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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. If the sperm are of good quality and the mechanics of the woman's reproductive structures are good (patent fallopian tubes, no adhesions or scarring), a course of ovulation induction maybe used. More than 15-20% bound is considered a positive test result. 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. Women 35 and older should see their doctor after six months of trying.

Varicocele and male factor infertility treatment: a new meta-analysis and review of the role of varicocele repair. 50% are female causes with 25% being due to anovulation and 25% tubal problems/other.[74] In Sweden, approximately 10% of couples wanting children are infertile.[75] In approximately one third of these cases the man is the factor, in one third the woman is the factor, and in the remaining third the infertility is a product of factors on both parts.

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As the major causes of infertility are sperm abnormalities, ovulation dysfunction, and fallopian tube obstruction, the preliminary adviced investigations for the infertile couple should be focused on semen analysis (to be compared with the WHO reference values [27]), detection of ovarian function by hormonal assay (early follicular FSH and LH levels, and mid-luteal progesterone), and evaluation of tubal patency by hysterosalpingography (HSG) [17-32], (Appendix 3). Broekmans FJ, Kwee J, Hendriks DJ, Mol BW, Lambalk CB. Thus, an intravenous pyelogram must be performed once this diagnosis is made.

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Ovarian Transplantation in a Series of Monozygotic Twins Discordant for Ovarian Failure. (PDF, 188 KB) The New England Journal of Medicine, 2007. The etiology is unknown but is probably multifactorial.

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Microsurgery for Vasectomy Reversal and Vasoepididymostomy. (PDF, 13 MB) Urology, 1984. A history of sexually transmitted infections could be another cause of infertility in either partner. When Predictions Don’t Predict. (PDF, 549 KB) The Australian and New Zealand Journal of Obstetrics and Gynaecology, 1991. Learn what factors can influence your fertility and whether to consider seeking medical help. Intrauterine insemination is a process by which sperm is washed and prepared for placement into the uterine cavity, therefore bypassing the cervix and bringing a higher concentration of motile sperm closer to the tubes and ovulated egg. Blood test: This can assess hormone levels and whether a woman is ovulating. Religious leaders' opinions on fertility treatments; for example, the Roman Catholic Church views infertility as a calling to adopt or to use natural treatments (medication, surgery, or cycle charting) and members must reject assisted reproductive technologies. If the woman is aged over 35 years, the couple may wish to see a doctor earlier, because fertility testing can take time, and female fertility starts to drop when a woman is in her 30s.