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Symptoms If a couple doesn't get pregnant after a year of unprotected intercourse, both the man and woman should be evaluated. Idiopathic hypogonadotropic hypogonadism A failure of GnRH secretion without any discernible underlying cause may be observed alone (isolated) or as part of Kallmann syndrome, which is associated with midline defects such as anosmia, cleft lip and cleft palate, deafness, cryptorchidism, and color blindness. Erectile dysfunction, vaginismus (painful involuntary spasm of vagina preventing intercourse) and dyspareunia (pain during sexual intercourse) can explain involuntary childlessness in some couples.

Hypospadias: The urethral opening is under the penis, instead of its tip. Analyses of the CFTR Gene in 67 Patients. (PDF, 4 MB) The American Journal of Human Genetics, 1995. Excess cortisol may be produced by adrenal hyperplasia, adenomas, carcinoma, or lung tumors. Having sex near the time of ovulation is the best way to increase the chance of becoming pregnant. Only an additional 7% of couples will conceive in the second year.

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This combination of laboratory test results may indicate ovarian insufficiency or diminished ovarian reserve. Microsurgical Reversal of Tubal Sterilization: Factors Affecting Pregnancy Rate, with Long-term Follow-up. (PDF, 2 MB) Obstetrics & Gynecology, 1984. Results of one study investigating a cohort of 315 men revealed changes within the hinge region of SF-1 and no rare allelic variants in fertile control men.

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Perspectives on infertility consultations in primary care: a qualitative study. Abnormal semen may not be able to carry the sperm effectively. Sperm count often returns to normal after stopping the medication. Pregnancy Caused by Sperm from Vasa Efferentia. (PDF, 1 MB) Fertility and Sterility, 1988. If a woman needs an HCG injection to activate ovulation and ultrasound scans show that too many follicles have developed, it is possible to withhold the HCG injection. Controversies in OB/GYN: Is Varicocelectomy Useful for Treatment of Male-factor Infertility? (PDF, 4 MB)Contemporary OB/GYN, 2001.

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As a result, estrogen levels are dramatically reduced, releasing the hypothalamic-pituitary axis from its negative feedback. What’s on the Mind of IVF Consumers? (PDF, 627 KB) Reproductive BioMedicine Online, 2009. Transrectal ultrasonography (TRUS) may reveal enlarged seminal vesicles, but this is not universal. Overheated testicles: Causes include an undescended testicle, a varicocele, or varicose vein in the scrotum, the use of saunas or hot tubs, wearing tight clothes, and working in hot environments. 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. London, United Kingdom: National Institute for Health and Clinical Excellence (NICE); February 2013:1–63. (Clinical guideline no. The rate increases to 10-12% after CC ovulation induction and to 12-15% per cycle after hMG/hCG ovulation induction. 4 IU per L]) can help differentiate between primary and secondary disorders. For example, high cortisol levels are seen in patients with Cushing syndrome, which causes negative feedback on the pituitary to decrease LH release. Generally, evaluation should be offered to couples who have not conceived after one year of unprotected vaginal intercourse. Clean, Intermittent Self-catheterization in the Treatment of Urinary Tract Disease. (PDF, 2 MB) The Journal of Urology, 1972. Semen analysis The semen analysis is a very important test and should be done early in the evaluation process. Hjollund NH, Storgaard L, Ernst E, Bonde JP, Olsen J.