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Known male factor semen abnormalities: If a male partner has a history of infertility with a prior partner, or if there are abnormalities on his semen analysis, then we advise earlier fertility evaluation, ideally within 6 months of attempting pregnancy. Leydig cell function is impaired, and most patients are infertile due to primary testicular failure.

8  A normal sample according to the 2010 World Health Organization (WHO) guidelines is described in Table 2. 3  Sometimes, a couple who’ve already had a child can have trouble conceiving again. In reproductive medicine, the most common surgical procedures are laparoscopy, hysteroscopy, and abdominal myomectomy (removal of uterine fibroids).

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In these methods, fertilization occurs inside the body. However, its value has been questioned because some studies have found no correlation between the presence or absence of viable sperm in the mucus and subsequent fertility. Practice Committee of American Society for Reproductive Medicine in collaboration with Society for Reproductive Endocrinology and Infertility. As there is surplus medical information everyday that can not be cached by healthcare providers, clinical guidelines created to endorse up-to-date evidence-based practice to improve patients' outcome [6].

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Ejaculatory Duct Obstruction. (PDF, 3 MB) The Journal of Urology, 1980. Erectile dysfunction or premature ejaculation: Medication, behavioral approaches, or both may help improve fertility. Surgery for hydrosalpinges before in-vitro fertilization treatment: Laparoscopic salpingectomy or disconnection of both tubes improve IVF/ICSI success rates.

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Zygote Intrafallopian Transfer (ZIFT) Zygote Intrafallopian Transfer (ZIFT) is another variation of IVF. Diet: A lack of folic acid, iron, zinc, and vitamin B-12 can affect fertility. Testicular Sperm Extraction (TESE) and Intracytoplasmic Sperm Injection (ICSI) for Non-obstructive Azoospermia.(PDF, 1 MB) 10th World Congress on In Vitro Fertilization and Assisted Reproduction, 1997. Frequency of intercourse The couple may be advised to have sexual intercourse more often around the time of ovulation. A variety of hormonal imbalances can affect a man's fertility. 18  If the semen analysis result is abnormal, further evaluation is indicated (Table 36–8,10,19,20). However, future pregnancy is possible with the other ovary and tube. The 3 classes of surgical techniques are conventional laparotomy, operative laparoscopy, and operative hysteroscopy, as follows: Laparotomy: This technique is indicated for large myomas, for submucous myomas larger than 3 cm in diameter, or for myomas that, regardless of being submucous, have a portion of the myoma that compromises the myometrium so that a complete resection through the hysteroscopy is not feasible. Fertility Evaluation: Obstetric and Gynecological History The obstetric and gynecological history should include: Reproductive history (children, mode of delivery, prematurity, stillbirth, extrauterine pregnancy, spontaneous and induced abortion, fertility and infertility in earlier relationships). An on-line WHO infertility virtual consultation course includes a 5 module WHO evidence-based medicine course, as well as a 16 module ASRM eLearning course which reviews the evidence-base for the basic diagnosis of the infertile male and female, coupled with management and treatment. Any abnormality in the tubes can affect or impede conception: hydrosalpinx, tubal occlusion or salpingitis. The male partner can be evaluated for infertility or subfertility using a variety of clinical interventions, and also from a laboratory evaluation of semen.” (Semen manual, 5th Edition3). RE: The Impalpable Testis: A Rational Approach to Management. (PDF, 389 KB) The Journal of Urology, 1979. Vasectomy Reversal. (PDF, 733 KB) The New England Journal of Medicine, 1977.