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Your doctor may ask you many of the following questions: How long have you been trying to get pregnant? Postcoital testing and antisperm antibody testing are no longer considered useful in this evaluation. Hormonal Problems A small percentage of male infertility is caused by hormonal problems.  The hypothalamus-pituitary endocrine system regulates the chain of hormonal events that enables testes to produce and effectively disseminate sperm.  Several things can go wrong with the hypothalamus-pituitary endocrine system: · The brain can fail to release gonadotrophic-releasing hormone (GnRH) properly.  GnRH stimulates   the hormonal pathway that causes testosterone synthesis and sperm production.  A disruption in   GnRH release leads to a lack of testosterone and a cessation in sperm production. · The pituitary can fail to produce enough lutenizing hormone (LH) and follicle stimulating hormone   (FSH) to stimulate the testes and testosterone/sperm production.  LH and FSH are intermediates   in the hormonal pathway responsible for testosterone and sperm production. · The testes� Leydig cells may not produce testosterone in response to LH stimulation. · A male may produce other hormones and chemical compounds which interfere with the   sex-hormone balance.

The opening improves the ability of the embryo to implant into the uterine lining. If abundant good sperm are found in the testicle, there's likely a blockage somewhere. There may be testicular malformations, hormone imbalance, or blockage of the man's duct system. 8–16 One retrospective case-control study of 650 men with infertility and 698 control participants questioned the role of environmental risk; no association could be determined after assessing for multiple factors including shift work, stress, and pesticides. Vasectomy and Vasectomy Reversal. (PDF, 7 MB) Fertility and Sterility, 1978. Gonadotropin-releasing hormone Synthetic GnRH (gonadorelin) has a chemical composition similar to native GnRH and is indicated for patients with hypothalamic dysfunction, especially those who do not respond to CC. [200, 201] Although quite effective, it is not available in the United States due to lack of use and low demand.

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Blood tests Depending on the individual couple's situation, various blood tests on either the female or the male may be needed. Its use is controversial in patients with a history of breast cancer. 6 The initial history should cover menstrual history, timing and frequency of intercourse, previous use of contraception, previous pregnancies and outcomes, pelvic infections, medication use, occupational exposures, substance abuse, alcohol intake, tobacco use, and previous surgery on reproductive organs. These factors may interfere with embryo implantation and a woman’s ability to carry pregnancy to term. Passive smoking has also been linked to lower fertility.

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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. 47 Motivational interviewing techniques for modifiable risk factors, such as obesity, tobacco, illicit drugs, and alcohol, can decrease the targeted risk factor.

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Therefore, this problem must be corrected first or concomitantly to obtain an ovulatory response. Causes include: Surgery: Pelvic surgery can sometimes cause scarring or damage to the fallopian tubes. The recourse for these specimens is to remove the seminal fluid by successive media washes. Charting of the menstrual cycle may be done by hand, or with the aid of various fertility monitors. The cause of sterility can also be found in the tubes. The effect of age upon men's fertility is less clear.[citation needed] In people going forward for IVF in the UK, roughly half of fertility problems with a diagnosed cause are due to problems with the man, and about half due to problems with the woman. Additionally, multiple pregnancies cumulatively occur after ovarian stimulation. Anovulation can also cause cessation of periods (secondary amenorrhea) or excessive bleeding (dysfunctional uterine bleeding). Men with Infertility Caused by AZFc Deletion can Produce Sons by Intracytoplasmic Sperm Injection, but are Likely to Transmit the Deletion and Infertility. (PDF, 102 KB) Human Reproduction, 1999. Surgeons who choose this hand-assist technique feel it reduces operative time significantly versus the straight laparoscopic approach. License: Public Domain Due to increased levels of prolactin, the pulsatile release of GnRH is inhibited. Progesterone deficiency can be corrected by the administration of progesterone during the luteal phase, starting 48 hours after ovulation. [204] Patients with hyperprolactinemia need a thorough evaluation to exclude a pituitary microadenoma. Gerrits T, Shaw M (2010). "Biomedical infertility care in sub-Saharan Africa: a social science review of current practices, experiences and view points".