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Key to the diagnosis of male infertility is a semen analysis, which assesses primarily sperm numbers, sperm movement and sperm form. GnRH travels down the portal system to the anterior pituitary, located on a stalk in the sella turcica, to stimulate the release of the gonadotropins, luteinizing hormone (LH), and follicle-stimulating hormone (FSH). Laparoscopy for Cryptorchidism. (PDF, 1 MB) The Journal of Urology, 1980. 8) Unexplained/other: Sometimes a full evaluation does not reveal the cause of infertility. Thyroid problems: An overactive or underactive thyroid gland can lead to a hormonal imbalance. We recommend immediate evaluation for a couple attempting pregnancy when the woman has a prior history of pelvic infection.

There is no reliable treatment, although microsurgery may be attempted. If oligospermia or azoospermia is noted, hypogonadism should be suspected.

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Hyperprolactinemia: If prolactin levels are high, and the woman is not pregnant or breastfeeding, it may affect ovulation and fertility. To reach timely ovulations, ovulation triggers are combined with chorionic gonadotropin (beta-HCG). Clomiphene citrate and/or Metformin. - folliculometry via TVUSS should be done to avoid multiple pregnancies and risk of OHSS. - Not for more than 6 months. Role of Epididymis in Sperm Maturation. (PDF, 3 MB) Urology, 1989. Varicocele The veins in a man’s scrotum (sac) can become too large.

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Ideally, using strict morphology criteria, a minimum of 5 – 15% normal forms leads to a better ability for sperm to fertilize the egg. An abnormal semen analysis warrants a further evaluation usually by a reproductive urologist. Microsurgical Reversal of Tubal Sterilization: Factors Affecting Pregnancy Rate, with Long-term Follow-up. (PDF, 2 MB) Obstetrics & Gynecology, 1984. The rate increases to 10-12% after CC ovulation induction and to 12-15% per cycle after hMG/hCG ovulation induction. The views expressed in this material are those of the authors, and do not reflect the official policy or position of the U. Unexplained infertility in women or men may be managed with another year of unprotected intercourse, or may proceed to assisted reproductive technologies, such as intrauterine insemination or in vitro fertilization.

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Calcification of the Seminal Vesicles and Vas Deferens in a Uremic Patient. (PDF, 3 MB) The Journal of Urology, 1971. Endometrial biopsy should be performed only in women with suspected pathology (chronic endometritis or neoplasia). Several days later, embryos -- or fertilized eggs -- get put back into your uterus with a device called an intrauterine insemination catheter. KU School of Medicine Source : Are Twins An Adverse Outcome After Infertility Treatments? In the United States, around 10 percent of women aged 15 to 44 years are estimated to have difficulty conceiving or staying pregnant. As they respond to hormones the same way as they would do in the uterus, that is by growing and shedding cyclically, endometriosis can cause both fallopian tube and ovarian scarring. Couples who do not conceive after treatment for six cycles with documented ovulation should also consider referral to an infertility specialist.