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A sperm count of under 15 million is considered low. 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. 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. Primary infertility is when a couple has not conceived after trying for at least 12 months without using birth control Secondary infertility is when they have previously conceived but are no longer able to. In contrast, anovulation usually manifests itself as irregularity of menstrual periods, that is, unpredictable variability of intervals, duration, or bleeding. IVF and related techniques (ICSI, ZIFT, GIFT) are called assisted reproductive technology (ART) techniques.

A penile exam should detect atrophy, tumors, epididymal cysts, cryptorchidism (undescended testicles), vas thickening or absence of the vas deferens, hydrocele (fluid accumulation in the testis or along the spermatic cord) or varicocele. It binds in a part of the brain called the hypothalamus, which is essential in stimulating the ovary to grow and release an egg. The majority of men with varicocele present no symptoms. Therefore, it is particularly important to evaluate both partners when investigating infertility. Once a diagnosis has been made, you and your partner can consider the various treatment options.

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Couples may decide to go ahead regardless if the desire to become pregnant is very strong. The transit time varies with age and sexual activity but is usually from 1-12 days.

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Vitrification of oocytes from endangered Mexican gray wolves (Canis lupus baileyi). (PDF, 319 KB) Theriogenology, 2010. The chance of a multiple birth is lower with an oral fertility drug.

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The basic work-up, or fertility evaluation, includes: Semen analysis of the male partner. Successful Pregnancy and Delivery after Calcium Ionophore Oocyte Activation in a Normozoospermic Patient with Previous Failed Fertilization after Intracytoplasmic Sperm Injection. (PDF, 57 KB) Fertility and Sterility, 2003. A doctor or WHNP takes a medical history and gives a physical examination. You take gonadotropins that trigger the development of more than one egg. Varicocele and male factor infertility treatment: a new meta-analysis and review of the role of varicocele repair. A history of sexually transmitted infections could be another cause of infertility in either partner. Infertility: Summary Infertility is a significant social and medical problem affecting couples worldwide. 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. When Predictions Don’t Predict. (PDF, 549 KB) The Australian and New Zealand Journal of Obstetrics and Gynaecology, 1991. Luteal phase support. (and cryopreservation choice offered if good quality embryos are available) IVF/ICSI 37. Down-regulation: - to avoid premature LH surge and spontenous ovulation. - either GnRH agonist protocol or GnRH antagonist protocol. - always use GnRH antagonist protocol in women with high risk of OHSS. Microsurgery Successful in Vasectomy Reversals. (PDF, 156 KB) The New York Times, 1975.