1. Normal uterus, fallopian tubes and ovary state in a woman with monthly menstruation. Such finding is what makes for a normal woman in the marriage context. The woman is usually informed about this.
  2. Bilateral tubal blockage. This is often from complications of previous infections (post aborted or puerperal) or complications of previous pelvic operations or a rare disease in the Africa called endometriosis or giant fibroid due to the consequent distortion or obstructions.
  3. Anovulation: This is inability to ovulate or grow and release an egg or eggs on a monthly basis. This may be a simple disease from hormone anomalies or result of other disease like polycystic ovary disease (PCOD) or diabetes or thyroid disease or functional ovarian cyst. Polycystic ovary diseases is a complex ovary disease syndrome with a wide spectrum of variants, often responsible for over 80% of all case in which ovulation is not occurring monthly in women. Women who have PCOD may have normal monthly menstruation but more commonly, delayed menses for some months or even at times no menstruation at all for over six consecutive months. However, whether the woman with PCOD have normal or disturbed menstruation, they typically have normal mucus secretions which by those who practice the billings method of cervical mucus examination as evidence of ovulation often mistake for normal mucus secretions, as is expected in normal cervical mucus production which in this case is the false positive normal mucus secretion in those who practice the billings method of assessing if ovulation is occurring in any woman. Hence, normal mucus production in the midcycle may not always indicate ovulation especially in the women with this PCOD disease which is as high as 80% of those not ovulating (d) Uterine disease: This commonly is either fibroids or intra-uterine adhesion (which may occur from previous infections, D&C, Caesarean section or myomectomy or intra-uterine fetal death or also insertion of native vaginal pessaries for the traditional treatment of various ailments). Fibroids whether big or small may often exist with anovulation, hence it is important to screen for evidence of concurrent anovalation in any women with fabroid. Haste in removing the fibroid surgically without screening for anovulation and treating it at the same time, will the infertility to persist and in consequence the fibroid will re-grow after some time.
  4. Other diseased like diabetes mellitus or thyroid diseases.


  1. Normal sperm count of 20 million or above with normal shape and motility. When this is what is found from the results of the testing in a man without any problem with erection, he will be counselled that he is normal.
  2. Oligospermia: This is a low sperm count of below 20 million per millimeter
  3. Asthenospermia: Normal of 20 million or above but sperms show low motility
  4. Teratospermia: Normal count of 20 million or above but many sperm have abnormal shape
  5. Azoospermia: There are no sperms seen on the semen which may occur with no obstruction or with obstruction which is the variant called obstructive azoospermia
  6. At times, there are combination of these anomalies in the sperm such as normal count but may have low motility and abnormal shape or oligospermia with either low motility and or abnormal shape.

All these abnormalities of the semen examination may have various causes and are the problems in the man but can cause the infertility in the couple.


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