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Low testosterone (male hypogonadism) and other hormonal problems have a number of possible underlying causes. Intracytoplasmic Sperm Injection. (PDF, 4 MB) Chapter 47 from textbook Current Therapy in Equine Reproduction, 2006.

There may be testicular malformations, hormone imbalance, or blockage of the man's duct system. In terms of deliveries per egg retrieval, GIFT has a higher success rate than IVF regardless of the woman’s age – approximately 28%. 8,45 Figure 1 provides an algorithmic approach to the evaluation of infertility.   Enlarge      Print Infertility Evaluation Figure 1. It's used to remove polyps and fibroid tumors, divide scar tissue, and open up blocked tubes. 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.

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Evaluation of cervical mucus is unreliable; therefore, investigation is not helpful with the management of infertility. The impact of small or single polyps is more controversial. With this treatment, the patient experience spermatogenesis, and therefore, it has the chance to have offspring if he wants to. Teratozoospermia is when there are a large number of sperms with abnormal morphology.

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Ultrastructure of Human Sperm in Men with Congenital Absence of the Vas Deferens: Clinical Implications. (PDF, 2 MB) Fertility and Sterility, 1992. A small number of specimens have acceptable original concentrations of motile sperm but poor recoveries with the gradient system. Tests and trials are available, but testing does not always reveal a specific cause. Ovulation-inducing drugs and ovarian cancer risk: results from an extended follow-up of a large United States infertility cohort. Some causes, such as hyperprolactinemia, are reversible with proper treatment. Some uterine and tubal abnormalities, such as adhesions, uterine septum, or fibromyoma, may be corrected by surgical procedures.

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Patients should undergo an MRI or CT scan of the sella turcica for diagnostic purposes to determine whether a microprolactinoma or a macroprolactinoma is present. Bromocriptine is used in cases when anovulation is caused by an elevated level of the hormone prolactin. If no improvement occurs, depending on the amount of functional sperm recovery after the sperm wash, the decision must be made to proceed with either intrauterine insemination or in vitro fertilization. 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.