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Gerrits T, Shaw M (2010). "Biomedical infertility care in sub-Saharan Africa: a social science review of current practices, experiences and view points". If they're damaged, it can seriously affect the quality of your semen.

9 Because anxiety over infertility may cause increased stress and decreased libido, further compounding the problem, formal counseling is encouraged for couples experiencing infertility. Sperm density Normal sperm density is greater than 20 million sperm/mL. In reproductive medicine, the most common surgical procedures are laparoscopy, hysteroscopy, and abdominal myomectomy (removal of uterine fibroids). Ovary Transplantation for Fertility Preservation in Cancer Patients: Fresh and Frozen. (PDF, 1 MB) Chapter 42 from textbook Clinial Infertility, 2010.

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A decreased testosterone level with an increased FSH level points to primary hypogonadism. Ovulation disorders can be treated with ovulation-inducing drugs. If conception does not occur after many months or years of trying, it can lead to stress and possibly depression.

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Noonan syndrome (46, XY) Patients with Noonan syndrome, also known as male Turner syndrome, have physical characteristics similar to that of women with Turner syndrome (45, X). The couples are not always consciously aware that they really are not interested in having children, but their sexual behavior reflects this attitude, e.g., in having sexual intercourse only after ovulation. Endometriosis Endometriosis is a condition where small pieces of the womb lining (the endometrium) start growing in other places, such as the ovaries. Theoretically, with this therapy, we can get artificial gamets in vitro.

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Evaluation of the uterus and fallopian tubes can be performed by hysterosalpingography in women with no risk of obstruction. These time intervals would seem to be reversed; this is an area where public policy trumps science. Tubal occlusion is a cause of infertility because an ovulated egg is unable to be fertilized by sperm or to reach the endometrial cavity. Adverse effects of metformin include GI intolerance, nausea, vomiting, and abdominal cramps. Factors effecting normal expectancy of conception. As part of the fertility evaluation, we will perform an HSG, a test designed to evaluate if the fallopian tubes are open.