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According to the literature survey, the most common causes of infertility are: male factor [5,7-9,13-15] such as sperm abnormalities [9,13,15], female factor [7-9,14-16] such as ovulation dysfunction [7,8] and tubal pathology [7-9], combined male and female factors [7,9,14,15] and unexplained infertility; where no obvious cause could be detected [7-9]. The most common cause of male infertility is varicoceles. 3,4  Infertility may arise from male factors, female factors, or a combination of these (Table 15–8). Happily, many couples treated for infertility go on to have babies. Oligozoospermia refers to a low sperm count under 20 million per milliliter. Fertility Evaluation of the Male Partner: Other Tests Other tests for men include: Urine analysis to rule out an infection.

7 million women reported impaired ability to get pregnant or carry a baby to term. Other causes may include: Genetic factors: A man should have an X and Y chromosome. Vitrification of oocytes from endangered Mexican gray wolves (Canis lupus baileyi). (PDF, 319 KB) Theriogenology, 2010. Medications in use for this effect are mainly clomifene citrate and tamoxifen (both being selective estrogen-receptor modulators), as well as letrozole (an aromatase inhibitor.[17] Follicle-stimulating hormone (FSH), directly stimulating the ovaries.

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The identification of anovulation is not easy; contrary to what is commonly believed, women undergoing anovulation still have (more or less) regular periods. However, the presence of fibroids alone doesn’t necessarily cause infertility or predispose a woman to pregnancy loss. If abundant good sperm are found in the testicle, there's likely a blockage somewhere. In the body, testosterone circulates 2% in the free form, 44% bound to sex hormone–binding globulin (SHBG), and 54% bound to albumin. 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. Obesity Research from 2015 noted that many studies link obesity in men with infertility.

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Hysterosalpingogram (HSG) – This test is essential for evaluating fallopian tubal patency, uterine filling defects such as fibroids and polyps, and scarring of the uterine cavity (Asherman syndrome). Subsequently, Semm submitted a paper on laparoscopic appendectomy to the American Journal of Obstetrics and Gynecology, at first rejected as unacceptable for publication on the grounds that the technique reported on was "unethical," but finally published in the journal Endoscopy.[40] The abstract of his paper on endoscopic appendectomy can be found at here.

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The embryo is then placed in the uterus to begin a pregnancy. ARTICLES FROM THE 2000s Evaluation and Treatment of Male Infertility. (PDF, 17 MB) Clinical Obstetrics and Gynecology, 2000. If stem cells remain viable after radiation therapy, patients may regain fertility within several years. They may go unnoticed until a man tries to have a baby. Infertility and impaired fecundity in the United States, 1982–2010: data from the National Survey of Family Growth. Endometriosis is usually more common in women in their mid-twenties and older, especially when postponed childbirth has taken place.[55] Another major cause of infertility in women may be the inability to ovulate. Ovulation of the egg occurs approximately 2 weeks before the start of the next period. Controversies in OB/GYN: Is Varicocelectomy Useful for Treatment of Male-factor Infertility? (PDF, 4 MB)Contemporary OB/GYN, 2001.