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8 Evaluation of Men Jump to section + Causes of male infertility include infection, injury, toxin exposures, anatomic variances, chromosomal abnormalities, systemic diseases, and sperm antibodies. These patients are often tall and severely oligospermic or azoospermic. Metformin (Glucophage) is another type of medication that may help you ovulate normally if you have insulin resistance or PCOS (polycystic ovarian syndrome).

Is Congenital Bilateral Absence of Vas Deferens a Primary Form of Cystic Fibrosis? 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.

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A small ejaculate volume may be observed in patients with retrograde ejaculation, absence of the vas deferens or seminal vesicles, ductal obstruction, hypogonadotropism, or poor sympathetic response. Estimating the prevalence of infertility in Canada [published correction appears in Hum Reprod. After interviewing the couple together, the man and woman should be interviewed separately to obtain confidential information. 8  A normal sample according to the 2010 World Health Organization (WHO) guidelines is described in Table 2. The good news is that most cases of male infertility can be resolved either by treating the problem or using fertility treatments.

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If a severe sperm defect is discovered, the testing on the female partner should be modified, and therapy can be immediately directed to the sperm problem. A woman with a suspicion of chronic anovulation most probably due to polycystic ovary (PCO) syndrome, as there is a long history of irregular cycles and clinical presentation with hirsutism, her serum levels of testosterone hormone, sex hormone binding globulin (SHBG), dihydroepiandrostenedione (DHEA), dihydroepiandrostenedione-sulfate (DHEAS) and prolactin should be evaluated to prove the provisional diagnosis and to detect the source of excess androgens. Poor egg quality: Eggs that are damaged or develop genetic abnormalities cannot sustain a pregnancy. 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. As an antiestrogen, CC requires that the patient have some circulating estrogen levels; otherwise, the patient will not respond to the treatment. This test is performed early in the menstrual cycle after bleeding has stopped but prior to ovulation.

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It will take time until these studies can be available for clinics and patients as a regularity. Algorithm for infertility evaluation. (ART = assisted reproductive technology.) Infertility Evaluation Figure 1. Corticosteroids are usually used to reduce the production of testosterone. Sertoli-cell-only syndrome (germinal cell aplasia) Patients with germinal cell aplasia have LH and testosterone levels within the reference range but have an increased FSH level. If there's a problem with the mucus, it can make it harder to conceive. Treatment of tubal obstruction generally requires referral for subspecialty care. For men, a visual inspection of sexual characteristics can identify such endocrinopathies as hypogonadism (a condition resulting in atrophy or deficient development of secondary sexual characteristics) or Klinefelter’s syndrome (a genetic anomaly often associated with infertility). Causes of Sterility in Women In women, the classification of possible causes is much more complex. Calcification of the Seminal Vesicles and Vas Deferens in a Uremic Patient. (PDF, 3 MB) The Journal of Urology, 1971. Causes in women Infertility in women can also have a range of causes. 6 The initial history should cover menstrual history, timing and frequency of intercourse, previous use of contraception, previous pregnancies and outcomes, pelvic infections, medication use, occupational exposures, substance abuse, alcohol intake, tobacco use, and previous surgery on reproductive organs. Radiation therapy: This can impair sperm production. Gonadotropin-releasing hormone (Gn-RH) analogs: These can help women who ovulate too early—before the lead follicle is mature—during hmG treatment. However, until approximately age 64, a man’s age does not affect sperm or the ability to fertilize eggs. These include advancing maternal age, severe male factor infertility (whereby ICSI can be used to fertilize the egg), and endometriosis, amongst many others. Possible problems could be that the egg is not released at the optimum time for fertilization, that it may not enter the fallopian tube, sperm may not be able to reach the egg, fertilization may fail to occur, transport of the zygote may be disturbed, or implantation fails. Quantitative Evaluation of Spermatogenesis by Testicular Histology in Men with Congenital Absence of the Vas Deferens Undergoing Epididymal Sperm Aspiration. (PDF, 3 MB) Human Reproduction, 1990.