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Understanding the normal reproductive process is essential in knowing when to seek help. Role of Epididymis in Sperm Maturation. (PDF, 3 MB) Urology, 1989. Evaluating the Infertile Male – Part 1. (PDF, 5 MB) Contemporary OB/GYN, 2004.

1) Advancing maternal age: Historically before the latter 20th century, women were conceiving in their teens and twenties, when age-related abnormalities with the egg were not evident. The Three-kidney Rat Model. (PDF, 2 MB) Investigative Urology, 1974. 8,46 Obesity impairs fertility and the response to fertility treatments, including in vitro fertilization; therefore, it is advisable to counsel patients who are obese to lose weight before conception or infertility treatments. Microsurgery for the Undescended Testicle. (PDF, 5 MB) Urologic Clinics of North America, 1982. It will take time until these studies can be available for clinics and patients as a regularity.

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Fertilizing Capacity of Epididymal and Testicular Sperm using Intracytoplasmic Sperm Injection (ICSI). (PDF, 7 MB)Reproduction, Fertility and Development, 1995. Article Sections Infertility is defined as the inability to achieve pregnancy after one year of regular, unprotected intercourse. Author disclosure: No relevant financial affiliations.

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Vasoepididymostomy to the Head of the Epididymis: Recovery of Normal Spermatozoal Motility. (PDF, 3 MB)Fertility and Sterility, 1980. Twelve months is the lower reference limit for Time to Pregnancy (TTP) by the World Health Organization.[7] a woman over 35 has not conceived after six months of contraceptive-free sexual intercourse. Male infertility tests: Going under the microscope Identifying the cause of a man's infertility is as much an art as a science. “The first step is an evaluation by a physician specializing in male infertility,” says Stephen Shaban, MD, a urologist specializing in male reproductive medicine and microsurgery in Raleigh, North Carolina. 9 Because anxiety over infertility may cause increased stress and decreased libido, further compounding the problem, formal counseling is encouraged for couples experiencing infertility. During this time, the cells cross from the basal to the adluminal compartments.

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Lack of pregnancy Lack of pregnancy can be related to disruption of the cervical mucus, inadequate follicular development, presence of luteinized unruptured follicle syndrome, progesterone deficiency, and premature administration of hCG to trigger ovulation. 17 Evaluation of male infertility starts with a history and physical examination focusing on previous fertility, pelvic or inguinal surgeries, systemic diseases, and exposures. Fertility treatments for men Treatment will depend on the underlying cause of the infertility. The couples are not always consciously aware that they really are not interested in having children, but their sexual behavior reflects this attitude, e.g., in having sexual intercourse only after ovulation. Pretesticular causes of infertility Pretesticular causes of infertility include congenital or acquired diseases of the hypothalamus, pituitary, or peripheral organs that alter the hypothalamic-pituitary axis. Showell MG, Brown J, Yazdani A, Stankiewicz MT, Hart RJ. The World Health Organization (WHO) published reference ranges for semen testing in 2010. [45] These include “lower reference limits” representing the 5th percentiles for semen characteristics. [46] Note that the lower reference limits do not serve as a cut-point between “fertile” and “infertile.” Volume Normal ejaculate volume is 1. About 25% of all infertility is caused by a sperm defect and 40-50% of infertility cases have a sperm defect as the main cause, or a contributing cause. The use of Epididymal and Testicular Spermatozoa for Intracytoplasmic Sperm Injection: The Genetic Implications for Male Infertility. (PDF, 8 MB) Human Reproduction, 1995. They may go unnoticed until a man tries to have a baby. Moderate alcohol consumption has not been shown to lower fertility in most men, but it may affect those who already have a low sperm count. Temperature charting is a useful way of providing early clues about anovulation, and can help gynaecologists in their diagnosis. Semen quality Semen is initially a coagulum that liquefies in 5-25 minutes due to prostatic enzymes.