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ARTICLES FROM THE 2000s Evaluation and Treatment of Male Infertility. (PDF, 17 MB) Clinical Obstetrics and Gynecology, 2000. Editorial: The Cure and Proliferation of Male Infertility. (PDF, 2 MB) The Journal of Urology, 1998. Infection and Disease: Mumps, tuberculosis, brucellosis, gonorrhea, typhoid, influenza, smallpox, and syphilis can cause testicular atrophy.  A low sperm count and low sperm motility are indicators of this condition.  Also, elevated FSH levels and other hormonal problems are indicative of testicular damage.  Some STDs like gonorrhea and chlamydia can cause infertility by blocking the epididimis or tubes.  These conditions are usually treated by hormonal replacement therapy and surgery in the case of tubular blockage.

Factors Affecting Fertility: Timing of Intercourse Intercourse prior to ovulation is key to maximizing the chance of pregnancy. Drugs used for both women and men[67] include clomiphene citrate, human menopausal gonadotropin (hMG), follicle-stimulating hormone (FSH), human chorionic gonadotropin (hCG), gonadotropin-releasing hormone (GnRH) analogues, aromatase inhibitors, and metformin. Options for Male Infertility Treatment Some causes of male infertility are treatable or correctable through surgery. Ovulation disorders appear to be the most common cause of infertility in women.

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3,4  Infertility may arise from male factors, female factors, or a combination of these (Table 15–8). Ovarian hyperstimulation syndrome is self-limited, and the symptoms subside within 2-6 weeks. [198] Patients with mild and moderate ovarian hyperstimulation syndrome are treated at home with bedrest and strict control of fluid intake and output. Possible problems could be that the egg is not released at the optimum time for fertilization, that it may not enter the fallopian tube, sperm may not be able to reach the egg, fertilization may fail to occur, transport of the zygote may be disturbed, or implantation fails. However, the presence of fibroids alone doesn’t necessarily cause infertility or predispose a woman to pregnancy loss. CI or intrauterine insemination is the treatment of choice if more than 2 million sperm are recovered after the sperm wash. (See Treatment of Cervical Factors). [106, 109] Patients whose reproductive tract, FSH, LH, and testosterone levels are determined to be normal or those who have low testosterone in the absence of any other hormonal abnormalities can be treated empirically with cycles of CC (25 mg PO qd for at least 6-12 mo). If there's a problem with the mucus, it can make it harder to conceive.

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A subgroup of patients has PCOS with hyperinsulinism, hyperandrogenism associated with acanthosis nigricans, and resistance to CC. [205, 206] This group is amenable to metformin treatment. [207, 208] Metformin improves insulin sensitivity and decreases hepatic gluconeogenesis and, therefore, reduces hyperinsulinism, basal and stimulated LH levels, and free testosterone concentration. 8 Involvement in group counseling and exercise is more effective than weight loss advice alone.

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The doctor or WHNP may also be able to suggest lifestyle changes to increase the chances of conceiving.[65] Women over the age of 35 should see their physician or WHNP after six months as fertility tests can take some time to complete, and age may affect the treatment options that are open in that case. Excess iron from multiple transfusions may get deposited in the pituitary gland and the testis, causing parenchymal damage and both pituitary and testicular insufficiency. Mumps: If this occurs after puberty, inflammation of the testicles may affect sperm production. Afterwards, fertilized eggs are placed directly into a fallopian tube (as with GIFT) and not into the uterine cavity. Bensdorp AJ, Cohlen BJ, Heineman MJ, Vandekerckhove P. Testicular Sperm Extraction (TESE) and Intracytoplasmic Sperm Injection (ICSI) for Non-obstructive Azoospermia.(PDF, 1 MB) 10th World Congress on In Vitro Fertilization and Assisted Reproduction, 1997. The eggs may never be released or they may only be released in some cycles. Semen and sperm Sometimes the sperm cannot travel effectively to meet the egg. Testicular Neoplasm in Father and Son. (PDF, 561 KB) The Journal of Urology, 1972.