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This process has revolutionized assisted reproductive technology and the way reproductive endocrinologists can help people in having a baby. To Transplant or Not to Transplant – That Is the Question. (PDF, 3 MB) 2010. Diagnosis and Management of Hypogonadism, Infertility, and Impotence. (PDF, 13 MB) Chapter 22 of textbook,Male Reproductive Dysfunction, 1986. 37 Clomiphene has also proven effective for ovulation induction in women with polycystic ovary syndrome. Normal Fertilization of Human Oocytes after Testicular Sperm Extraction and Intracytoplasmic Sperm Injection.(PDF, 2 MB) Fertility and Sterility, 1994.

This may be used if IVF has not been effective, if there has been poor embryo growth rate, and if the woman is older. An estimated 28% of all couples seeking reproductive assistance may have normal findings on their clinical evaluation, making the unexplained infertility a more common provisional diagnosis. Advising surgery in cases of primary infertility is difficult. A low testosterone level with a low FSH level signals a secondary cause. The Relationship of Abnormal Semen Parameters to Male Fertility. (PDF, 4 MB) Human Reproduction, 1989. Drugs used for both women and men[67] include clomiphene citrate, human menopausal gonadotropin (hMG), follicle-stimulating hormone (FSH), human chorionic gonadotropin (hCG), gonadotropin-releasing hormone (GnRH) analogues, aromatase inhibitors, and metformin.

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Testicular Neoplasm in Father and Son. (PDF, 561 KB) The Journal of Urology, 1972. Immotility of the sperm can be caused by antibodies against the sperm. Segmental dysplasia is defined as a vas deferens with at least 2 distinct sites of vasal obstruction. Germ cells (precursors to spermatozoa) are derived from the gonadal ridge and migrate to the testicle before testicular descent. Physical Problems A variety of physical problems can cause male infertility.  These problems either interfere with the sperm production process or disrupt the pathway down which sperm travel from the testes to the tip of the penis.  These problems are usually characterized by a low sperm count and/or abnormal sperm morphology.  The following is a list of the most common physical problems that cause male infertility: Variocoele: A varicocele is an enlargement of the internal spermatic veins that drain blood from the testicle to the abdomen (back to the heart) and are present in 15% of the general male population and 40% of infertile men.  These images show what a variocoele looks like externally and internally.  A varicocele develops when the one way valves in these spermatic veins are damaged causing an abnormal back flow of blood from the abdomen into the scrotum creating a hostile environment for sperm development.  Varicocoeles may cause reduced sperm count and abnormal sperm morphology which cause infertility.  Variococles can usually be diagnosed by a physical examination of the scrotum which can be aided by the Doppler stethoscope and scrotal ultrasound.  Varicocoele can be treated in many ways (see treatment section), but the most successful treatments involve corrective surgery.

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This elevates the abdominal wall above the internal organs to create a working and viewing space. Tests and trials are available, but testing does not always reveal a specific cause. Treatment of the cause: 28. Tubal and uterine factors: 4.

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Practice Committee of American Society for Reproductive Medicine. ICSI with Epididymal and Testicular Sperm Retrieval. (PDF, 1 MB) Male Sterility and Motility Disorders: Etiological Factors and Treatment, 1998. In closed social groups, a degree of rejection (or a sense of being rejected by the couple) may cause considerable anxiety and disappointment. Ejaculatory Duct Obstruction. (PDF, 3 MB) The Journal of Urology, 1980.