In cases of fertility problems,About 50 out of 100 are caused by a problem with the woman's reproductive system. These may be problems with her fallopian tubes or uterus or her ability to ovulate (release an egg). About 35 out of 100 are caused by a problem with the man's reproductive system. The most common is low sperm count. In about 10 out of 100, no cause can be found in spite of testing. About 5 out of 100 are caused by an uncommon problem. Before you have fertility tests, try fertility awareness. A woman can learn when she is likely to ovulate and be fertile by charting her basal body temperature and using home tests. Some couples find that they simply have been missing their most fertile days when trying to conceive. If you aren't sure when you ovulate, try this Interactive Tool: When Are You Most Fertile? If these methods don't help, the first step is for both partners to have some simple tests. A doctor can: Do a physical exam of both of you. Ask questions about your past health to look for clues, such as a history of miscarriages or pelvic inflammatory disease. Ask about your lifestyle habits, such as how often you exercise and whether you drink alcohol or use drugs. Do tests that check semen quality and both partners' hormone levels in the blood. Hormone imbalances can be a sign of ovulation problems or sperm problems that can be treated. Your family doctor can do these tests.
For more complete testing, you may need to see a fertility specialist.
another fertility issue is Adnexal torsion is twisting of the ovary and sometimes the fallopian tube, cutting off the blood supply of these organs.
Twisting causes sudden, severe pain and often vomiting.
Doctors use an ultrasound device inserted into the vagina (transvaginal ultrasonography) to confirm the diagnosis.
Surgery is done immediately to untwist the ovary or to remove it.
An ovary and sometimes the fallopian tube twist on the ligament-like tissues that support them. Twisting of an ovary (adnexal torsion) is uncommon but is more likely to occur in women of reproductive age. It usually occurs when there is a problem with an ovary. The following conditions make it more likely to occur:
Pregnancy
Use of hormones to trigger ovulation (for infertility problems)
Enlargement of the ovary, usually due to noncancerous (benign) tumors or cysts
Noncancerous tumors are more likely to cause twisting than cancerous ones.
Adnexal torsion usually occurs on only one side. Usually, only the ovary is involved, but occasionally, the fallopian tube also twists. Sometimes the blood supply to the ovary is cut off long enough to cause tissue in the ovary to die. Adnexal torsion can cause peritonitis—infection of the spaces in the abdomen (abdominal cavity) and the tissues lining it.