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2 or more - sperm concentration: 15 million spermatozoa per ml or more - total sperm number: 39 million spermatozoa per ejaculate or more - total motility: 40% or more motile or 32% or more with progressive motility - vitality: 58% or more live spermatozoa - sperm morphology (percentage of normal forms): 4% or more Basic Work-up for Infertility 13. Evidence of ovulation: 1. Options include intrauterine insemination (also known as IUI) or IVF with intracytoplasmic sperm injection (also known as ICSI). Obesity and increased risk for oligozoospermia and azoospermia. Unfortunately, some men have to cope with the reality that nothing can be done about their infertility. Patients with a high number of immature sperm should be evaluated for excessive exposure to heat or radiation or for infectious processes.

8 However, if your doctor diagnoses you with infertility, then it’s likely that you’ll need some additional help to conceive.  This may be as simple as timing when you have sex, or you may need more advanced fertility treatment.   Discovering that you’re infertile can be overwhelming, but the right support can help you to conceive successfully. The hypothalamus, the primary integration center, responds to various signals from the central nervous system (CNS), pituitary gland, and testicles to secrete gonadotropin-releasing hormone (GnRH) in a pulsatile pattern approximately every 70-90 minutes. Once the follicular diameter reaches 18 mm and the E2 level is below 2000 pc/mL, ovulation is triggered by the administration of hCG (10,000 IU IM). Sertoli Cell only Revisited. (PDF, 1 MB) Human Reproduction, 1995. Luteal phase support. (and cryopreservation choice offered if good quality embryos are available) IVF/ICSI 37. Down-regulation: - to avoid premature LH surge and spontenous ovulation. - either GnRH agonist protocol or GnRH antagonist protocol. - always use GnRH antagonist protocol in women with high risk of OHSS.

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Reversal of Vasectomy and the Treatment of Male Infertility. (PDF, 4 MB) Journal of Andrology, 1980. Causes of Sterility in Men Image: “Colorized sperm sample under the light microscope” by Bobjgalindo. In current practice, an alternative for patients with more than 5 sizable follicles is to convert the treatment to IVF.

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Drugs used for both women and men[67] include clomiphene citrate, human menopausal gonadotropin (hMG), follicle-stimulating hormone (FSH), human chorionic gonadotropin (hCG), gonadotropin-releasing hormone (GnRH) analogues, aromatase inhibitors, and metformin. Treatment of the cause: 25. Ovulation disorders: (Group II “PCO”) 1. After recovery, the testicle may return to normal or may atrophy. Although tubal disease was the original indication for IVF, many more indications have developed over the years. One of the best known is the HFEA – The UK's regulator for fertility treatment and embryo research.

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In men who have the necessary reproductive organs to procreate, infertility can be caused by low sperm count due to endocrine problems, drugs, radiation, or infection. Epididymal Extravasation Following Vasectomy as a Cause for Failure of Vasectomy Reversal. (PDF, 22 MB)Fertility and Sterility, 1979. 30–32 Other treatment options include antiestrogens and gonadotropin therapy, which showed a trend toward increased live birth rates in a Cochrane review. Apparently there are only 0,014% of them (this could be an explanation of why they were not discovered until now). In patients with varicocele, there is insufficient evidence to suggest corrective surgery will increase live birth rates, despite improvement in semen analysis results. Chemotherapy: Some chemotherapy drugs can result in ovarian failure. Most couples (about 84%) who have regular sexual intercourse (that is, every two to three days) and who do not use contraception get pregnant within a year. 3  Sometimes, a couple who’ve already had a child can have trouble conceiving again. Mannitol Induced Central Nervous System Toxicity in Renal Failure. (PDF, 4 MB) Investigative Urology, 1972.