1. Number of swimming sperm are low

1. Grow more than 1 mature egg each month (get more targets)
2. Intrauterine insemination (get more sperm where they need to go)

2. Very low sperm count (less than 10 million swimming sperm)

1. IVF (in vitro fertilization): many eggs are grown in the female partner; they are taken from the ovary and added to the sperm in a plastic Petri dish. Five days later we take the best 2 embryos and transfer them into the uterus.
2. ICSI (intracytoplasmic sperm injection): the most normal sperm are chosen and injected into each mature egg. This is useful when sperm shapes are abnormal, there is very little movement, or there are only a few sperm.

1. Polycystic ovary syndrome (you may not grow an egg each month)

1. Surgery: Ovarian Drilling or Wedge resection.
2. Medication: Glucophage (metformin), Actos or Avandia to help grow one egg. If that is unsuccessful, oral or injectable drugs that grow eggs can be used.

2. Tubal Factor (one or both tubes are blocked)

1. Surgery:  If one or both of your tubes is blocked you can elect to try surgery to open the tubes.
2. Medication:  If one tube is blocked, oral or injectable fertility drugs that grow eggs can be used. Eggs will grow in both ovaries, but we will be focusing on the eggs on the open side.
3. IVF:  as above, especially if both tubes are blocked.

3. Diminished Ovarian Reserve (there aren’t many eggs left to grow)

1. Medication: Oral or injectable fertility drugs can be used.
2. Egg or embryo donation

4. Endometriosis (growth of tissue in the female pelvis that blocks tubes and is toxic to eggs)

1. Surgery:  to remove the abnormal tissue and remove scar tissue.
2. Medication:  oral or injectable drugs to grow more than 1 egg a month
3. Intrauterine inseminations

1. Oral or injectable fertility drugs to grow more than 1 egg
2. Intrauterine inseminations

See more information on Treatment of Unexplained Infertility.