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The diagnostic charts, which may be photocopied, provide an unambiguous route to diagnosis of the underlying cause of infertility, whilst the text fully explains and describes the essential clinical tests. Causes include: Surgery: Pelvic surgery can sometimes cause scarring or damage to the fallopian tubes. As the major causes of infertility are sperm abnormalities, ovulation dysfunction, and fallopian tube obstruction, the preliminary adviced investigations for the infertile couple should be focused on semen analysis (to be compared with the WHO reference values [27]), detection of ovarian function by hormonal assay (early follicular FSH and LH levels, and mid-luteal progesterone), and evaluation of tubal patency by hysterosalpingography (HSG) [17-32], (Appendix 3).

The incidence rate of ectopic pregnancy after surgery is in the range of 5%. Anatomic causes of infertility include acquired and congenital problems.

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If oligospermia or azoospermia is noted, hypogonadism should be suspected. Broekmans FJ, Kwee J, Hendriks DJ, Mol BW, Lambalk CB. Web of Science, in-addition to the relevant printed medical journals and periodicals. The recourse for these specimens is to remove the seminal fluid by successive media washes.

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The following is a list of hormonal disorders which can disrupt male infertility: Hyperprolactinemia: Elevated prolactin--a hormone associated with nursing mothers, is found in 10 to 40 percent of infertile males.  Mild elevation of prolactin levels produces no symptoms, but greater elevations of the hormone reduces sperm production, reduces libido and may cause impotence.  This condition responds well to the drug Parlodel (bromocriptine). Intrauterine insemination. For this procedure, after semen gets rinsed with a special solution, a doctor places it into your uterus when you're ovulating. Male fertility starts declining in their thirties, while women older than 35 years may experience problems conceiving. Women presenting with a history of this anomaly should be considered high-risk obstetrical patients. [115] Bicornuate uterus A bicornuate uterus causes only minimal problems with infertility (if any). Microsurgery and Andrology. (PDF, 5 MB) Chapter from textbook, 1991. Exercise: Both too much and too little exercise can lead to fertility problems.

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With this treatment, the patient experience spermatogenesis, and therefore, it has the chance to have offspring if he wants to. The principal indications for CC use are oligomenorrhea, especially polycystic ovarian syndrome (PCOS), and for patients with slight menstrual irregularities. These endometrial cells can extend as far as the outside of the fallopian tubes, the ovaries and the bladder. At this point, psychological consultation and support should be provided [44]. Therefore, data estimating the prevalence of infertility cited by various sources differs significantly.[8] A couple that tries unsuccessfully to have a child after a certain period of time (often a short period, but definitions vary) is sometimes said to be subfertile, meaning less fertile than a typical couple. Ovary Transplantation for Fertility Preservation in Cancer Patients: Fresh and Frozen. (PDF, 1 MB) Chapter 42 from textbook Clinial Infertility, 2010. Primary infertility When a woman is unable to ever bear a child, either due to the inability to become pregnant or the inability to carry a pregnancy to a live birth she would be classified as having primary infertility. Problems with sexual intercourse These can include trouble keeping or maintaining an erection sufficient for sex (erectile dysfunction), premature ejaculation, painful intercourse, anatomical abnormalities such as having a urethral opening beneath the penis (hypospadias), or psychological or relationship problems that interfere with sex. IUI treatment, where the sperm is transferred into the uterus via the cervix, is commonly used in cases of low sperm count or quality. Prostatitis can be subclinical or contribute to subfertility and infertility in dogs. Infertility is more likely in men who have had this condition. Patients with hyperthyroidism or hypothyroidism must be treated accordingly. [210, 211] Weight reduction should be part of the treatment because it helps the patient's response to ovulation induction. [212] Treatment of Male Factors Asthenospermia associated with varicocele is treated surgically with varicocelectomy or with embolization of the spermatic veins. If natural selection is the primary error correction mechanism that prevents random mutations on the Y chromosome, then fertility treatments for men with abnormal sperm (in particular ICSI) only defer the underlying problem to the next male generation. This can help a man who cannot ejaculate normally, for example, because of a spinal cord injury. Many uterine and tubal abnormalities detected by the HSG can be surgically corrected.