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Treatment of Male-factor Infertility. (PDF, 10 MB) Chapter 9 from Progress in Infertility, 1993. It is important to undergo a thorough fertility evaluation to determine the problem. Physical Problems A variety of physical problems can cause male infertility.  These problems either interfere with the sperm production process or disrupt the pathway down which sperm travel from the testes to the tip of the penis.  These problems are usually characterized by a low sperm count and/or abnormal sperm morphology.  The following is a list of the most common physical problems that cause male infertility: Variocoele: A varicocele is an enlargement of the internal spermatic veins that drain blood from the testicle to the abdomen (back to the heart) and are present in 15% of the general male population and 40% of infertile men.  These images show what a variocoele looks like externally and internally.  A varicocele develops when the one way valves in these spermatic veins are damaged causing an abnormal back flow of blood from the abdomen into the scrotum creating a hostile environment for sperm development.  Varicocoeles may cause reduced sperm count and abnormal sperm morphology which cause infertility.  Variococles can usually be diagnosed by a physical examination of the scrotum which can be aided by the Doppler stethoscope and scrotal ultrasound.  Varicocoele can be treated in many ways (see treatment section), but the most successful treatments involve corrective surgery. The Jones metroplasty consists of resecting the septum using an anteroposterior wedge incision and closing the defect in the same direction (see the images below). [117, 118, 119] Infertility. In those with azoospermia and a varicocele, sperm may appear after repair in up to one third, but most of these men return to an azoospermic state within a few months.

For example, treatment for Hodgkin disease has been estimated to lead to infertility in as many as 80-100% of patients. Psychological/Physical/Behavioral Problems: Several sexual problems exist that can affect male fertility.  These problems are most often both psychological and physical in nature:  it is difficult to separate the physiological and physical components.

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There are three main types of fertility treatment: medical treatment (such as ovulation induction therapy); surgical treatment (such as laparoscopy and hysteroscopy); and the different assisted reproduction techniques [37]. 41 Treatment of Unexplained Infertility Jump to section + Couples who have no identified cause of infertility should be counseled on timing of intercourse for the most fertile period (i.e., the six days preceding ovulation). 0 nmol per L]) and follicle-stimulating hormone (FSH; normal range = 1. The most commonly prescribed injections that stimulate the ovary are called gonadotropins.

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Transvaginal or abdominal paracentesis should be performed if the patient becomes uncomfortable. Once eggs and sperm are collected, the actual process of injecting a single sperm into the egg is carried out in a laboratory using a petri dish or a glass slide with a well in the center. Patients with severe ovarian hyperstimulation syndrome are often hospitalized and confined to bed, with strict control of fluid intake and output. Couples will have to consider the ethical and emotional aspects of this procedure.

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This can happen as a result of: an infection of your testicles testicular cancer  testicular surgery a problem with your testicles you were born with (a congenital defect) when one or both testicles hasn't descended into the scrotum, the loose sac of skin that contains your testicles (undescended testicles) injury to your testicles Sterilisation Some men choose to have a vasectomy if they don't want children or any more children.  It involves cutting and sealing off the tubes that carry sperm out of your testicles (the vas deferens) so your semen will no longer contain any sperm. After ruling out female infertility concerns, tests for male infertility may be needed. The initial result of the procedure is not detected before 3 months because spermatogenesis takes 72 days. If a weight gain greater than 2 lb occurs, the patient should be evaluated to determine if hospitalization is required. Reduced hormones may result, which could potentially translate into trouble conceiving. In the authors' experience, ovulation may occur any time from the menstrual cycle day 10-23 or between day 1 and day 14 after the last tablet of CC is administered. Exposure to some chemicals: Some pesticides, herbicides, metals, such as lead, and solvents have been linked to fertility problems in both men and women. 33 Use of antioxidants such as zinc, vitamin E, or l-carnitine showed increased live birth rates in three small randomized controlled trials in couples undergoing assisted reproductive technology. Lack of estrogen brings about decreased spinnbarkeit of the cervical mucus. Some diseases: Conditions that are sometimes linked to lower fertility in males are anemia, Cushing's syndrome, diabetes, and thyroid disease. The doctor or WHNP may also be able to suggest lifestyle changes to increase the chances of conceiving.[65] Women over the age of 35 should see their physician or WHNP after six months as fertility tests can take some time to complete, and age may affect the treatment options that are open in that case. There are some common risk factors that can increase the likelihood of a man experiencing some form of reversible or permanent infertility. Congenital Absence of the Vas Deferens: The Fertilizing Capacity of Human Epididymal Sperm. (PDF, 3 MB) New England Journal of Medicine, 1990. The fluid comes from the prostate gland, the seminal vesicle, and other sex glands.