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A decreased testosterone level with an increased FSH level points to primary hypogonadism. 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.

Laparoscopy: A thin, flexible tube with a camera at the end is inserted into the abdomen and pelvis, allowing a doctor to look at the fallopian tubes, uterus, and ovaries. Vasectomy. (PDF, 5 MB) From the Encyclopedia of Reproduction, 1999. Factors affecting Fertility Caffeinated beverages: - No evidence on effect of caffeine on fertility. Alcohol - Female patients should be informed that 1 or 2 units of alcohol once or twice per week reduces risk of harming a developing fetus. - Intoxication may affect semen quality. Reversal of Vasectomy and the Treatment of Male Infertility. (PDF, 4 MB) Journal of Andrology, 1980. The AZFc Region of the Y Chromosome Features Massive Palindromes and Uniform Recurrent Deletions in Infertile Men. (PDF, 5 MB) Nature Genetics, 2001.

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Fallopian tubes that are patent and will function to permit the sperm and ovum to meet and allow migration of the conceptus to the uterus. Traumatic Renal Hemorrhage Treatment by Arterial Embolization. (PDF, 3 MB) The Journal of Urology, 1973. Hystersalpingography (HSG): - usually after failed successive cycles of ovulation induction, and in some centres after failed IUI. - good predictive but requires expertise. The eggs may never be released or they may only be released in some cycles.

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Debate: Are Spermatid Injections of any Clinical Value? (PDF, 6 MB) Human Reproduction, 1998. Laparoscopy for Cryptorchidism. (PDF, 1 MB) The Journal of Urology, 1980. A doctor or WHNP takes a medical history and gives a physical examination. PID can damage and scar the fallopian tubes, making it virtually impossible for an egg to travel down into the womb.

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Veltman-Verhulst SM, Cohlen BJ, Hughes E, Heineman MJ. Oligospermia is the most frequent cause of male infertility. On the day of ovulation, a mucus sample is taken after intercourse. Electric or vibratory stimulation to achieve ejaculation: Ejaculation is achieved with electric or vibratory stimulation. Uterine synechiae development is a potential complication after the surgery; therefore, a postoperative HSG should be part of follow-up care. Diagnosis Most people will visit a physician if there is no pregnancy after 12 months of trying.