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3,4  Infertility may arise from male factors, female factors, or a combination of these (Table 15–8). Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. 30% of women face reproduction issues at this age because ovarian reserve decreases, there are fewer eggs and they are of an inferior quality. The majority of men with varicocele present no symptoms. Causes include: Surgery: Pelvic surgery can sometimes cause scarring or damage to the fallopian tubes. Testicular histology typically reveals a decreased number of Leydig cells and decreased spermatogenesis.

Some diseases: Conditions that are sometimes linked to lower fertility in males are anemia, Cushing's syndrome, diabetes, and thyroid disease. Testis Biopsy and the Infertile Male. (PDF, 20 MB) Chapter 15 from textbook Office Andrology, 2005. Lack of pregnancy Lack of pregnancy can be related to disruption of the cervical mucus, inadequate follicular development, presence of luteinized unruptured follicle syndrome, progesterone deficiency, and premature administration of hCG to trigger ovulation. A thorough physical exam can detect varicocele and give clues to hormone problems. Pregnancy Caused by Sperm from Vasa Efferentia. (PDF, 1 MB) Fertility and Sterility, 1988. Previous pelvic surgeries involving the fallopian tubes can also increase your chances of infertility.

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If the correction is not done, it may be harder for the sperm to get to the female's cervix. 48 However, there is no firm evidence that preconception counseling leads to increased live birth rates, in part because no studies on this topic have been performed. 9 Because anxiety over infertility may cause increased stress and decreased libido, further compounding the problem, formal counseling is encouraged for couples experiencing infertility.

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Sperm motility Motility is described as the percent of sperm present with flagellar motion viewed on a bright-field or phase-contrast microscope. A defect in any of these sperm structures may result in infertility that will not be detected by semen analysis.[60] Antisperm antibodies cause immune infertility.[23][24] Cystic fibrosis can lead to infertility in men.

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Diverse Spermatogenic Defects in Humans Caused by Y Chromosome Deletions Encompassing a Novel RNA-binding Protein Gene. (PDF, 2 MB) Human Reproduction, 1996. Infertility and impaired fecundity in the United States, 1982–2010: data from the National Survey of Family Growth. Treatment of Tubal and Peritoneal Factors The treatment of tubal-factor infertility underwent major changes, especially during the last quarter of the century when microsurgery became available. [126, 127] Tubal reconstruction was the only hope for those patients before assisted reproductive therapy became available. On the other hand, swollen, painful, or tender testicles may be a sign of an underlying issue, such as an infection, that can also impact sperm quality and male fertility. Conception and Fertility The chance of conceiving in any given menstrual cycle is less than 20% in a woman of reproductive age. The recourse for these specimens is to remove the seminal fluid by successive media washes. Ascites Petechial bleedings Weight loss Visual disorders Gait pattern in small steps 2. Ejaculation disorders Ejaculation disorders include premature ejaculation, anejaculation (the failure to ejaculate), and retrograde ejaculation, which is when semen enters the bladder during orgasm instead of coming out the tip of the penis. Mutations in the Cystic Fibrosis Gene in Patients with Congenital Absence of the Vas Deferens. (PDF, 5 MB) New England Journal of Medicine, 1995.