The treating doctor may feel inadequacy and the trust between the doctor and patient breaks down [43].

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Vasoepididymostomy to the Head of the Epididymis: Recovery of Normal Spermatozoal Motility. (PDF, 3 MB)Fertility and Sterility, 1980. Normal sperm have a smooth oval head approximately 3-5 μm long and 2-3 μm wide.

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Intracytoplasmic Sperm Injection. (PDF, 4 MB) Chapter 47 from textbook Current Therapy in Equine Reproduction, 2006. 8 Counseling on lifestyle modifications is reasonable because exposures to tobacco and alcohol are associated with lower rates of fertility.

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About 92 out of 100 couples who are trying to get pregnant do so within two years.[citation needed] Women become less fertile as they get older. In general, patients only notice that there is a problem once they have started trying to conceive. Primary vs. secondary infertility[edit] Primary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months, during which they have not used any contraceptives.[14] The World Health Organisation also adds that 'women whose pregnancy spontaneously miscarries, or whose pregnancy results in a still born child, without ever having had a live birth would present with primarily infertility'.[15] Secondary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months since their last live birth, during which they did not use any contraceptives.[15] Thus the distinguishing feature is whether or not the couple have ever had a pregnancy which led to a live birth. Microsurgery Successful in Vasectomy Reversals. (PDF, 156 KB) The New York Times, 1975.