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Microsurgical Solutions to Male Infertility. (PDF, 2 MB) Contemporary OB/GYN, 2005. Unexplained Even after a full fertility work-up, for one in five couples an exact cause of infertility cannot be determined. Male fertility starts declining in their thirties, while women older than 35 years may experience problems conceiving.

The idea is that for women beyond age 35, every month counts and if made to wait another six months to prove the necessity of medical intervention, the problem could become worse. Surprisingly, the complete absence of sperm in the semen (a condition known as azoospermia), can be a good thing. Laboratory studies have suggested that long-term acetaminophen use during pregnancy may affect fertility in males by lowering testosterone production. It involves removing eggs from the ovary of a donor who has taken fertility drugs.

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Bilateral anorchia (vanishing testes syndrome) Patients have a normal male karyotype (46, XY) but are born without testis bilaterally. Mental stress: This may affect female ovulation and male sperm production and can lead to reduced sexual activity. There are several requirements for male fertility.

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ICSI with Epididymal and Testicular Sperm Retrieval. (PDF, 1 MB) Male Sterility and Motility Disorders: Etiological Factors and Treatment, 1998. GIFT (gamete intrafallopian tube transfer) and ZIFT (zygote intrafallopian transfer).  Like IVF, these procedures involve retrieving an egg, combining it with sperm in a lab, and then transferring it back to your body.

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Microsurgical Epididymal Sperm Aspiration and Assisted Reproductive Techniques. (PDF, 4 MB) Frontiers in Human Reproduction, 1991. Only an additional 7% of couples will conceive in the second year. Negative tests with immotile sperm in the cervical mucus suggest rare immunological causes of sterility. Factors contributing to the formation of antisperm antibodies in women are disturbance of normal immunoregulatory mechanisms, infection, violation of the integrity of the mucous membranes, rape and unprotected oral or anal sex. VITRIKAS, MD, David Grant Medical Center Family Medicine Residency, Travis Air Force Base, California Am Fam Physician. 2015 Mar 1;91(5):308-314.   Patient information: See related handout on infertility, written by the authors of this article.   Related letter: Natural Procreative Technology for Treating Infertility This clinical content conforms to AAFP criteria for continuing medical education (CME). No Differences in Outcome after Intracytoplasmic Sperm Injection with Fresh or with Frozen-thawed Epididymal Spermatozoa. (PDF, 66 KB) Human Reproduction, 1999.