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A smaller amount may suggest a structural or hormonal problem leading to deficient semen production; 2) sperm concentration – normal concentration should be at least 20 million sperm per 1 ml of semen. Up to 2 percent of men are thought to have suboptimal sperm.

For example, endometriosis can cause infertility with the growth of endometrial tissue in the Fallopian tubes or around the ovaries. For patients with a history of endometriosis, pelvic infections, or ectopic pregnancy, evaluation with hysteroscopy or laparoscopy is recommended.

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Women with regular menstrual cycles are likely to be ovulating and should be offered serum progesterone testing at day 21 to confirm ovulation. High cortisol levels may also be seen with exogenous steroid use, such as that administered to patients with ulcerative colitis, asthma, arthritis, or organ transplant. A high serum estradiol level (greater than 60 to 80 pg per mL [220 to 294 pmol per L]) in conjunction with a normal FSH level has also been associated with lower pregnancy rates. As new technology becomes available, fertility treatment is now accessible to more people, and success rates and safety are improving all the time. World Health Organization reference values for human semen characteristics. Testis Biopsy and the Infertile Male. (PDF, 20 MB) Chapter 15 from textbook Office Andrology, 2005.

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Preliminary Tests of a New Reversible Male Contraceptive in Bush Dog, Speothos Venaticus: Open-ended Vasectomy and Microscopic Reversal. (PDF, 106 KB) Journal of Zoo and Wildlife, 2006. Reduced fecundability in women with prenatal exposure to cigarette smoking. Epididymal Extravasation Following Vasectomy as a Cause for Failure of Vasectomy Reversal. (PDF, 22 MB)Fertility and Sterility, 1979. After repair, 40-70% of patients have improved semen parameters, while 40% are able to impregnate their partner without other interventions. Usually no more than 1 – 2 embryos are transferred, and therefore additional embryos can be frozen, or cryopreserved, for future use; 3) embryo donation – a process where a fully developed embryo from another person in combination w/donor sperm, or couple who underwent IVF, are donated to another woman, the future intended mother, for transfer into her uterus; and 4) gestational surrogacy – a process where another woman will undergo an embryo transfer and carry the pregnancy for another person. One type of ovulation problem, polycystic ovarian syndrome, is effectively treated with medications.

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The most commonly prescribed injections that stimulate the ovary are called gonadotropins. Exposure to chemicals: Pesticides, for example, may increase the risk. Paternal age > or = 40 years: an important risk factor for infertility. The epididymis is a coil-like structure in the testicles which helps store and transport sperm. Some methods may be used in concert with other methods. The most commonly prescribed pill to stimulate ovulation (generally of one mature egg) is clomiphene citrate. The gonadotropins in these formulations are FSH, and in some cases, a combination of FSH and LH (luteinizing hormone). Clinical Asst Professor, Obstetrics and Gynecology.