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These questions will be regarding your medical, surgical, gynecological, and obstetric history, as well as some lifestyle questions. Arcuate uterus In general, an arcuate uterus does not cause infertility.

Normal Fertilization of Human Oocytes after Testicular Sperm Extraction and Intracytoplasmic Sperm Injection.(PDF, 2 MB) Fertility and Sterility, 1994. 29 When the semen analysis is abnormal, referral to a male fertility specialist or reproductive endocrinologist is warranted.

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Treatment of Male-factor Infertility. (PDF, 10 MB) Chapter 9 from Progress in Infertility, 1993. A bicornuate uterus can be associated with a history of recurrent miscarriages, and its repair is indicated only if other etiologies for the miscarriage have been excluded (see Surgical intervention below). This allows for the diagnosis and treatment of conditions such as endometriosis with one procedure. The Intra-abdominal Testes: Microvascular Autotransplantation. (PDF, 4 MB) The Journal of Urology, 1981.

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Search dates: January 6, 2014; January 28, 2014; February 5, 2014; and November 18, 2014. Possible problems could be that the egg is not released at the optimum time for fertilization, that it may not enter the fallopian tube, sperm may not be able to reach the egg, fertilization may fail to occur, transport of the zygote may be disturbed, or implantation fails. The likelihood of fertilization improves significantly for men with low sperm concentrations. For women aged 35, about 94% who have regular unprotected sexual intercourse get pregnant after three years of trying.

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Hormonal Problems A small percentage of male infertility is caused by hormonal problems.  The hypothalamus-pituitary endocrine system regulates the chain of hormonal events that enables testes to produce and effectively disseminate sperm.  Several things can go wrong with the hypothalamus-pituitary endocrine system: · The brain can fail to release gonadotrophic-releasing hormone (GnRH) properly.  GnRH stimulates   the hormonal pathway that causes testosterone synthesis and sperm production.  A disruption in   GnRH release leads to a lack of testosterone and a cessation in sperm production. · The pituitary can fail to produce enough lutenizing hormone (LH) and follicle stimulating hormone   (FSH) to stimulate the testes and testosterone/sperm production.  LH and FSH are intermediates   in the hormonal pathway responsible for testosterone and sperm production. · The testes� Leydig cells may not produce testosterone in response to LH stimulation. · A male may produce other hormones and chemical compounds which interfere with the   sex-hormone balance. Semm established several standard procedures that were regularly performed, such as ovarian cyst enucleation, myomectomy, treatment of ectopic pregnancy and finally laparoscopic-assisted vaginal hysterectomy (nowadays termed as cervical intra-fascial Semm hysterectomy). It delivers a constant supply of Gn-RH to the pituitary gland, which alters the production of hormone, allowing the doctor to induce follicle growth with FSH. Congenital Adrenal Hyperplasia: Occurs when the pituitary is suppressed by increased levels of adrenal androgens.  Symptoms include low sperm count, an increased number of immature sperm cells, and low sperm cell motility.  Is treated with cortisone replacement therapy.  This condition is found in only 1 percent of infertile men. Aetiology of Congenital Absence of Vas Deferens: Genetic Study of Three Generations. (PDF, 4 MB) Human Reproduction, 1993. Macroscopic deletions of Yq11 are often observed in patients with azoospermia, although many new microdeletions have been implicated as a significant cause of infertility. These are both treatment options for microprolactinoma. The results of these tests help determine the best fertility treatment. Fertility awareness methods are used to discern when these changes occur by tracking changes in cervical mucus or basal body temperature.