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Effectiveness of the postcoital test: randomised controlled trial. Surgery or embolization for varicoceles in subfertile men. Quantitative Evaluation of Spermatogenesis by Testicular Histology in Men with Congenital Absence of the Vas Deferens Undergoing Epididymal Sperm Aspiration. (PDF, 3 MB) Human Reproduction, 1990. Conventional IVF vs ICSI (Intra Cytoplasmic Sperm Injection) for Patients Requiring Microsurgical Epididymal Sperm Aspiration (MESA). (PDF, 4 MB) Chapter from textbook, Frontiers in Endocrinology: Perspectives on Assisted Reproduction, 1994.

Disorders of the hypothalamus lead to hypogonadotropic hypogonadism. Additionally, transvaginal ultrasound affords the opportunity for your physician to assess the relative number of available eggs.

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Your doctor will carry out a series of tests to diagnose what’s causing your fertility difficulties.  There are many reasons why you may have problems conceiving, including:  Your sperm does not have the concentration, motility or shape required to conceive Existing medical conditions that affect your fertility, such as issues with sperm production or duct obstructions  Your sperm may not be strong or healthy enough to fertilise your partner’s egg  As your partner gets older, her fertility quickly declines3 Depending on the cause, your doctor will recommend a treatment path for you. In some women, and especially with age, the membrane becomes harder. Fertility treatments for men Treatment will depend on the underlying cause of the infertility. The endometrium can be damaged from previous curettages or infections like endometritis.

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The authors of the new global standards said the revised definition gave every individual “the right to reproduce.” Until now, the WHO’s definition of infertility—which it classed as a disability—has been the failure to achieve pregnancy after 12 months or more of regular unprotected sex. Microsurgery for the Undescended Testicle. (PDF, 5 MB) Urologic Clinics of North America, 1982.

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The Relationship of Abnormal Semen Parameters to Male Fertility. (PDF, 4 MB) Human Reproduction, 1989. Optimal sperm conditions Although only one sperm is needed to fertilise your partner’s egg, the enzymes from multiple sperm are needed to break down the egg’s protective barrier. Infertility may be caused by blockage of the Fallopian tube due to malformations, infections such as chlamydia or scar tissue. Endometriosis can only be confirmed by surgery, usually laparoscopy. Grading is as follows: Grade 0 – No movement Grade 1 – Sluggish movement Grade 2 – Slow movement in a poorly defined direction Grade 3 – Slow or curved forward movement Grade 4 – Fast movement straight forward  Patients with abnormal sperm motility should be evaluated for the following: Pyospermia Antisperm antibodies Varicocele Sperm ultrastructural abnormalities Partial ductal obstruction Sperm morphology The head, acrosome, mid piece, and tail of individual spermatozoa are analyzed with phase-contrast microscopy after fixation with Papanicolaou stain. Clomiphene citrate for unexplained subfertility in women. Unexplained infertility in women or men may be managed with another year of unprotected intercourse, or may proceed to assisted reproductive technologies, such as intrauterine insemination or in vitro fertilization. Some women are infertile because their ovaries do not mature and release eggs. The Disappearing Y Chromosome – “I Told You So!” (PDF, 266 KB) Human Reproduction, 1997. A high serum estradiol level (greater than 60 to 80 pg per mL [220 to 294 pmol per L]) in conjunction with a normal FSH level has also been associated with lower pregnancy rates. Factors contributing to the formation of antisperm antibodies in women are disturbance of normal immunoregulatory mechanisms, infection, violation of the integrity of the mucous membranes, rape and unprotected oral or anal sex. Prozac and other SSRIs, Propecia).  Luckily, many treatment options exist for ED depending on the cause--these will be discussed in the treatment section. Nonfunctional pituitary tumors may compress the pituitary stalk or the gonadotropic cells, interrupting the proper chain of signals leading to pituitary failure. Blood test: The lab will test for levels of testosterone and other hormones. The test is rated positively when motile sperm can be proved in the mucus.