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Causes of infertility include male factors, ovulatory dysfunction, uterine abnormalities, tubal obstruction, peritoneal factors, or cervical factors. Optimizing natural fertility: a committee opinion. If necessary, they refer patients to a fertility clinic or local hospital for more specialized tests. In general, ART involves surgically removing eggs from a woman’s ovaries, combining them with sperm in the laboratory, and returning them to the woman’s body. Large submucosal uterine fibroids may make the uterus' cavity bigger, increasing the distance the sperm has to travel.

Enzymatic Digestion of Testicular Tissue May Rescue the Intracytoplasmic Sperm Injection Cycle in Some Patients with Non-obstructive Azoospermia. (PDF, 66 KB) Human Reproduction, 1998. The mature spermatid is then located adjacent to the tubule lumen and contains dark chromatin with an oval-shaped nucleus. Hypothyroidism: Low thyroid hormone levels--can cause poor semen quality, poor testicular function and may disturb libido.  May be caused by a diet high in iodine.  Reducing iodine intake or beginning thyroid hormone replacement therapy can elevate sperm count.  This condition is found in only 1 percent of infertile men. There may be testicular malformations, hormone imbalance, or blockage of the man's duct system.

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Health problems such as mumps or hormone problems. Frequency of intercourse Probability of conception (within 6 months) 1 time per week 17 % 3 times per week 50 % 6.

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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. The effect of age upon men's fertility is less clear.[citation needed] In people going forward for IVF in the UK, roughly half of fertility problems with a diagnosed cause are due to problems with the man, and about half due to problems with the woman. Klinefelter�s Syndrome: Is a genetic condition in which each cell in the human body has an additional X chromosome--men with Klinefelter�s Syndrome have one Y and two X chromosomes.  Physical symptoms include peanut-sized testicles and enlarged breasts.  A chromosome analysis is used to confirm this analysis.  If this condition is treated in its early stages (with the drug hCG), sperm production may commence and/or improve.  However, Klinefelter�s Syndrome eventually causes all active testicular structures to atrophy.  Once testicular failure has occurred, improving fertility is impossible. Abnormalities of sperm may be treated with gonadotropin therapy, intrauterine insemination, or in vitro fertilization. Apparent Fertility of Human Spermatozoa from the Caput Epididymidis. (PDF, 4 MB) Journal of Andrology, 1989. Congenital forms of anestrus may be due to lack of function of the hypothalamic-pituitary axis or ovarian dysgenesis.

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Treatment of tubal obstruction generally requires referral for subspecialty care. 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). Testicular neoplasia, commonly producing estrogen, usually causes infertility. 37 Clomiphene has also proven effective for ovulation induction in women with polycystic ovary syndrome. 4 IU per L]) can help differentiate between primary and secondary disorders. XX male (sex reversal syndrome) An XX karyotype is due to a crossover of the sex-determining region (SRY) of the Y chromosome (with the testis determining factor) to either the X chromosome or an autosome. History-taking Couples with infertility problem should be interviewed separately as well as together, to bring out important facts that one partner might not wish to disclose to the other. Adolescents with a varicocele and testicular atrophy or lack of growth should similarly consider repair. Chromosomal defects Hereditary disorders, such as Klinefelter’s syndrome (when a male is born with two X chromosomes and one Y chromosome instead of one X and one Y) impacts the normal development of the male reproductive organs. Other causes of ovulation disorders include ovarian insufficiency and hypothalamic amenorrhea. These and many other questions will help your physician design a specific evaluation and potential treatment for you. Fertilizing Capacity of Epididymal and Testicular Sperm with ICSI. (PDF, 5 MB) Frontiers in Endocrinology, 1995. Patients with azoospermia or severe oligospermia seeking assisted reproductive techniques should be screened.


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Female Infertility Medscape
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