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Congenital Adrenal Hyperplasia: Occurs when the pituitary is suppressed by increased levels of adrenal androgens.  Symptoms include low sperm count, an increased number of immature sperm cells, and low sperm cell motility.  Is treated with cortisone replacement therapy.  This condition is found in only 1 percent of infertile men. Around one third of couples have difficulty conceiving due to a low sperm count. Used by some clinicians to evaluate the motility of the sperm and its ability to travel through the cervical mucus. Generally, their response to hMG ovulation induction is too brisk or delayed, and predicting whether the patient will respond easily is not possible. Generally, evaluation should be offered to couples who have not conceived after one year of unprotected vaginal intercourse.

Patients with a high number of immature sperm should be evaluated for excessive exposure to heat or radiation or for infectious processes. Key to the diagnosis of male infertility is a semen analysis, which assesses primarily sperm numbers, sperm movement and sperm form. The Most Common Causes of Male Sterility There are several causes of male sterility, including: Abnormal sperm production Impaired delivery of sperm Testosterone deficiency Genetic defects Undescended testes Also, erectile dysfunction or low libido can make the process of procreation that much more difficult. They can interfere with implantation or block the fallopian tube, preventing sperm from fertilizing the egg. Other tests include: ovarian reserve testing, to find out how effective the eggs are after ovulation genetic testing, to see if a genetic abnormality is interfering with fertility pelvic ultrasound, to produce an image of the uterus, fallopian tubes, and ovaries Chlamydia test, which may indicate the need for antibiotic treatment thyroid function test, as this may affect the hormonal balance Complications Some complications can result from infertility and its treatment.

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Surgical ablation: - In minimal or mild endometriosis; surgical ablation or resection of endometriosis plus laparoscopic adhesiolysis improves the chance of pregnancy. - Laparoscopic resection of endometriomas may be beneficial, however recent RCTs suggest intervention only in endometriomas > 4cm. - In moderate or sever endometriosis; surgical treatment should be offered. (Debatable) - Post-operative medical treatment does not improve pregnancy rates. Testis Biopsy and the Infertile Male. (PDF, 20 MB) Chapter 15 from textbook Office Andrology, 2005. In 1978, the first baby was born as a result of IVF.

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Abnormal sperm: The sperm may have an unusual shape, making it harder to move and fertilize an egg. Infertility is defined as the inability to become pregnant after 12 months of regular, unprotected intercourse. The most common disorders impacting ovulation include polycystic ovary syndrome (PCOS), hypogonadotropic hypogonadism (from signaling problems in the brain), and ovarian insufficiency (from problems of the ovary). Worldwide, 8 to 12 percent of couples experience fertility problems.

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Semen is the milky fluid that a man's penis releases during orgasm. Pelvic inflammatory disease Pelvic inflammatory disease (PID) is an infection of the upper female genital tract, which includes the womb, fallopian tubes and ovaries. Vause TD, Cheung AP, Sierra S, et al.; Society of Obstetricians and Gynecologists of Canada. Bushnik T, Cook JL, Yuzpe AA, Tough S, Collins J. Other considerations include preconception screening and vaccination for preventable diseases such as rubella and varicella, sexually transmitted infections, and cervical cancer, based on appropriate guidelines and risk. A decreased testosterone level with an increased FSH level points to primary hypogonadism. 8,46 Obesity impairs fertility and the response to fertility treatments, including in vitro fertilization; therefore, it is advisable to counsel patients who are obese to lose weight before conception or infertility treatments. If a person is experiencing other symptoms, they may wish to speak to a doctor. Microsurgery of the Male Genitalia for Infertility. (PDF, 8 MB) Chapter 59 from Reconstructive Urologic Surgery, 1994. There are many disorders that may impact the ability for a woman to ovulate normally.