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European Association of Urology guidelines on male infertility: the 2012 update. The vas deferens carries sperm from the epididymis to the ejaculatory duct and the urethra. There is still some controversy about their existence, but if the discoveries are true, this could mean a new treatment for infertility.[71] Stem cell therapy is really new, and everything is still under investigation. 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. Fertilization takes place outside the body, and the fertilized egg is reinserted into the woman's reproductive tract, in a procedure called embryo transfer. A variety of disorders ranging from hormonal disturbances to physical problems, to psychological problems can cause male infertility.  Although many treatment options are now available, in many cases treatment will not work.  In many instances, male infertility is caused by testicular damage resulting in an inability of the testicle to produce sperm.  Once damaged, the testicle will not usually regain its sperm-making capabilities; this aspect of male infertility is analogous to menopause (though not natural like menopause) for women and cannot usually be treated.  Despite medicine�s limited ability to treat male infertility, many successful treatment options are available for its many causes.  Besides testicular damage, the main causes of male infertility are low sperm production and poor sperm quality.   The Causes of Male Infertility Male infertility has many causes--from hormonal imbalances, to physical problems, to psychological and/or behavioral problems.  Moreover, fertility reflects a man�s �overall� health.  Men who live a healthy lifestyle are more likely to produce healthy sperm.  The following list highlights some lifestyle choices that negatively impact male fertility--it is not all-inclusive: · Smoking--significantly decreases both sperm count and sperm cell motility. · Prolonged use of marijuana and other recreational drugs. · Chronic alcohol abuse. · Anabolic steroid use--causes testicular shrinkage and infertility. · Overly intense exercise--produces high levels of adrenal steroid hormones which cause a    testosterone deficiency resulting in infertility. · Inadequate vitamin C and Zinc in the diet. · Tight underwear--increases scrotal temperature which results in decreased sperm production. · Exposure to environmental hazards and toxins such as pesticides, lead, paint, radiation, radioactive   substances, mercury,  benzene, boron, and heavy metals · Malnutrition and anemia. · Excessive stress!

The Use of Epididymal Sperm in Assisted Reproduction. (PDF, 8 MB) Chapter from textbook, Frontiers in Endocrinology: Perspectives on Assisted Reproduction, 1994. Treatment of Renal Trauma by Angiographic Injection of Autologous Clot. (PDF, 422 KB) British Journal of Urology, 1974. Thalassemia Patients with thalassemia have ineffective erythropoiesis and undergo multiple blood transfusions. Here, the hormones FSH (= follicle stimulating hormone) and LH (= luteinizing hormone) play an important role. Symptoms of hormonal imbalance: Sudden weight gain, hair loss, constant fatigue, edema, headaches, nipple discharge, facial hair, or severe acne are all signs of possible hormonal disorders. Ovulation disorders appear to be the most common cause of infertility in women.

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However, hormones are not the main problem in 97% of infertile men. The laboratory evaluation begins with a semen analysis. Intracytoplasmic Sperm Injection Today: A Personal Review. (PDF, 5 MB) Human Reproduction, 1998. KU School of Medicine Source : Are Twins An Adverse Outcome After Infertility Treatments? In some cases, the egg may have matured properly, but the follicle may have failed to burst (or the follicle may have burst without releasing the egg). Isodicentric Y Chromosomes and Sex Disorders as Byproducts of Homologous Recombination that Maintains Palindromes. (PDF, 1 MB) Cell, 2009.

