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8) Unexplained/other: Sometimes a full evaluation does not reveal the cause of infertility. Depending on the therapeutic agent and the duration of treatment, endometriosis can be treated with oral contraceptives, progestins, androgens, or GnRH agonists. Suspect antisperm antibodies when semen analysis reveals abnormal clumping, agglutination, unexplained decreased motility, or an abnormal postcoital test result. It is hoped that the standardized approach presented here will go some way towards countering this major problem.LINDSAY, MD, Saint Louis University Family Medicine Residency, Belleville, Illinois KIRSTEN R. Infant Source : Fertility And Family Fembryo PPT Presentation Summary : FERTILITY AND FAMILY.

ART procedures, such as GIFT, IVF, and ICSI, also can be used in cases of male infertility. These may cause abortion, neonatal death, fetal resorption, and apparent infertility. Linthicum, Md.: American Urological Association, Inc.; 2010.

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Endometriosis can only be confirmed by surgery, usually laparoscopy. Povey AC, Clyma JA, McNamee R, et al.; Participating Centres of Chaps-UK. 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. These risks include: Age (past age 40, men experience more fertility problems). Mumps: If this occurs after puberty, inflammation of the testicles may affect sperm production.

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Progesterone deficiency can be corrected by the administration of progesterone during the luteal phase, starting 48 hours after ovulation. [204] Patients with hyperprolactinemia need a thorough evaluation to exclude a pituitary microadenoma. These microdeletions are not observed on regular karyotype testing; rather, their identification requires polymerase chain reaction (PCR)–based sequence-tagged site mapping or Southern blot analysis. Patients may be candidates for assisted reproduction techniques after appropriate genetic screening in the partner.[29] Acquired blockage of the ductal system Genital ducts may become obstructed secondary to infections, such as chlamydia, gonorrhea, tuberculosis, and smallpox.

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Causes of Male Infertility Male infertility may be a result of some conditions that affect the quality of sperm, lead to low sperm production (oligospermia), or lead to the absence of sperm production (azoospermia). In 1978, the first baby was born as a result of IVF. Calcification of the Seminal Vesicles and Vas Deferens in a Uremic Patient. (PDF, 3 MB) The Journal of Urology, 1971. Successful Pregnancy and Delivery after Calcium Ionophore Oocyte Activation in a Normozoospermic Patient with Previous Failed Fertilization after Intracytoplasmic Sperm Injection. (PDF, 57 KB) Fertility and Sterility, 2003. These questions will be regarding your medical, surgical, gynecological, and obstetric history, as well as some lifestyle questions. Primary testicular causes of infertility Primary testicular problems may be chromosomal or nonchromosomal in nature. An evaluation by a physician is the only way to sort it out. Additionally, because insulin-like growth factor (IGF) has been shown to have an effect on semen quality, its role in varicocele pathology has been studied.[25] One study showed that IGF levels significantly increased after a varicocelectomy to levels that were no different than fertile controls, suggesting that varicocele-related infertility may involve IGF.[26] Varicoceles lead to an increased incidence of sperm immaturity, apoptosis, and necrosis with severe disturbances in meiotic segregation compared to fertile men without varicoceles, and these parameters generally improve after repair. 3) Tubal occlusion (blockage): As discussed previously, a history of sexually transmitted infections including chlamydia, gonorrhea, or pelvic inflammatory disease can predispose a woman to having blocked fallopian tubes. Many health conditions can make it hard to get pregnant. No consensus exists as to whether the medical treatment should precede surgery or vice versa. [154, 155, 156] Those who prefer medical treatment first argue that the size of the endometriosis decreases; therefore, surgery will be easier and shorter.