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CI or intrauterine insemination is the treatment of choice if more than 2 million sperm are recovered after the sperm wash. (See Treatment of Cervical Factors). [106, 109] Patients whose reproductive tract, FSH, LH, and testosterone levels are determined to be normal or those who have low testosterone in the absence of any other hormonal abnormalities can be treated empirically with cycles of CC (25 mg PO qd for at least 6-12 mo). Fimbrial phimosis and periadnexal disease can be treated with laparoscopy. [134, 135, 136, 137, 138] The pregnancy rate after salpingolysis is 50-60% during the first year after treatment. In-vitro fertilization (IVF): Sperm are placed with unfertilized eggs in a petri dish, where fertilization can take place.

What Forms of Male Infertility are there left to Cure? (PDF, 2 MB) Human Reproduction, 1995. It can either be used to inspect and diagnose certain conditions or to surgically correct an abnormality such as removing scar tissue, endometriosis, or a damaged fallopian tube. Microsurgery for the Undescended Testicle. (PDF, 5 MB) Urologic Clinics of North America, 1982.

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In 30% of all cases, the cause is in both partners: combined sterility. Ovulation induction in polycystic ovary syndrome [published corrections appear in J Obstet Gynaecol Can. Microcirugía y fertilición in vitro para la azoospermia obstructiva. (PDF, 5 MB) Chapter 14 from textbook, Avances en reproducción asistida, 1992. Problems in the uterus or fallopian tubes can prevent the egg from traveling from the ovary to the uterus, or womb. 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.

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Uterine surgery: - Women with amenorrhoea who are found to have intrauterine adhesions should be offered hysteroscopic adhesiolysis because this is likely to restore menstruation and improve the chance of pregnancy. Surgical ablation: - In minimal or mild endometriosis; surgical ablation or resection of endometriosis plus laparoscopic adhesiolysis improves the chance of pregnancy. - Laparoscopic resection of endometriomas may be beneficial, however recent RCTs suggest intervention only in endometriomas > 4cm. - In moderate or sever endometriosis; surgical treatment should be offered. (Debatable) - Post-operative medical treatment does not improve pregnancy rates. However, in our modern era, women are delaying child birth until their thirties and forties, which has lead to the discovery of the adverse effect of advanced maternal age on egg function. Known male factor semen abnormalities: If a male partner has a history of infertility with a prior partner, or if there are abnormalities on his semen analysis, then we advise earlier fertility evaluation, ideally within 6 months of attempting pregnancy. Even if you are diagnosed with infertility, you may still be able to conceive.Continued Hysteroscopy . In this procedure, your doctor places a hysteroscope into your uterus through your cervix. Abnormal sperm: The sperm may have an unusual shape, making it harder to move and fertilize an egg.

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Medication. If you have ovulation problems, you may be prescribed drugs such as clomiphene citrate (Clomid, Serophene), gonadotropins (such as Gonal-F, Follistim, Humegon and Pregnyl), or letrozole. London, United Kingdom: National Institute for Health and Clinical Excellence (NICE); February 2013:1–63. (Clinical guideline no. The increase of gonadotropins can provoke ovulation. If the sperm are of good quality and the mechanics of the woman's reproductive structures are good (patent fallopian tubes, no adhesions or scarring), a course of ovulation induction maybe used. The surgery is performed during the early follicular phase. Gracia CR, Sammel MD, Coutifaris C, Guzick DS, Barnhart KT. 50% are female causes with 25% being due to anovulation and 25% tubal problems/other.[74] In Sweden, approximately 10% of couples wanting children are infertile.[75] In approximately one third of these cases the man is the factor, in one third the woman is the factor, and in the remaining third the infertility is a product of factors on both parts. Factors contributing to the formation of antisperm antibodies in women are disturbance of normal immunoregulatory mechanisms, infection, violation of the integrity of the mucous membranes, rape and unprotected oral or anal sex. New Concepts in Operative Andrology: A Review. (PDF, 7 MB) International Journal of Andrology, 2000. In cases when the quality of sperm is very poor, or sperm is completely absent in the ejaculate (azoospermia), donor’s sperm can be used (if culturally acceptable).