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Have you had any sexually transmitted infections or abnormal pap smears? Pelvic ultrasonography can be used once a week until the dominant follicle is detected; once this occurs, ultrasonography can be used more frequently until ovulation occurs. An evaluation by a physician is the only way to sort it out.

Adhesions with the surrounding tissue can develop as well, and reduce the motility of the tubes. The effects of age on fertility are moderate and do not begin to take an effect until the late 30s. Follicle-stimulating hormone (Gonal-F, Bravelle): This hormone is produced by the pituitary gland that controls estrogen production by the ovaries. When used in the early follicular phase, letrozole inhibits estrogen synthesis, thereby causing enhanced GnRH pulsatility and consequent FSH and inhibin stimulation.

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The Treatment of Azoospermia with Surgery and ICSI. (PDF, 4 MB) Chapter 10 from Male Fertility & Infertility, 1998. The volume provides clear guidelines and a logical sequence of steps which will quickly lead the clinician or physician to an accurate diagnosis of the underlying cause of infertility. The bladder must be emptied 1 hour prior to sperm collection, and a second dose of sodium bicarbonate is taken along with 16 ounces of fluid. Ejaculatory Duct Obstruction. (PDF, 3 MB) The Journal of Urology, 1980. There is a consistent association of Mycoplasma genitalium infection and female reproductive tract syndromes. Abnormal sperm: The sperm may have an unusual shape, making it harder to move and fertilize an egg.

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The emotional toll on both partners can affect their relationship. However, hormones are not the main problem in 97% of infertile men. 8 Involvement in group counseling and exercise is more effective than weight loss advice alone. Treatment of Male-factor Infertility. (PDF, 10 MB) Chapter 9 from Progress in Infertility, 1993.

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The relation between daily activities and scrotal temperature. Medicines are usually given to the woman first to increase the number of eggs she releases. Vasectomy Reversal. (PDF, 733 KB) The New England Journal of Medicine, 1977. Algorithm for infertility evaluation. (ART = assisted reproductive technology.) Infertility Evaluation Figure 1. Luciano AA, Peluso J, Koch EI, Maier D, Kuslis S, Davison E. Adding recombinant human FSH to HCG has been shown to be effective in achieving spermatogenesis in most patients.[18] Select patients with adult-onset idiopathic hypogonadotropic hypogonadism may respond to clomiphene citrate therapy.[19] Prader-Willi syndrome Patients have characteristic obesity, mental retardation, small hands and feet, and hypogonadotropic hypogonadism due to a GnRH deficiency. Recovery of Spermatogenesis after Testicle Autotransplantation in an Adult Male. (PDF, 2 MB) Fertility and Sterility, 1982. Predominantly anovulation is caused by hormonal imbalances such as Polycystic Ovarian Syndrome (PCOS) but ovarian scarring and premature menopause can also result in failure to ovulate. • Tubal disease, comprising anything from mild adhesions to complete blockage of the fallopian tubes, prevents fertilised eggs from travelling from the site of fertilisation to the uterus. In other cases, the cause is suspected to be immunological or genetic; it may be that each partner is independently fertile but the couple cannot conceive together without assistance. Epididymal Extravasation Following Vasectomy as a Cause for Failure of Vasectomy Reversal. (PDF, 22 MB)Fertility and Sterility, 1979. The woman may be given a low dose of ovary stimulating hormones.