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Fertilizing Capacity of Epididymal and Testicular Sperm with ICSI. (PDF, 5 MB) Frontiers in Endocrinology, 1995. Urofollitropin (eg, Bravelle) contains 75 U of FSH.

Torsion: Is a common problem affecting fertility that is caused by a supportive tissue abnormality which allows the testes to twist inside the scrotum which is characterized by extreme swelling.  Torsion pinches the blood vessels that feed the testes shut which causes testicular damage.  If emergency surgery is not performed to untwist the testes, torsion can seriously impair fertility and cause permanent infertility if both testes twist. Treatment of Anovulatory Conditions Jump to section + Women with WHO group I ovulatory disorders should be counseled to achieve a normal body weight. This allows for the diagnosis and treatment of conditions such as endometriosis with one procedure. Affected individuals displayed more severe forms of infertility such as azoospermia and severe oligozoospermia.[27] Other causes[edit] Factors that can cause male as well as female infertility are: DNA damage DNA damage reduces fertility in female ovocytes, as caused by smoking,[28] other xenobiotic DNA damaging agents (such as radiation or chemotherapy)[29] or accumulation of the oxidative DNA damage 8-hydroxy-deoxyguanosine[30] DNA damage reduces fertility in male sperm, as caused by oxidative DNA damage,[31] smoking,[28] other xenobiotic DNA damaging agents (such as drugs or chemotherapy)[32] or other DNA damaging agents including reactive oxygen species, fever or high testicular temperature.[33] The damaged DNA related to infertility manifests itself by the increased susceptibility to denaturation inducible by heat or acid [34] or by the presence of double-strand breaks that can be detected by the TUNEL assay.[35] General factors Diabetes mellitus,[36][37] thyroid disorders,[38] undiagnosed and untreated coeliac disease,[39][40][41][42] adrenal disease[43] Hypothalamic-pituitary factors Hyperprolactinemia Hypopituitarism The presence of anti-thyroid antibodies is associated with an increased risk of unexplained subfertility with an odds ratio of 1.

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The treatment approach depends on the cause(s) of the infertility. The hypothalamus also produces thyrotropin-releasing hormone (TRH) and vasoactive intestinal peptide (VIP), both of which stimulate prolactin release from the anterior pituitary, and dopamine, which inhibits prolactin release. An ultrasound scan can detect an ectopic pregnancy. If both tubes are blocked, then in vitro fertilization (IVF) is required.

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Furthermore, as aging occurs, egg quality, or the likelihood of an egg being genetically normal, decreases. The most commonly prescribed pill to stimulate ovulation (generally of one mature egg) is clomiphene citrate. Ovulation induction is somewhat different from controlled ovarian hyperstimulation, which involves the use of some of the same medications to stimulate the development of multiple mature follicles and eggs in order to increase pregnancy rates with various infertility treatments. When anatomic variance or obstruction is suspected, referral for surgical evaluation and treatment is appropriate. 2) Medications to induce egg development and ovulation: The medications that help stimulate the ovary to develop mature eggs for ovulation come in two forms: pills taken by mouth and injections.

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34 Although intrauterine insemination has been shown to be equally effective as timed intercourse in unstimulated cycles, there is a modest increase in live birth rates when combined with ovarian stimulation. The surgery is performed during the early follicular phase. Medical conditions Some medical conditions can affect fertility. Restrict the treatment to 4 ovulatory cycles because 85% of patients conceive by the fourth ovulatory cycle. [204] If pregnancy is not achieved, further evaluation is required to exclude other factors that may be associated with infertility and may interfere with the success of CC therapy. Isolated LH deficiency (fertile eunuch) In these patients, LH levels are decreased while FSH levels are within the reference range. Semen and sperm Sometimes the sperm cannot travel effectively to meet the egg. If sperm does not appear in the ejaculate, but they are being produced, the doctor may be able to take sperm directly from the testicles, or from the bladder (in cases of retrograde ejaculation), and use that sperm to fertilize an egg in the lab. Results of one study investigating a cohort of 315 men revealed changes within the hinge region of SF-1 and no rare allelic variants in fertile control men. Treatment Possibilities: Male Infertility Surgical treatment may be successful in some cases, such as varicocele. In patients with nonobstructive azoospermia, retrograde ejaculation can be the etiologic factor. [107] The treatment consists of recovering sperm from a urine sample collected immediately after ejaculation. Etiology of Sterility Causes of sterility can be manifold and diverse.