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In patients with varicocele, there is insufficient evidence to suggest corrective surgery will increase live birth rates, despite improvement in semen analysis results. Laparotomy with histopathology is usually indicated, because medical attempts at inducing ovulation (human chorionic gonadotropin, FSH, GnRH) are usually unrewarding.

Primary infertility When a woman is unable to ever bear a child, either due to the inability to become pregnant or the inability to carry a pregnancy to a live birth she would be classified as having primary infertility. If the egg does not travel, it can be harder to conceive naturally. Pro-life opposition to the destruction of embryos not transferred in vivo. The normal working of the male reproductive system involves first the production of sufficient numbers of functional sperm cells and then the delivery of these sperm to the ejaculate. Male infertility refers to a male’s inability to cause a pregnancy in a fertile female.   Causes vary.   Testing is available.   Medication or surgery. Physical Problems A variety of physical problems can cause male infertility.  These problems either interfere with the sperm production process or disrupt the pathway down which sperm travel from the testes to the tip of the penis.  These problems are usually characterized by a low sperm count and/or abnormal sperm morphology.  The following is a list of the most common physical problems that cause male infertility: Variocoele: A varicocele is an enlargement of the internal spermatic veins that drain blood from the testicle to the abdomen (back to the heart) and are present in 15% of the general male population and 40% of infertile men.  These images show what a variocoele looks like externally and internally.  A varicocele develops when the one way valves in these spermatic veins are damaged causing an abnormal back flow of blood from the abdomen into the scrotum creating a hostile environment for sperm development.  Varicocoeles may cause reduced sperm count and abnormal sperm morphology which cause infertility.  Variococles can usually be diagnosed by a physical examination of the scrotum which can be aided by the Doppler stethoscope and scrotal ultrasound.  Varicocoele can be treated in many ways (see treatment section), but the most successful treatments involve corrective surgery.

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Testis Biopsy and the Infertile Male. (PDF, 20 MB) Chapter 15 from textbook Office Andrology, 2005. 25 Women with no clear risk of tubal obstruction should be offered hysterosalpingography to screen for tubal occlusion and structural uterine abnormalities. The following problems are possible: Low sperm count: The man ejaculates a low number of sperm. Products include enzymes and proteases to liquefy the seminal coagulum. Gonadotrophins for idiopathic male factor subfertility.

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Cholesterol One study has found that high cholesterol levels may have an impact on fertility in women. Minimal Ovarian Stimulation (mini-IVF) for IVF Utilizing Vitrification and Cryopreserved Embryo Transfer. (PDF, 406 KB) Reproductive BioMedicine Online, 2010. 42 Urinary luteinizing hormone kits indicate the midcycle luteinizing hormone surge that precedes ovulation by one to two days. Histological dating of timed endometrial biopsy tissue is not related to fertility status. Clinical diagnostic testing for the cytogenetic and molecular causes of male infertility: the Mayo Clinic experience.

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Ejaculatory Incompetence: This rare psychological condition prevents men from ejaculating during sexual intercourse even though they can ejaculate normally through masturbation.  This condition sometimes responds well to behavioral therapy; if this technique does not work, artificial insemination can be employed using an ejaculate from masturbation.Continued Hysteroscopy . In this procedure, your doctor places a hysteroscope into your uterus through your cervix. 8,46 Obesity impairs fertility and the response to fertility treatments, including in vitro fertilization; therefore, it is advisable to counsel patients who are obese to lose weight before conception or infertility treatments. The typical indication is the oligoasthenoteratozoospermia here. Couples will have to consider the ethical and emotional aspects of this procedure. Microsurgical Epididymal Sperm Aspiration and Assisted Reproductive Techniques. (PDF, 4 MB) Frontiers in Human Reproduction, 1991. A review of systems and physical examination of the endocrine and gynecologic systems should be performed. ARTICLES FROM THE 2010s Ovarian Function 6 Years after Cryopreservation and Transplantation of Whole Sheep Ovaries. (PDF, 496 KB)Reproductive BioMedicine Online, 2010. With this treatment, the patient experience spermatogenesis, and therefore, it has the chance to have offspring if he wants to.