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Female and male factors are equally responsible for infertility, about 30% to 40% each, and in 20% of the cases, there is a combination of both. The vas is divided into the convoluted, scrotal, inguinal, retroperitoneal, and ampullary regions and receives its blood supply from the inferior vesical artery. This can happen as a result of: an infection of your testicles testicular cancer  testicular surgery a problem with your testicles you were born with (a congenital defect) when one or both testicles hasn't descended into the scrotum, the loose sac of skin that contains your testicles (undescended testicles) injury to your testicles Sterilisation Some men choose to have a vasectomy if they don't want children or any more children.  It involves cutting and sealing off the tubes that carry sperm out of your testicles (the vas deferens) so your semen will no longer contain any sperm. Epididymal Extravasation Following Vasectomy as a Cause for Failure of Vasectomy Reversal. (PDF, 22 MB)Fertility and Sterility, 1979.

Medications, treatments, and drugs Some drugs can affect fertility in a woman. Patients have with small- to normal-sized testes and azoospermia, but normal secondary sex characteristics. Theoretically, with this therapy, we can get artificial gamets in vitro. Surgical procedures for women If the fallopian tubes are blocked or scarred, surgical repair may make it easier for eggs to pass through.

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Men who are underweight tend to have lower sperm concentrations than those who are at a normal BMI. The dye outlines the cavity of the uterus and spills out of the fallopian tubes. 2. serum progesterone in the mid-luteal phase of their cycle (day 21 of a 28-day cycle) even if they have regular menstrual cycles. In men who have the necessary reproductive organs to procreate, infertility can be caused by low sperm count due to endocrine problems, drugs, radiation, or infection. Female factor Dysfunction of the female reproductive organs is also apparent in around 40% of infertile couples. Guidelines and recommendations were retrieved from the best evidence reviews at the American College of Obstetricians and Gynaecologists (ACOG), American Society for Reproductive Medicine (ASRM), Canadian Fertility and Andrology Society (CFAS), European Society of Human Reproduction and Embryology (ESHRE), Human Fertilisation and Embryology Authority (HFEA), Royal College of Obstetricians and Gynaecologists (RCOG), and the World Health Organization (WHO).

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Implantation: the process when the fertilized egg attaches to the uterine wall. Varicocele: Surgically removing a varicose vein in the scrotum may help. Chemotherapy: Some chemotherapy drugs can result in ovarian failure. These are agents that support the follicular maturation and the secretion of gonadotropins.

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This diagnosis is therefore shared by 15% of couples attempting to conceive. 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. Drugs used for both women and men[67] include clomiphene citrate, human menopausal gonadotropin (hMG), follicle-stimulating hormone (FSH), human chorionic gonadotropin (hCG), gonadotropin-releasing hormone (GnRH) analogues, aromatase inhibitors, and metformin. Epididymal Extravasation Following Vasectomy as a Cause for Failure of Vasectomy Reversal. (PDF, 22 MB)Fertility and Sterility, 1979. Primary spermatocytes undergo meiosis as the cells successively pass through the preleptotene, leptotene, zygotene, and pachytene stages to become secondary spermatocytes. Diet: A lack of folic acid, iron, zinc, and vitamin B-12 can affect fertility. 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. 549 KB Effect of Age on Male Fertility. (PDF, 5 MB) Chapter from textbook, Seminars in Reproductive Endocrinology, 1991. Legal, cultural and religious inquiries have limited the available choices in some countries, such as the use of donor sperms or oocytes.