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Regression of Metastases after Nephrectomy for Renal Cell Carcinoma. (PDF, 1 MB) British Journal of Urology, 1975. El Uso de las Espermátides en la Azoospermia. (PDF, 12 MB) Chapter 42 from Reproducción Humana, 2002. Cervical factors are also thought to play a minor role, although they are rarely the sole cause. Endometriosis may be treated through laparoscopic surgery. 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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NIH: National Institute of Child Health and Human Development Start Here How Common is Male Infertility, and What Are Its Causes? (National Institute of Child Health and Human Development) Male Infertility (American Academy of Family Physicians) Also in Spanish Male Infertility (Mayo Foundation for Medical Education and Research) Also in Spanish Diagnosis and Tests Diagnostic Testing for Male Factor Infertility (American Society for Reproductive Medicine) - PDF Also in Spanish Semen Analysis (National Library of Medicine) Also in Spanish Testosterone Levels Test (National Library of Medicine) Also in Spanish Treatments and Therapies Assisted Reproductive Technology: MedlinePlus Health Topic (National Library of Medicine) Also in Spanish Healthy Sperm: Improving Your Fertility (Mayo Foundation for Medical Education and Research) Also in Spanish Intracytoplasmic Sperm Injection (ICSI) (American Society for Reproductive Medicine) Also in Spanish Intrauterine Insemination (IUI) (Mayo Foundation for Medical Education and Research) Also in Spanish What Treatment Options Are Available for Male Infertility? (National Institute of Child Health and Human Development) Living With Foods That Can Affect Fertility (Academy of Nutrition and Dietetics) Related Issues Fertility Issues in Boys and Men with Cancer (National Cancer Institute) Finasteride (Propecia/Proscar) and Pregnancy (Organization of Teratology Information Specialists) - PDF Low Testosterone and Men's Health (Hormone Health Network) Also in Spanish Optimizing Male Fertility (American Society for Reproductive Medicine) Specifics Dry Orgasm (Orgasm without Discharge of Semen) (Mayo Foundation for Medical Education and Research) Also in Spanish Low Sperm Count (Mayo Foundation for Medical Education and Research) Also in Spanish Sperm Shape (Morphology): Does It Affect Fertility? (American Society for Reproductive Medicine) Also in Spanish Genetics Genetics Home Reference: 48,XXYY syndrome (National Library of Medicine) Genetics Home Reference: CATSPER1-related nonsyndromic male infertility (National Library of Medicine) Genetics Home Reference: congenital bilateral absence of the vas deferens (National Library of Medicine) Genetics Home Reference: globozoospermia (National Library of Medicine) Genetics Home Reference: macrozoospermia (National Library of Medicine) Genetics Home Reference: sensorineural deafness and male infertility (National Library of Medicine) Genetics Home Reference: X-linked adrenal hypoplasia congenita (National Library of Medicine) Genetics Home Reference: Y chromosome infertility (National Library of Medicine) Learning about Klinefelter Syndrome (National Human Genome Research Institute) Videos and Tutorials Causes of Male Infertility (American Society for Reproductive Medicine) Sperm release pathway (Medical Encyclopedia) Also in Spanish Statistics and Research High Plasticizer Levels In Males Linked to Delayed Pregnancy for Female Partners (National Institute of Child Health and Human Development) Infertility Research at the NICHD (National Institute of Child Health and Human Development) Clinical Trials ClinicalTrials.gov: Infertility, Male (National Institutes of Health) ClinicalTrials.Differences between sterility and infertility (primary and secondary) ARE STERILITY AND INFERTILITY THE SAME? Obesity and increased risk for oligozoospermia and azoospermia. Patients with hyperthyroidism or hypothyroidism must be treated accordingly. [210, 211] Weight reduction should be part of the treatment because it helps the patient's response to ovulation induction. [212] Treatment of Male Factors Asthenospermia associated with varicocele is treated surgically with varicocelectomy or with embolization of the spermatic veins. Patients generally have long arms and legs due to a delayed closure of the epiphyseal plates, delayed puberty, and atrophic testis. Etiologies include cysts (midline and eccentric), ductal calcification and stones, postinfectious, and postoperative. Pregnancies after Testicular Sperm Extraction and Intracytoplasmic Sperm Injection in Non-obstructive Azoospermia. (PDF, 3 MB) Human Reproduction, 1995. The Male-specific Region of the Human Y Chromsome is a Mosaic of Discrete Sequence Classes. (PDF, 754 KB) Nature, 2003. Ultrastructure of Human Sperm in Men with Congenital Absence of the Vas Deferens: Clinical Implications. (PDF, 2 MB) Fertility and Sterility, 1992. Normal motility is defined as more than 60% of sperm having normal movement, and the WHO 2010 lower reference limit (5th percentile) is 40%. Eating disorders such as anorexia nervosa are also associated with extremely low BMI.