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Causes include: Surgery: Pelvic surgery can sometimes cause scarring or damage to the fallopian tubes. 24 Other tests of ovarian reserve, such as the clomiphene (Clomid) challenge test, antral follicle count, and antimüllerian hormone level, are also generally performed to predict response to ovarian stimulation with exogenous gonadotropins and assisted reproductive technology. Hysterosalpingogram (HSG) – This test is essential for evaluating fallopian tubal patency, uterine filling defects such as fibroids and polyps, and scarring of the uterine cavity (Asherman syndrome).

The content of counselling may differ depending on the concerned couple and the existing treatment options. The medicalization of infertility has unwittingly led to a disregard for the emotional responses that couples experience, which include distress, loss of control, stigmatization, and a disruption in the developmental trajectory of adulthood.[16] Infertility may have psychological effects. Refinements in the Methodology of Injection for Transvaginal Gamete Intra-Fallopian Transfer. (PDF, 2 MB) Human Reproduction, 1994.

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Techniques for the Resolution of Testicular Obstruction. (PDF, 8 MB) Chapter 78 from textbook, Reconstructive Urology, 1992. Follicle-stimulating hormone (Gonal-F, Bravelle): This hormone is produced by the pituitary gland that controls estrogen production by the ovaries. In some women, and especially with age, the membrane becomes harder.

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Your physician will discuss these approaches to having a baby if appropriate to your particular case. High-cost treatments are out of financial reach for some couples. A doctor or WHNP takes a medical history and gives a physical examination.

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The Relationship of Abnormal Semen Values to Pregnancy Outcome. (PDF, 770 KB) Chapter 10 from textbook, 1992. A variety of disorders ranging from hormonal disturbances to physical problems, to psychological problems can cause male infertility.  Although many treatment options are now available, in many cases treatment will not work.  In many instances, male infertility is caused by testicular damage resulting in an inability of the testicle to produce sperm.  Once damaged, the testicle will not usually regain its sperm-making capabilities; this aspect of male infertility is analogous to menopause (though not natural like menopause) for women and cannot usually be treated.  Despite medicine�s limited ability to treat male infertility, many successful treatment options are available for its many causes.  Besides testicular damage, the main causes of male infertility are low sperm production and poor sperm quality.   The Causes of Male Infertility Male infertility has many causes--from hormonal imbalances, to physical problems, to psychological and/or behavioral problems.  Moreover, fertility reflects a man�s �overall� health.  Men who live a healthy lifestyle are more likely to produce healthy sperm.  The following list highlights some lifestyle choices that negatively impact male fertility--it is not all-inclusive: · Smoking--significantly decreases both sperm count and sperm cell motility. · Prolonged use of marijuana and other recreational drugs. · Chronic alcohol abuse. · Anabolic steroid use--causes testicular shrinkage and infertility. · Overly intense exercise--produces high levels of adrenal steroid hormones which cause a    testosterone deficiency resulting in infertility. · Inadequate vitamin C and Zinc in the diet. · Tight underwear--increases scrotal temperature which results in decreased sperm production. · Exposure to environmental hazards and toxins such as pesticides, lead, paint, radiation, radioactive   substances, mercury,  benzene, boron, and heavy metals · Malnutrition and anemia. · Excessive stress! M. genitalium infection is associated with increased risk of infertility.[25][26] Genetic[edit] A Robertsonian translocation in either partner may cause recurrent spontaneous abortions or complete infertility.[citation needed] Mutations to NR5A1 gene encoding Steroidogenic Factor-1 (SF-1) have been found in a small subset of men with non-obstructive male factor infertility where the cause is unknown. Women in group II include those with polycystic ovary syndrome and hyperprolactinemia. Unexpected resilience of species with temperature-dependent sex determination at the Cretaceous–Palaeogene boundary. (PDF, 238 KB) Biology Letters, 2010. However, medical treatment can be used to reduce the myoma size prior to removal. Varicocele: Surgically removing a varicose vein in the scrotum may help. A small number of specimens have acceptable original concentrations of motile sperm but poor recoveries with the gradient system. 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. The man must be producing healthy sperm in quantities large enough to fertilize an egg cell. Extra Renal Function in Patients with Duplication Anomaly: Obligatory and Compensatory Renal Growth. (PDF, 1 MB) The Journal of Urology, 1974. Passive smoking has also been linked to lower fertility. The initial result of the procedure is not detected before 3 months because spermatogenesis takes 72 days.