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Vause TD, Cheung AP, Sierra S, et al.; Society of Obstetricians and Gynecologists of Canada. New Treatment for Infertility Due to Congenital Absence of Vas Deferens. (PDF, 1 MB) The Lancet, 1987. Judaism and Repoductive Technology. (PDF, 160 KB) 2003. Theoretically, with this therapy, we can get artificial gamets in vitro. High-cost treatments are out of financial reach for some couples. Medication. If you have ovulation problems, you may be prescribed drugs such as clomiphene citrate (Clomid, Serophene), gonadotropins (such as Gonal-F, Follistim, Humegon and Pregnyl), or letrozole.

Mental stress: This may affect female ovulation and male sperm production and can lead to reduced sexual activity. An ovarian insufficiency can also occur from the decreased release of gonadotropins. They may benefit from referral to a physician comfortable with prescribing pulsatile administration of gonadotropin-releasing hormone or gonadotropins with luteinizing hormone activity to induce ovulation. Aetiology of Congenital Absence of Vas Deferens: Genetic Study of Three Generations. (PDF, 4 MB) Human Reproduction, 1993.

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Unfortunately, clinical examinations, ultrasounds and analyses rarely indicate the reason for the problem and, as such, medical or surgical treatment is infrequent. Assisted conception The following methods are currently available for assisted conception. 48 However, there is no firm evidence that preconception counseling leads to increased live birth rates, in part because no studies on this topic have been performed. There are also a number of sperm production problems that can contribute to infertility, including: Scrotal varicose veins (varicoceles)  Scrotal varicose veins (varicoceles) are swollen veins causing your testicles to get hotter and affect the production of sperm  These are treated with surgery  Testicular injury   Serious trauma to the testicles such as becoming twisted (torsion) can affect sperm production  Damage from playing sports or an accident can rupture the vessels that supply blood to the testicles  Previous injuries can’t be treated, but an ART treatment may help you to conceive Undescended testicles  In the uterus, baby boys’ testicles form in their abdomen and descend into their scrotum shortly before birth  Some men’s testicles don’t descend before they are born (cryptorchidism), although in these cases they usually drop in the first six months after birth  If left untreated, undescended testicles can affect fertility Testicular cancer  This happens when a malignant tumour in the testicle destroys testicular tissue  If undetected, testicular cancer can spread to other parts of the body  This is treated either by surgery, medication, radiotherapy or chemotherapy  However, cancer therapy can also damage sperm production  Genetic defects  Sometimes, genetic information on the Y chromosome (which is only present in men) is deleted (micro-deletions),6 which can reduce the production of sperm  Depending on where the micro-deletion is on the chromosome, this may be treated by surgically extracting sperm from part of your reproductive tract  However, some couples may need to consider using a donor sperm to conceive Mumps Contracting mumps (or mumps-related orchitis) after puberty may damage the sperm-producing cells in your testicles,  causing infertility or subfertility7 Usually, only one testicle is affected and if you have one functioning testicle you may not need treatment  However, some couples may need to use a sperm donor in order to conceive Anti-sperm antibodies  Anti-sperm antibodies are large proteins in your blood that are hostile to sperm  They can cause sperm to clump together and prevent them from swimming, or they may mistake sperm cells for an infection and try to destroy them  This can be treated using an ART treatment   Lifestyle   Sperm production can be affected by a range of lifestyle factors, including smoking, drinking, drugs, stress, overweight and unhealthy food Environmental factors can also affect your sperm quality, including overheating of your testicles, some sexual lubricants, the chemicals involved in certain manufacturing, painting or printing jobs   These factors are treated by making lifestyle changes, such as wearing loose clothing to avoid overheating Hormonal problems  Hormonal problems are rarely the cause of male infertility problems  However, some men have a natural deficiency in follicle-stimulating hormone (FSH) and luteinising hormone (LH), which prevents the testicles from producing testosterone or developing healthy sperm  Hormonal problems can usually be treated with medication Obstruction problems Blocked sperm ducts  Occasionally, male sperm ducts (epididymis and vas deferens) can become blocked, meaning that your semen doesn’t contain any sperm  This can be treated with surgery, or sperm may be surgically extracted from part of your reproductive tract  Vasectomy  Some men have had a previous vasectomy to stop them being able to conceive  This can sometimes be reversed using surgery  The procedure’s success depends on how long ago your vasectomy was performed  Previous infections  Infections can cause scarring or adhesions (organs sticking together) in your sperm ducts  This can usually be treated with surgery  Does age affect male fertility? It involves removing eggs from the ovary of a donor who has taken fertility drugs. Scrotal surgery, including vasectomy, hydrocelectomy (5-6%), and spermatocelectomy (up to 17%), may lead to epididymal injury and subsequent obstruction.[30] Antisperm antibodies Antisperm antibodies bind to sperm, impair motility, and lead to clumping, impairing movement through the female reproductive tract and interaction with the oocyte.

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This may reflect an unknown immunological incompatibility or other unknown problem with fertilization or implantation. Intra-uterine insemination for unexplained subfertility.

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The Use of Epididymal Sperm in Assisted Reproduction. (PDF, 8 MB) Chapter from textbook, Frontiers in Endocrinology: Perspectives on Assisted Reproduction, 1994. Infertility is defined as a failure to conceive within one or more years of regular unprotected coitus. Frequency of intercourse The couple may be advised to have sexual intercourse more often around the time of ovulation. There are many factors that may be causing your fertility difficulties. If you and your partner agree, extra embryos can be frozen and saved to use later. ART: Intracytoplasmic Sperm Injection (ICSI) (Continued) Once an egg is injected, it is observed for approximately 14 hours to see if fertilization has occurred (average fertilization rate is about 65%), and for 24 hours to ensure that cell division has started. A bicornuate uterus is characterized by the presence of an indentation at the fundus. The Disappearing Male. (PDF, 1 MB) From Towards Reproductive Certainty, 1999. World Health Organization reference values for human semen characteristics.