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Problems with ejaculation or ejaculate Having difficulty ejaculating or noticing changes in the ejaculate, such as a drop in volume, may also be a sign of an underlying issue related to a man's fertility. Chlamydia test: Chlamydia can affect fertility, but antibiotics can treat it. 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. Congenital Absence of the Vas Deferens: The Fertilizing Capacity of Human Epididymal Sperm. (PDF, 3 MB) New England Journal of Medicine, 1990.

Treatment is with human menopausal gonadotropin (HMG) or exogenous FSH. Some respond by actively avoiding the issue altogether; middle-class men are the most likely to respond in this way.[21] In the United States some treatments for infertility, including diagnostic tests, surgery and therapy for depression, can qualify one for Family and Medical Leave Act leave.

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Exposure to chemicals: Pesticides, for example, may increase the risk. Patients with hyperthyroidism or hypothyroidism must be treated accordingly. [210, 211] Weight reduction should be part of the treatment because it helps the patient's response to ovulation induction. [212] Treatment of Male Factors Asthenospermia associated with varicocele is treated surgically with varicocelectomy or with embolization of the spermatic veins. During this time, the cells cross from the basal to the adluminal compartments. Nonfunctional pituitary tumors may compress the pituitary stalk or the gonadotropic cells, interrupting the proper chain of signals leading to pituitary failure. 6,28 Additionally, postcoital testing of cervical mucus is no longer recommended because it does not affect clinical management or predict the inability to conceive.

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Cushing disease Increased cortisol levels cause a negative feedback on the hypothalamus, decreasing GnRH release. Uterine fibroids Fibroids are noncancerous growths in the uterus. However, some have suggested that patients should avoid conception for 6 months to 2 years after completion of radiation therapy because of the possibility of chromosomal aberrations in their sperm caused by the mutagenic properties of radiation therapy. A Series of Monozygotic Twins Discordant for Ovarian Failure: Ovary Transplantation (Cortical versus Microvascular) and Crypreservation. (PDF, 791 KB) Human Reproduction, 2008.

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Moderate ovarian hyperstimulation syndrome is characterized by ovarian enlargement (5-12 cm in diameter) moderate ascites, nausea, vomiting, abdominal discomfort, and weight gain greater than 10 lb. Enzymatic Digestion of Testicular Tissue May Rescue the Intracytoplasmic Sperm Injection Cycle in Some Patients with Non-obstructive Azoospermia. (PDF, 66 KB) Human Reproduction, 1998. Three main events necessary for pregnancy to occur are: Ovulation: the process by which the mature egg is released from one of the woman’s ovaries. You take gonadotropins that trigger the development of more than one egg. Embryo Development after ICSI Using Testicular, Epididymal and Ejaculated Spermatozoa. (PDF, 2 MB) Frontiers in Endocrinology, 1995. Some medications increase the risk of fertility problems in men. Role of Semen Analysis in Subfertile Couples. (PDF, 250 KB) Fertility and Sterility, 2010. Primary infertility is when a couple has not conceived after trying for at least 12 months without using birth control Secondary infertility is when they have previously conceived but are no longer able to. Evaluation of the Female Partner: Evidence of Ovulation (Continued) Progesterone test.