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22 Treatment of Male Infertility Jump to section + Underlying etiology determines the therapeutic course, although male infertility is unexplained in 40% to 50% of cases. This test is based on the fact that the ovaries produce progesterone in the second half of the menstrual cycle after a woman has ovulated.

Infection and Disease: Mumps, tuberculosis, brucellosis, gonorrhea, typhoid, influenza, smallpox, and syphilis can cause testicular atrophy.  A low sperm count and low sperm motility are indicators of this condition.  Also, elevated FSH levels and other hormonal problems are indicative of testicular damage.  Some STDs like gonorrhea and chlamydia can cause infertility by blocking the epididimis or tubes.  These conditions are usually treated by hormonal replacement therapy and surgery in the case of tubular blockage. Other considerations include preconception screening and vaccination for preventable diseases such as rubella and varicella, sexually transmitted infections, and cervical cancer, based on appropriate guidelines and risk. Causes[edit] Hormonal imbalance[edit] This is the most common cause of anovulation and is thought to account for about 70% of all cases.

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Disadvantages of IVF include failure to conceive, OHSS and expensiveness. The likelihood of fertilization improves significantly for men with low sperm concentrations. The acrosome should be 40-70% of the size of the head, and no mid piece or tail abnormalities should be present. Severe ovarian hyperstimulation syndrome is characterized by easily palpable ovaries, severe ascites, nausea, vomiting, diarrhea, shortness of breath, hydrothorax, peripheral edema, oliguria, hemoconcentration (eg, hematocrit level >48% and hemoglobin level >16 g), and creatinine level greater than 1.

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If ovulation does not occur with the 50-mg dose, the CC dose must be increased in subsequent cycles to 100 mg for 5 days. On Regenerating the Ovary and Generating Controversy. (PDF, 37 KB) Cell, 2005. Once a follicle containing an egg reaches a mature size, another hormone injection called HCG is often given to mimic the natural LH surge that occurs at the time of ovulation. 8,26,27 As opposed to laparoscopy or hysteroscopy, hysterosalpingography is a minimally invasive procedure with potentially therapeutic effects and should be considered before more invasive methods of assessing tubal patency. 0.[44] Environmental factors Toxins such as glues, volatile organic solvents or silicones, physical agents, chemical dusts, and pesticides.[45][46] Tobacco smokers are 60% more likely to be infertile than non-smokers.[47] German scientists have reported that a virus called adeno-associated virus might have a role in male infertility,[48] though it is otherwise not harmful.[49] Other diseases such as chlamydia, and gonorrhea can also cause infertility, due to internal scarring (fallopian tube obstruction).[50][51][52] Alimentary habits[53] Obesity: The obesity epidemic has recently become is a serious issue, particularly in industrialized nations.

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Adding recombinant human FSH to HCG has been shown to be effective in achieving spermatogenesis in most patients.[18] Select patients with adult-onset idiopathic hypogonadotropic hypogonadism may respond to clomiphene citrate therapy.[19] Prader-Willi syndrome Patients have characteristic obesity, mental retardation, small hands and feet, and hypogonadotropic hypogonadism due to a GnRH deficiency. In vitro fertilization (IVF). In this technique, your doctor places into your uterus that were fertilized in a dish. Signs and Symptoms of Infertility Signs and symptoms of infertility are often related to other underlying conditions. Other factors that can affect a woman's chances of conceiving include being overweight or underweight,[56] or her age as female fertility declines after the age of 30.[57] Sometimes it can be a combination of factors, and sometimes a clear cause is never established. Sterility can affect both men and women, with the cause involving either one or both parties. In all cases, however, the pain is transient, as the body tissues will absorb the CO2 and eliminate it through respiration.[28] Coagulation disorders and dense adhesions (scar tissue) from previous abdominal surgery may pose added risk for laparoscopic surgery and are considered relative contra-indications for this approach. Coutifaris C, Myers ER, Guzick DS, et al.; NICHD National Cooperative Reproductive Medicine Network. Also possible is increased body mass and facial hair, which is relatively easy to treat, and is often associated with PCOS, or polycystic ovary syndrome. This produces a sensation of pain that may extend to the patient's shoulders. M. genitalium infection is associated with increased risk of infertility.[25][26] Genetic[edit] A Robertsonian translocation in either partner may cause recurrent spontaneous abortions or complete infertility.[citation needed] Mutations to NR5A1 gene encoding Steroidogenic Factor-1 (SF-1) have been found in a small subset of men with non-obstructive male factor infertility where the cause is unknown. IVF and related techniques (ICSI, ZIFT, GIFT) are called assisted reproductive technology (ART) techniques.