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The epididymis is a coil-like structure in the testicles which helps store and transport sperm. Infection and Disease: Mumps, tuberculosis, brucellosis, gonorrhea, typhoid, influenza, smallpox, and syphilis can cause testicular atrophy.  A low sperm count and low sperm motility are indicators of this condition.  Also, elevated FSH levels and other hormonal problems are indicative of testicular damage.  Some STDs like gonorrhea and chlamydia can cause infertility by blocking the epididimis or tubes.  These conditions are usually treated by hormonal replacement therapy and surgery in the case of tubular blockage. Ultrasound can detect uterine abnormalities such as fibroids and polyps, distal fallopian tube occlusion, and ovarian abnormalities including ovarian cysts. Investigations will be requested to prove the clinical diagnosis and to exclude other close possibilities. The bladder must be emptied 1 hour prior to sperm collection, and a second dose of sodium bicarbonate is taken along with 16 ounces of fluid. Spermatogonia rest on the basement membrane and contain dense nuclei and prominent nucleoli.

Group II: hypothalamic-pituitary-ovarian dysfunction (predominately polycystic ovary syndrome). The doctor may ask about the couple's sexual habits and make recommendations regarding these. The anamnesis includes sexual behavior concerning ovulation here.

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Hystersalpingography (HSG): Further investigations 17. Investigation of suspected tubal and uterine abnormalities: 2. There are some common risk factors that can increase the likelihood of a man experiencing some form of reversible or permanent infertility. Clinical Characterization of 42 Oligospermic or Azoospermic Men with Microdeletion of the AZFc Region of the Y Chromosome, and of 18 Children Conceived via ICSI. (PDF, 606 KB) Human Reproduction, 2002. Laboratory testing – Depending on the results of the evaluation discussed above, your physician may request specific blood tests. The rest of the time, it is because of both partners or no cause can be found.

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Feedback inhibition is from testosterone and inhibin. In vitro fertilization (IVF). In this technique, your doctor places into your uterus that were fertilized in a dish. The predictive value of hysterosalpingography for tubal and peritoneal infertility factors. Birth after Preimplantation Diagnosis of the Cystic Fibrosis F508 Mutation by Polymerase Chain Reaction in Human Embryos Resulting from Intracytoplasmic Sperm Injection with Epididymal Sperm. (PDF, 2 MB) The Journal of the American Medical Association, 1994. These injections are taken nightly, typically for 5 – 10 days, and act directly on the cells of the ovary to stimulate egg development.

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As a result, estrogen levels are dramatically reduced, releasing the hypothalamic-pituitary axis from its negative feedback. Surgical Management of Male Infertility. (PDF, 2 MB) Chapter 12 from textbook, Male Infertility, 1992. As soon as it reaches a specific size, the administration of beta-HCG takes place. Large polyps or multiple polyps can impact fertility by interfering with the ability of embryo to implant and should be removed. The enzyme aromatase is responsible for this conversion, and is found primarily in adipose tissue. A uterus capable of developing and sustaining the conceptus to maturity. Ovarian Transplantation between Monozygotic Twins Discordant for Premature Ovarian Failure. (PDF, 315 KB) The New England Journal of Medicine, 2005. However, future pregnancy is possible with the other ovary and tube.