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When the ovaries do not release an egg during a menstrual cycle.


  • Type 1 – (Hypo hypo) Secretion of hormones from the brain is less.
  • Type 2 – (Normo) Commonest cause major contributor being PCOS.
  • Type 3 – (Hyper) Indication of ovarian failure.


  • Blood investigation Checking of hormones like FSH, and LH & Progesterone
  • Ultrasound – follicular monitoring


  • Ovulation induction – use of medicines or injections to stimulate the ovaries to produce eggs
  • Surgical management – Laparoscopic ovarian drilling in resistant PCO patients.

Absence of sperm in the semen.


  • Pre testicular – Imbalance in the hormones required for production of sperm
  • Testicular – Defect in the testis due to congenital problem, disease or injury.
  • Post testicular – Obstruction in the ducts transporting sperms produced in the testis.


  • Semen Analysis
  • Blood investigation – Testing of hormones like FSH, Prolactin, Serum testosterone
  • Karyotyping to rule out chromosomal problems.


  • Scrotal Ultrasound
  • Trans rectal Ultrasound
  • Testicular biopsy


  • Medical Management: GnRH therapy, hCG, hMG in pre testicular cause
  • Surgical management:
    Surgical Anastomotic procedures in obstructive causes
    Sperm extraction procedures like TESE, TESA, MESA, PESA in testicular causes
  • Donor insemination