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The chance of a multiple birth is lower with an oral fertility drug. She will also undergo a gynecologic examination and a number of tests: Laparoscopy involves inserting a thin tube with a camera on to investigate and possibly remove unwanted tissue. Exposure to some chemicals: Some pesticides, herbicides, metals, such as lead, and solvents have been linked to fertility problems in both men and women. The main symptom of infertility is not getting pregnant. In another third of cases, it is because of the man. Infertility may be caused by blockage of the Fallopian tube due to malformations, infections such as chlamydia or scar tissue.

Treatment The cost of infertility treatment is high [34]. Hormonal abnormalities can sometimes be treated with medicine or surgery. ART: Intracytoplasmic Sperm Injection (ICSI) Another ART procedure  Intracytoplasmic Sperm Injection (ICSI)  involves the injection of a single sperm into the egg. The embryo is then placed in the uterus to begin a pregnancy.

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Successful Pregnancy and Delivery after Calcium Ionophore Oocyte Activation in a Normozoospermic Patient with Previous Failed Fertilization after Intracytoplasmic Sperm Injection. (PDF, 57 KB) Fertility and Sterility, 2003. IVF in action Intracytoplasmic sperm injection (ICSI): A single sperm is injected into an egg to achieve fertilization during an IVF procedure. In 1978, the first baby was born as a result of IVF. Ovulation problems can be a result of:  polycystic ovary syndrome (PCOS) thyroid problems – both an overactive thyroid gland and an underactive thyroid gland can prevent ovulation premature ovarian failure – where a woman's ovaries stop working before the age of 40 Scarring from surgery Pelvic surgery can damage and scar the fallopian tubes, which link the ovaries to the womb. Couples may decide to go ahead regardless if the desire to become pregnant is very strong. With the fast progression in reproductive medicine and the experiences gained through infertility management, a wider range of treatment options have become available to infertile couples [17-19,21-26,31,36], (Appendix 4).

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Vasectomy. (PDF, 5 MB) From the Encyclopedia of Reproduction, 1999. Pro-life opposition to the destruction of embryos not transferred in vivo. The content of counselling may differ depending on the concerned couple and the existing treatment options. In the United States, around 10 percent of women aged 15 to 44 years are estimated to have difficulty conceiving or staying pregnant.

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Removal of polyps by the minimally invasive procedure hysteroscopy is associated with a doubling of pregnancy rate. Cervical factors are also thought to play a minor role, although they are rarely the sole cause. Those with a varicocele diagnosable only on scrotal ultrasonography have subclinical varicoceles and will likely not benefit from repair. They can be blocked due to numerous causes, including infections,  trauma or abnormal development, such as with cystic fibrosis or similar inherited conditions. 29 When the semen analysis is abnormal, referral to a male fertility specialist or reproductive endocrinologist is warranted. The Three-kidney Rat Model. (PDF, 2 MB) Investigative Urology, 1974. In other cases, the cause is suspected to be immunological or genetic; it may be that each partner is independently fertile but the couple cannot conceive together without assistance. Known male factor semen abnormalities: If a male partner has a history of infertility with a prior partner, or if there are abnormalities on his semen analysis, then we advise earlier fertility evaluation, ideally within 6 months of attempting pregnancy. Diverse Spermatogenic Defects in Humans Caused by Y Chromosome Deletions Encompassing a Novel RNA-binding Protein Gene. (PDF, 7 MB) Nature Genetics, 1995. The presence of open tubes is essential for natural conception, as sperm must traverse the tubes in order to reach and fertilize the ovulated egg.