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The number of days in between each period varies each month. In some cases, hormonal problems may be suspected if a man has abnormal hair growth, low libido, or other indications of sexual dysfunction.

This is taken from the vaginal vault as well as from the cervical canal. Unfortunately, there are some forms of male infertility that are not treatable.

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ARTICLES FROM THE 1990s Microsurgery, Andrology, and Its Role in IVF. (PDF, 6 MB) Chapter in text book, Advances in Assisted Reproductive Technology, 1990. 8 Patients should be counseled that 50% of couples who have not conceived in the first year of trying will conceive in the second year. The patient's electrolyte levels must be checked to consider the need for diuretics. Irregular periods The average woman’s cycle is 28 days long. The presence of antibodies in serum or seminal plasma is less prognostic than antibodies bound to sperm. Couples may decide to go ahead regardless if the desire to become pregnant is very strong.

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Evaluation should be pursued by 6 months of attempted pregnancy in women with a known history of these abnormalities or a history of bleeding between menstrual cycles. However, there are various scenarios where one may be advised to seek help earlier. Testosterone and multiple hormones made in the brain control sperm production. Screening tests include increased plasma 17-hydroxylase and urine 17-ketosteroids. A history and physical examination can help direct the evaluation. Medications in use for this effect are mainly clomifene citrate and tamoxifen (both being selective estrogen-receptor modulators), as well as letrozole (an aromatase inhibitor.[17] Follicle-stimulating hormone (FSH), directly stimulating the ovaries.

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8 Intrauterine insemination and ovulation induction do not result in increased pregnancy rates in women with unexplained infertility. The use of Epididymal and Testicular Spermatozoa for Intracytoplasmic Sperm Injection: The Genetic Implications for Male Infertility. (PDF, 8 MB) Human Reproduction, 1995. If oligospermia or azoospermia is noted, hypogonadism should be suspected. The AZFc Region of the Y Chromosome Features Massive Palindromes and Uniform Recurrent Deletions in Infertile Men. (PDF, 5 MB) Nature Genetics, 2001. It is better for a couple to see the doctor together. Fallopian tube factor: in vivo fertilisation takes place inside the fallopian tubes. Religious leaders' opinions on fertility treatments; for example, the Roman Catholic Church views infertility as a calling to adopt or to use natural treatments (medication, surgery, or cycle charting) and members must reject assisted reproductive technologies. Intrauterine insemination (IUI): At the time of ovulation, a fine catheter is inserted through the cervix into the uterus to place a sperm sample directly into the uterus. In order to maximize the patient’s chances for successful fertilization, physicians typically use ovarian stimulation medications rather than using the single egg normally developed each cycle. A prolactin level of more than 150 mcg/L suggests a pituitary adenoma, while levels greater than 300 mcg/L are nearly diagnostic. Nowadays, given the huge emotional impact caused by pregnancy loss, in those cases where two pregnancy losses have taken place, an analysis and treatment is advised. Unfortunately, tubal cauterization destroys a large amount of tissue, so the amount of fallopian tube remaining is often not long enough to facilitate a successful reanastomosis. Y Chromosome Deletions in Azoospermic and Severely Oligozoospermic Men Undergoing Intracytoplasmic Sperm Injection after Testicular Sperm Extraction. (PDF, 336 KB) Human Reproduction, 1998. Debate over whether health insurance companies (e.g. in the US) should be required to cover infertility treatment. As part of the fertility evaluation, we will perform an HSG, a test designed to evaluate if the fallopian tubes are open. Microscopic Vasectomy Reversal 30 Years Later: A Summary of 4010 Cases by the Same Surgeon. (PDF, 295 KB)Journal of Andrology, 2004.