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Intrauterine insemination (IUI): At the time of ovulation, a fine catheter is inserted through the cervix into the uterus to place a sperm sample directly into the uterus. Postcoital testing and antisperm antibody testing are no longer considered useful in this evaluation.

Programming of Ovarian Stimulation with Norethindrone Acetate in IVF/GIFT Cycles. (PDF, 2 MB) Human Reproduction, 1989. The likelihood of fertilization improves significantly for men with low sperm concentrations. For women, being underweight and having extremely low amounts of body fat are associated with ovarian dysfunction and infertility and they have a higher risk for preterm birth. A mouse study has suggested that ingredients in some household detergents may reduce fertility. 21,22 Evaluation of Women Jump to section + The etiology of female infertility can be broken down into ovulation disorders, uterine abnormalities, tubal obstruction, and peritoneal factors. Definition “A woman of reproductive age who has not conceived after 1 year of unprotected vaginal sexual intercourse, in the absence of any known cause of infertility” NICE guideline, CG156 Primary infertility; couple have failed to conceive before. Secondary infertility; woman has previously been pregnant regardless of the outcome of the pregnancy and now unable to conceive.

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Problems maintaining erection A man’s ability to maintain an erection is often linked to his hormone levels. Sperm Retrieval for Azoospermia and Intracytoplasmic Sperm Injection Success Rates – A Personal Overview.(PDF, 1 MB) Human Fertility, 2010. Uterine fibroids Fibroids are noncancerous growths in the uterus. Unhealthy living and poor eating habits, as well as exposure to toxic substances such as alcohol, tobacco and other contaminants, also have a negative impact on fertility.

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Castration of the affected testis may allow the other testis to regain its ability to produce sperm, but the prognosis is guarded. While these injuries are rare, significant complications can occur, and they are primarily related to the umbilical insertion site. Possible problems could be that the egg is not released at the optimum time for fertilization, that it may not enter the fallopian tube, sperm may not be able to reach the egg, fertilization may fail to occur, transport of the zygote may be disturbed, or implantation fails. Once patients desire to have children, they proceed with stimulation of the ovaries, oocyte aspiration, and in vitro fertilization, but the embryos are transferred to a gestational carrier (see In Vitro Fertilization). Assisted Reproductive Technology: Using Ejaculated, Fresh, and Frozen-thawed Epididymal and Testicular Spermatozoa Gives Rise to Comparable Results after Intracytoplasmic Sperm Injection. (PDF, 5 MB) Fertility and Sterility, 1995.

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Infertility rates have increased by 4% since the 1980s, mostly from problems with fecundity due to an increase in age.[72] Fertility problems affect one in seven couples in the UK. Motility, adhesions and focusses of endometriosis can precisely be assessed by laparoscopy with blue instillation. It is very important that these injuries be recognized as early as possible.[26] Some patients have sustained electrical burns unseen by surgeons who are working with electrodes that leak current into surrounding tissue. Epididymal Surgery. (PDF, 8 MB) Chapter 8 from textbook, Infertility, 1992. As in the case of sterility, the process will get under way right away in those cases where there is a background of reproduction issues. The male partner can be evaluated for infertility or subfertility using a variety of clinical interventions, and also from a laboratory evaluation of semen.” (Semen manual, 5th Edition3). Ultrasound can detect uterine abnormalities such as fibroids and polyps, distal fallopian tube occlusion, and ovarian abnormalities including ovarian cysts. Practice Committee of the American Society for Reproductive Medicine. When the big veins heat the testes too much, the heat damages the sperm. Vitrification of oocytes from endangered Mexican gray wolves (Canis lupus baileyi). (PDF, 319 KB) Theriogenology, 2010. If they are blocked, it indicates the site of the block. Causes Potential causes of male infertility are: The complete absence of sperm (azoospermia) Low sperm count (oligospermia) Abnormal sperm shape (teratozoospermia) Problems with sperm movement (asthenozoospermia) Sperm that is completely immobile (necrozoospermia); the sperm may be alive and not moving, or they may be dead Problems with sperm delivery, due to sexual dysfunction, an obstruction, previous vasectomy, or retrograde ejaculation Problems with erections or other sexual problems There are a variety of conditions that may lead to male infertility. Further investigations Investigation of suspected tubal and uterine abnormalities: 1. 8,33,35,36 Lastly, in vitro fertilization, with or without intracytoplasmic sperm injection, is the mainstay of assisted reproductive technology for male factor infertility.