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There are many disorders that may impact the ability for a woman to ovulate normally. A low testosterone level with a low FSH level signals a secondary cause.

Obese women have a higher rate of recurrent, early miscarriage compared to non-obese women. IVF and related techniques (ICSI, ZIFT, GIFT) are called assisted reproductive technology (ART) techniques. The quality of the cervical mucus can be improved with the administration of a small dose of estrogens, or the problem can be bypassed by intrauterine insemination. [163, 209] If the follicle is smaller than 23-24 mm at the time of ovulation, a better size can be obtained by starting the CC therapy on the menstrual cycle day 2. Fertility: assessment and treatment for people with fertility problems. Fertility treatments for men Treatment will depend on the underlying cause of the infertility.

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Dealing with Fertility Problems After Vasectomy Reversal. (PDF, 7 MB) Contemporary OB/GYN, 1978. This hormone then binds to another area of the brain called the pituitary gland and leads to the release of FSH (follicle stimulating hormone), a hormone that directly binds to cells in the ovary, leading to egg growth and maturation. Blood test: The lab will test for levels of testosterone and other hormones.

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Intrauterine insemination (IUI): At the time of ovulation, a fine catheter is inserted through the cervix into the uterus to place a sperm sample directly into the uterus. Careful monitoring during treatment and pregnancy can help reduce the risk of complications. The Use of Epididymal Sperm in Assisted Reproduction. (PDF, 8 MB) Chapter from textbook, Frontiers in Endocrinology: Perspectives on Assisted Reproduction, 1994. This is called the fulcrum effect.[22] Some surgeries (carpal tunnel for instance) generally turn out better for the patient when the area can be opened up, allowing the surgeon to see "the whole picture" surrounding physiology, to better address the issue at hand. Frustratingly, sometimes there may be no clear reason and you may be diagnosed with unexplained infertility.

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Endometriosis can be treated with hormones that suppress the displaced endometrial tissue or the tissue can be removed by a surgical procedure. Fibroids should be treated if they are associated with abnormal uterine bleeding or if they are thought to be the cause of infertility. Microsurgery Successful in Vasectomy Reversals. (PDF, 156 KB) The New York Times, 1975. Intracytoplasmic Sperm Injection. (PDF, 4 MB) Chapter 47 from textbook Current Therapy in Equine Reproduction, 2006. Outlook For couples who experience fertility problems and those who wish to have children at an older age, there are more options available than ever before. Microsurgery Successful in Vasectomy Reversals. (PDF, 156 KB) The New York Times, 1975. Gonadotrophins for idiopathic male factor subfertility. Affected individuals displayed more severe forms of infertility such as azoospermia and severe oligozoospermia.[27] Other causes[edit] Factors that can cause male as well as female infertility are: DNA damage DNA damage reduces fertility in female ovocytes, as caused by smoking,[28] other xenobiotic DNA damaging agents (such as radiation or chemotherapy)[29] or accumulation of the oxidative DNA damage 8-hydroxy-deoxyguanosine[30] DNA damage reduces fertility in male sperm, as caused by oxidative DNA damage,[31] smoking,[28] other xenobiotic DNA damaging agents (such as drugs or chemotherapy)[32] or other DNA damaging agents including reactive oxygen species, fever or high testicular temperature.[33] The damaged DNA related to infertility manifests itself by the increased susceptibility to denaturation inducible by heat or acid [34] or by the presence of double-strand breaks that can be detected by the TUNEL assay.[35] General factors Diabetes mellitus,[36][37] thyroid disorders,[38] undiagnosed and untreated coeliac disease,[39][40][41][42] adrenal disease[43] Hypothalamic-pituitary factors Hyperprolactinemia Hypopituitarism The presence of anti-thyroid antibodies is associated with an increased risk of unexplained subfertility with an odds ratio of 1. Such tissue growth and its surgical removal can cause scarring and prevent fertilization.  Uterine and cervical causes  Problems in the uterus or cervix may also affect fertility. Quantitative Analysis of Testicle Biopsy: Determination of Partial Obstruction and Prediction of Sperm Count after Surgery for Obstruction. (PDF, 4 MB) Fertility and Sterility, 1981.