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Once a diagnosis has been made, you and your partner can consider the various treatment options. Editorial: The Cure and Proliferation of Male Infertility. (PDF, 2 MB) The Journal of Urology, 1998. Low testosterone (male hypogonadism) and other hormonal problems have a number of possible underlying causes.

In some cases, the cause of infertility or subfertility could not be suspected from the history taking and clinical examination. Further reading[edit] Fertility: Assessment and Treatment for People with Fertility Problems. Effect of male age on fertility: evidence for the decline in male fertility with increasing age. ARTICLES FROM THE 1990s Microsurgery, Andrology, and Its Role in IVF. (PDF, 6 MB) Chapter in text book, Advances in Assisted Reproductive Technology, 1990. For men, a visual inspection of sexual characteristics can identify such endocrinopathies as hypogonadism (a condition resulting in atrophy or deficient development of secondary sexual characteristics) or Klinefelter’s syndrome (a genetic anomaly often associated with infertility). Large polyps or multiple polyps can impact fertility by interfering with the ability of embryo to implant and should be removed.

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Treatment of tubal obstruction generally requires referral for subspecialty care. Affected individuals displayed more severe forms of infertility such as azoospermia and severe oligozoospermia.[27] Other causes[edit] Factors that can cause male as well as female infertility are: DNA damage DNA damage reduces fertility in female ovocytes, as caused by smoking,[28] other xenobiotic DNA damaging agents (such as radiation or chemotherapy)[29] or accumulation of the oxidative DNA damage 8-hydroxy-deoxyguanosine[30] DNA damage reduces fertility in male sperm, as caused by oxidative DNA damage,[31] smoking,[28] other xenobiotic DNA damaging agents (such as drugs or chemotherapy)[32] or other DNA damaging agents including reactive oxygen species, fever or high testicular temperature.[33] The damaged DNA related to infertility manifests itself by the increased susceptibility to denaturation inducible by heat or acid [34] or by the presence of double-strand breaks that can be detected by the TUNEL assay.[35] General factors Diabetes mellitus,[36][37] thyroid disorders,[38] undiagnosed and untreated coeliac disease,[39][40][41][42] adrenal disease[43] Hypothalamic-pituitary factors Hyperprolactinemia Hypopituitarism The presence of anti-thyroid antibodies is associated with an increased risk of unexplained subfertility with an odds ratio of 1. A decreased testosterone level with an increased FSH level points to primary hypogonadism. It causes a blood stasis that raises the temperature of the scrotum.

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The sperm must provide the zygote with DNA, centrioles, and activation factor for the embryo to develop. Gerrits T, Shaw M (2010). "Biomedical infertility care in sub-Saharan Africa: a social science review of current practices, experiences and view points".

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It is increasingly recognized that egg quality is of critical importance and women of advanced maternal age have eggs of reduced capacity for normal and successful fertilization. The fertilized egg is then implanted in the uterus. A decreased testosterone level with an increased FSH level points to primary hypogonadism. Additionally, because insulin-like growth factor (IGF) has been shown to have an effect on semen quality, its role in varicocele pathology has been studied.[25] One study showed that IGF levels significantly increased after a varicocelectomy to levels that were no different than fertile controls, suggesting that varicocele-related infertility may involve IGF.[26] Varicoceles lead to an increased incidence of sperm immaturity, apoptosis, and necrosis with severe disturbances in meiotic segregation compared to fertile men without varicoceles, and these parameters generally improve after repair. Recent Advances in Male Reproductive Surgery. (PDF, 10 MB) Chapter 13 from Annual Progress in Reproductive Medicine, 1993. Hypothyroidism has no effect on male libido or semen quality. Open-ended Vasectomy, Sperm Granuloma, and Postvasectomy Orchialgia. (PDF, 13 MB) Fertility and Sterility, 1979. Fertilization takes place outside the body, and the fertilized egg is reinserted into the woman's reproductive tract, in a procedure called embryo transfer. Undescended testicles During fetal development one or both testicles may fail to descend from the abdomen into the sac that normally contains the testicles. The patients are classified as WHO1 (15%) - hypo-gonadotropic, hypo-estrogenic, WHO2 (80%) - normo-gonadotropic, normo-estrogenic, and WHO3 (5%) - hyper-gonadotropic, hypo-estrogenic. This may be used if IVF has not been effective, if there has been poor embryo growth rate, and if the woman is older. Medicamentous Induction of Ovulation Ovulation inductors are used for dysfunctions in the hypophyseal-hypothalamic area. Treatment is with human menopausal gonadotropin (HMG) or exogenous FSH. The facilities available and the skills of personnel are the major determining factors for the success rate. Endometriosis: Cells that normally occur within the lining of the uterus start growing elsewhere in the body.