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As in the case of sterility, the process will get under way right away in those cases where there is a background of reproduction issues. These time intervals would seem to be reversed; this is an area where public policy trumps science. Source : (1).pptx Evaluation of Fertility: A Cornerstone to Improved ... Varicocele: Surgically removing a varicose vein in the scrotum may help. In women whose ovulation is suppressed by hyperprolactinemia (high blood levels of the pituitary hormone prolactin), ovulation may be induced with prolactin-suppressing drugs. Similarly, there is no need for testing tubal patency for couples who will require IVF or ICSI procedure.

Aetiology of Congenital Absence of Vas Deferens: Genetic Study of Three Generations. (PDF, 4 MB) Human Reproduction, 1993. Generally, evaluation should be offered to couples who have not conceived after one year of unprotected vaginal intercourse. Some causes, such as hyperprolactinemia, are reversible with proper treatment. Intrauterine insemination (IUI): At the time of ovulation, a fine catheter is inserted through the cervix into the uterus to place a sperm sample directly into the uterus.

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Congenital disorders and chryptorchidism (undescended testicles). Some suggest that the number of times a couple has intercourse should be reduced to increase sperm supply, but this is unlikely to make a difference. Intra-uterine insemination for unexplained subfertility. In 1978, the first baby was born as a result of IVF. Just before those eggs would otherwise be ovulated, they are retrieved under mild anesthesia in an operating room. Hysterosalpingo-contrast-ultrasonography - TVS scan during which air and saline or a solution of D-galactose is infused into the uterine cavity and observed to flow along the fallopian tubes. - Requires more expertise. - Less invasive.

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Listen to Professor Cheong talk about the fertility investigations we offer       Repeated pregnancy loss Some people may not have difficulty conceiving, but have suffered from miscarriages. Microsurgery of the Male Genitalia for Infertility. (PDF, 8 MB) Chapter 59 from Reconstructive Urologic Surgery, 1994.

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Surgical ablation: - In minimal or mild endometriosis; surgical ablation or resection of endometriosis plus laparoscopic adhesiolysis improves the chance of pregnancy. - Laparoscopic resection of endometriomas may be beneficial, however recent RCTs suggest intervention only in endometriomas > 4cm. - In moderate or sever endometriosis; surgical treatment should be offered. (Debatable) - Post-operative medical treatment does not improve pregnancy rates. Varicocele: Surgically removing a varicose vein in the scrotum may help. Abnormal sperm: The sperm may have an unusual shape, making it harder to move and fertilize an egg. Androgen receptor dysfunction Because the androgen receptor is essential for the process of spermatogenesis, dysfunctions in this receptor can cause infertility. Testicular Neoplasm in Father and Son. (PDF, 561 KB) The Journal of Urology, 1972. This process bypasses the normal fertilization process, which may be compromised due to poor sperm function.