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Patients have eunuchoidal body habitus, large testis, and a low ejaculatory volume. Have you had any sexually transmitted infections or abnormal pap smears?

Frequency of intercourse Probability of conception (within 6 months) 1 time per week 17 % 3 times per week 50 % 6. Hystersalpingography (HSG): Further investigations 17. Investigation of suspected tubal and uterine abnormalities: 2. Perspectives on infertility consultations in primary care: a qualitative study. The male partner can be evaluated for infertility or subfertility using a variety of clinical interventions, and also from a laboratory evaluation of semen.” (Semen manual, 5th Edition3). Frequency of intercourse The couple may be advised to have sexual intercourse more often around the time of ovulation.

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Most couples (about 84%) who have regular sexual intercourse (that is, every two to three days) and who do not use contraception get pregnant within a year. Medications Testosterone replacement therapy, long-term anabolic steroid use, cancer medications (chemotherapy), certain antifungal medications, some ulcer drugs and certain other medications can impair sperm production and decrease male fertility. 18  If the semen analysis result is abnormal, further evaluation is indicated (Table 36–8,10,19,20). Non-steroidal anti-inflammatory drugs (NSAIDs): Long-term use of aspirin or ibuprofen may make it harder to conceive.

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Simultaneous Treatment of the Wife in Infertile Couples with Oligospermia. (PDF, 4 MB) Fertility and Sterility, 1983. The introduction in 1990 of a laparoscopic clip applier with twenty automatically advancing clips (rather than a single load clip applier that would have to be taken out, reloaded and reintroduced for each clip application) made general surgeons more comfortable with making the leap to laparoscopic cholecystectomies (gall bladder removal).

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Compensatory and Obligatory Renal Growth in Rats. (PDF, 1 MB) American Journal of Physiology, 1974. Immunological testing has not been proven to have any value in infertility patients without a history of 2 or more miscarriages. Supplementation with acetyl L carnitine and antioxidants such as Vitamins C or E are encouraged to enhance sperm maturation and function. A varicocele is like a varicose vein that can appear in the leg. Endometriosis Endometriosis is when the tissue of the uterine lining grows outside of the uterus. In this case, symptoms can also include: Skin changes, including more acne Changes in sex drive and desire Dark hair growth on the lips, chest, and chin Loss of hair or thinning hair Weight gain Other symptoms of disorders that may lead to infertility include: Milky white discharge from nipples unrelated to breastfeeding Pain during sex Many other things can be related to infertility in women, and their symptoms vary. Hormonal Problems A small percentage of male infertility is caused by hormonal problems.  The hypothalamus-pituitary endocrine system regulates the chain of hormonal events that enables testes to produce and effectively disseminate sperm.  Several things can go wrong with the hypothalamus-pituitary endocrine system: · The brain can fail to release gonadotrophic-releasing hormone (GnRH) properly.  GnRH stimulates   the hormonal pathway that causes testosterone synthesis and sperm production.  A disruption in   GnRH release leads to a lack of testosterone and a cessation in sperm production. · The pituitary can fail to produce enough lutenizing hormone (LH) and follicle stimulating hormone   (FSH) to stimulate the testes and testosterone/sperm production.  LH and FSH are intermediates   in the hormonal pathway responsible for testosterone and sperm production. · The testes� Leydig cells may not produce testosterone in response to LH stimulation. · A male may produce other hormones and chemical compounds which interfere with the   sex-hormone balance. Judaism and Reproductive Technology. (PDF, 2 MB) 2010.