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If he has two X chromosomes and one Y chromosome, as in Klinefelter's syndrome, the testicles will develop abnormally and there will be low testosterone and a low sperm count or no sperm. Y Chromosome Deletions in Azoospermic and Severely Oligozoospermic Men Undergoing Intracytoplasmic Sperm Injection after Testicular Sperm Extraction. (PDF, 336 KB) Human Reproduction, 1998. Seminoma Discovered in Two Males Undergoing Successful Testicular Sperm Extraction for Intracytoplasmic Sperm Injection. (PDF, 807 KB) Human Reproduction, 1995. Surgery or embolization for varicoceles in subfertile men. On Regenerating the Ovary and Generating Controversy. (PDF, 37 KB) Cell, 2005.

In fact, the “window of opportunity” for fertilization is thought to last only a few hours, thus requiring sperm availability in the female genital tract at or shortly before ovulation. Tumors Cancers and nonmalignant tumors can affect the male reproductive organs directly, through the glands that release hormones related to reproduction, such as the pituitary gland, or through unknown causes. Especially in men, psychological explanations should be considered as they are frequently the cause of sexual dysfunctions. For example, polycystic ovarian syndrome is when the eggs only partially developed within the ovary and there is an excess of male hormones. Thyroid dysfunction can halt ovulation by upsetting the balance of the body’s natural reproductive hormones. Approximately 10% of cases are unexplained, where no definitive cause can be identified.

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18  If the semen analysis result is abnormal, further evaluation is indicated (Table 36–8,10,19,20). It can also help if a man has severe erectile dysfunction.

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Abdominal myomectomy is a surgical procedure performed through a very low horizontal abdominal incision allowing access to the uterus for removal of fibroids. As treatment begins, couples may experience cycles of optimism and despair with each passing menstrual cycle. Celiac disease A digestive disorder caused by sensitivity to gluten, celiac disease can cause male infertility.

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Oei SG, Helmerhorst FM, Bloemenkamp KW, Hollants FA, Meerpoel DE, Keirse MJ. The findings of the biopsy help determine whether the endometrium is adequately developed to support implantation and growth of a fertilized egg. Other causes may include: Genetic factors: A man should have an X and Y chromosome. Those with a varicocele diagnosable only on scrotal ultrasonography have subclinical varicoceles and will likely not benefit from repair. Bromocriptine (Parlodel): This drug inhibits prolactin production. It has been proven useful in overcoming infertility conditions, such as blocked or damaged tubes, endometriosis, repeated IUI failure, unexplained infertility, poor ovarian reserve, poor or even nil sperm count. Primary spermatocytes undergo meiosis as the cells successively pass through the preleptotene, leptotene, zygotene, and pachytene stages to become secondary spermatocytes. Effect of male age on fertility: evidence for the decline in male fertility with increasing age. Exposure to chemicals: Pesticides, for example, may increase the risk. If the E2 level is below 100 pc/mL and the sonogram shows small follicular development, hMG is increased to 150 IU/day for an additional 5 days. Most couples (approximately 85%) will achieve pregnancy within one year of trying, with the greatest likelihood of conception occurring during the earlier months. IVF was a major breakthrough because it allowed for successful pregnancies in women that were previous deemed permanently infertile, such as when the fallopian tubes are both markedly damaged. Menstrual blood is usually bright red at the beginning of a person's period and may get darker over the following days. Causes of Female Infertility (Continued) Other causes of female infertility include: Local factors in the uterus and cervix, including uterine septum, uterine fibroids and endometriosis. Due to improved patient outcomes, in the last two decades, laparoscopic surgery has been adopted by various surgical sub-specialties, including gastrointestinal surgery (including bariatric procedures for morbid obesity), gynecologic surgery, and urology. Tumors Cancers and nonmalignant tumors can affect the male reproductive organs directly, through the glands that release hormones related to reproduction, such as the pituitary gland, or through unknown causes. Testis Biopsy and the Infertile Male. (PDF, 20 MB) Chapter 15 from textbook Office Andrology, 2005.