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Algorithm for infertility evaluation. (ART = assisted reproductive technology.) Lifestyle Factors Jump to section + All couples should be counseled to abstain from tobacco use, limit alcohol consumption, and aim for a body mass index less than 30 kg per m2 to improve their chances of natural conception or using assisted reproductive technology. The Intra-abdominal Testes: Microvascular Autotransplantation. (PDF, 4 MB) The Journal of Urology, 1981.

Because cortisol is not secreted, a lack of feedback inhibition on the pituitary gland occurs, leading to adrenocorticotropic hormone (ACTH) hypersecretion. In this procedure, 5–10 mm diameter instruments (graspers, scissors, clip applier) can be introduced by the surgeon into the abdomen through trocars (hollow tubes with a seal to keep the CO 2 from leaking). Physical Problems A variety of physical problems can cause male infertility.  These problems either interfere with the sperm production process or disrupt the pathway down which sperm travel from the testes to the tip of the penis.  These problems are usually characterized by a low sperm count and/or abnormal sperm morphology.  The following is a list of the most common physical problems that cause male infertility: Variocoele: A varicocele is an enlargement of the internal spermatic veins that drain blood from the testicle to the abdomen (back to the heart) and are present in 15% of the general male population and 40% of infertile men.  These images show what a variocoele looks like externally and internally.  A varicocele develops when the one way valves in these spermatic veins are damaged causing an abnormal back flow of blood from the abdomen into the scrotum creating a hostile environment for sperm development.  Varicocoeles may cause reduced sperm count and abnormal sperm morphology which cause infertility.  Variococles can usually be diagnosed by a physical examination of the scrotum which can be aided by the Doppler stethoscope and scrotal ultrasound.  Varicocoele can be treated in many ways (see treatment section), but the most successful treatments involve corrective surgery.

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Anabolic steroids: Popular with bodybuilders and athletes, long-term use can seriously reduce sperm count and mobility. Results of Microsurgical Vasoepididymostomy: Role of Epididymis in Sperm Maturation. (PDF, 3 MB) Human Reproduction, 1989. Unicornuate uterus is associated with renal abnormalities including absence of a kidney or presence of a pelvic kidney; this occurs in 15% of cases.

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If you’re worried about your fertility, the best thing to do is talk to your doctor. Microscopic Vasectomy Reversal 30 Years Later: A Summary of 4010 Cases by the Same Surgeon. (PDF, 295 KB)Journal of Andrology, 2004. High-cost treatments are out of financial reach for some couples. A history of pelvic infections or sexually transmitted diseases: Sexually transmitted infections, such as chlamydia or gonorrhea, can cause inflammation and permanent scarring of the fallopian tubes. 8,37 Women in WHO group II, including those who are overweight and who have polycystic ovary syndrome, can benefit from weight loss, exercise, and lifestyle modifications to restore ovulatory cycles and achieve pregnancy.

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This applies to the ability to conceive with her eggs, but not with donor eggs. After fertilization, implantation may then take place in the uterus. Ultrasound can detect uterine abnormalities such as fibroids and polyps, distal fallopian tube occlusion, and ovarian abnormalities including ovarian cysts. Microsurgery Successful in Vasectomy Reversals. (PDF, 156 KB) The New York Times, 1975. It involves: A vagina capable of receiving sperm. Surgeons who choose this hand-assist technique feel it reduces operative time significantly versus the straight laparoscopic approach. Sperm count often returns to normal after stopping the medication. Myoma treatment In general, small and asymptomatic myomas do not require treatment, but the patient should be periodically monitored. Epidemiology of Sterility and Infertility Sterility and infertility affect about 10 – 15% of couples. Chromosomal Abnormalities in Embryos Derived from Testicular Sperm Extraction. (PDF, 324 KB) Fertility and Sterility, 2003. High Fertilization and Pregnancy Rate after Intracytoplasmic Sperm Injection with Spermatozoa Obtained from Testicle Biopsy. (PDF, 3 MB) Human Reproduction, 1995. Following his lecture on laparoscopic appendectomy, the president of the German Surgical Society wrote to the Board of Directors of the German Gynecological Society suggesting suspension of Semm from medical practice. The ICSI process takes place following a cycle during which fertility drugs are administered to the female partner to aid in the production of multiple eggs. 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. Quantitative Analysis of Testicle Biopsy: Determination of Partial Obstruction and Prediction of Sperm Count after Surgery for Obstruction. (PDF, 4 MB) Fertility and Sterility, 1981. Transplantation of Rat Kidneys with Acute Tubular Necrosis into Salt-loaded and Normal Recipients. (PDF, 2 MB)Surgery, 1975.