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Low sperm mobility (motility): The sperm cannot "swim" as well as they should to reach the egg. The anamnesis includes sexual behavior concerning ovulation here.

Gynecological history, including operations and medical treatment. Bensdorp AJ, Cohlen BJ, Heineman MJ, Vandekerckhove P. World Health Organization reference values for human semen characteristics. Unlike women, whose fertility significantly declines after the age of 35, men’s fertility doesn’t decline until they are much older. Individual tests evaluate only one aspect of a quality necessary for fertility and do not imply the ability or inability to achieve conception (see the Table in the Procedures section).

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ART procedures, such as GIFT, IVF, and ICSI, also can be used in cases of male infertility. Any of the following can cause a man to have a low sperm count or abnormal sperm: Varicocele — an abnormal collection of bulging veins above the testicle; they’re the most common cause of correctable male infertility, accounting for 38% of cases Undescended testicle Infections in the testicle (orchitis), the prostate (prostatitis), or elsewhere in the body that causes a fever Chemotherapy for cancer Medicines such as anabolic steroids or anti-seizure medicines Genetic abnormalities Hormone problems In some cases, these problems can be reversed, but other times they can’t. Role of Semen Analysis in Subfertile Couples. (PDF, 250 KB) Fertility and Sterility, 2010. It varies with the age (the optimal female age is between 23 and 39 years) and with body weight (the ideal body mass index is between 19 and 30).

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A penile exam should detect atrophy, tumors, epididymal cysts, cryptorchidism (undescended testicles), vas thickening or absence of the vas deferens, hydrocele (fluid accumulation in the testis or along the spermatic cord) or varicocele. It is possible that this mechanism evolved to protect the mother’s health. 25 Women with no clear risk of tubal obstruction should be offered hysterosalpingography to screen for tubal occlusion and structural uterine abnormalities. Problems with sperm If a man makes too few sperm or none at all, the woman cannot become pregnant. Ovarian Transplantation in a Series of Monozygotic Twins Discordant for Ovarian Failure. (PDF, 188 KB) The New England Journal of Medicine, 2007.

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Vasectomy. (PDF, 5 MB) From the Encyclopedia of Reproduction, 1999. IVF was a major breakthrough because it allowed for successful pregnancies in women that were previous deemed permanently infertile, such as when the fallopian tubes are both markedly damaged. 8,45 Figure 1 provides an algorithmic approach to the evaluation of infertility.   Enlarge      Print Infertility Evaluation Figure 1. Approximately 10% of cases are unexplained, where no definitive cause can be identified. Microsurgery for Vasectomy Reversal and Vasoepididymostomy. (PDF, 13 MB) Urology, 1984. The average pregnancy rate achieved after a natural-cycle intrauterine insemination is 8%. Intra-uterine insemination for male subfertility. Antibodies that are bound to sperm decrease the sperm’s ability to penetrate the cervical mucus and bind to the zona pellucida. Testosterone is converted to dihydrotestosterone (DHT) by the action of 5-alpha reductase, both locally and in the periphery, and to estrogen in the periphery. For one, don’t do things to hurt your chances to have viable sperm — marijuana, cocaine, tobacco, and more than two alcoholic drinks a day harm sperm production, says Ross. PID is a major cause of tubal infertility and can lead to ectopic pregnancy, which may further damage the reproductive system. If the cilial epithelium has been destroyed, the outcome of the procedure is poor, and it is better to perform a salpingectomy in preparation for future IVF. Counseling about options should be offered to couples who are not physically able to conceive (i.e., same-sex couples or persons lacking reproductive organs).