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Malformation of the eggs themselves may complicate conception. The Use of Epididymal Sperm in Assisted Reproduction. (PDF, 8 MB) Chapter from textbook, Frontiers in Endocrinology: Perspectives on Assisted Reproduction, 1994.

Men can still ejaculate with a low sperm count or poor-quality sperm. Treatment is with human menopausal gonadotropin (HMG) or exogenous FSH. Postcoital testing and antisperm antibody testing are no longer considered useful in this evaluation. The CC response is monitored using pelvic ultrasonography starting on menstrual cycle day 12.

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Intracytoplasmic sperm injection (ICSI.)A single sperm is injected through a tiny needle into an egg. Patients with azoospermia or severe oligospermia are more likely to have a chromosomal abnormality (10-15%) than infertile men with sperm density within the reference range (1%). A postcoital test to determine if sperm are able to move through the cervical mucus is still performed by some clinicians. Female factor Dysfunction of the female reproductive organs is also apparent in around 40% of infertile couples. Clomiphene citrate (Clomid, Serophene) The chemical formula for clomiphene citrate (CC) is 2-[p -(2-chloro-1,2-difhenylvinyl) phenoxy] triethylamine dihydrogen citrate.

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If the woman is aged over 35 years, the couple may wish to see a doctor earlier, because fertility testing can take time, and female fertility starts to drop when a woman is in her 30s. Injuries to the bowel can cause a delayed peritonitis. Infertility caused by DNA defects on the Y chromosome is passed on from father to son. Varicocele The veins in a man’s scrotum (sac) can become too large. Weight loss in obese infertile women results in improvement in reproductive outcome for all forms of fertility treatment. For conception, sperm must reach the cervix, penetrate the cervical mucus, migrate up the uterus to the fallopian tube, undergo capacitation and the acrosome reaction to digest the zona pellucida of the oocyte, attach to the inner membrane, and release its genetic contents within the egg.

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Testicular Transplantation and Autotransplantation. (PDF, 8 MB) Chapter 22 of textbook, Extracorporeal and Microvascular Surgery, 1982. Microsurgery for the Undescended Testicle. (PDF, 5 MB) Urologic Clinics of North America, 1982. Down syndrome These patients have mild testicular dysfunction with varying degrees of reduction in germ cell number. Isodicentric Y Chromosomes and Sex Disorders as Byproducts of Homologous Recombination that Maintains Palindromes. (PDF, 1 MB) Cell, 2009. After repair, 40-70% of patients have improved semen parameters, while 40% are able to impregnate their partner without other interventions. A paper published in JAVMA (Journal of the American Veterinary Medical Association) in 2005 showed that dogs spayed laparoscopically experienced significantly less pain (65%) than those that were spayed with traditional "open" methods.[8] Arthroscopy, thoracoscopy, cystoscopy are all performed in veterinary medicine today. If fertilization occurs, the developing embryos remain in the fallopian tube and then move to the uterus for the natural implantation process to be completed. Reducing the risk of multiple pregnancies Injectable fertility drugs can sometimes result in multiple births, for example, twins or triplets. For example, treatment for Hodgkin disease has been estimated to lead to infertility in as many as 80-100% of patients. As a woman gets older, the number of her eggs decreases rapidly. Laparoscopic and thoracoscopic surgery belong to the broader field of endoscopy. Your physician will refer you to a reproductive urologist if appropriate.