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Clinical examination Full clinical examination of both partners usually stands for the underlying physical problem [17-22,24-26], (Appendix 2). The 3 classes of surgical techniques are conventional laparotomy, operative laparoscopy, and operative hysteroscopy, as follows: Laparotomy: This technique is indicated for large myomas, for submucous myomas larger than 3 cm in diameter, or for myomas that, regardless of being submucous, have a portion of the myoma that compromises the myometrium so that a complete resection through the hysteroscopy is not feasible. Suspect antisperm antibodies when semen analysis reveals abnormal clumping, agglutination, unexplained decreased motility, or an abnormal postcoital test result. A doctor injects sperm directly into the egg in a dish and then places it into your uterus.

Do you have pain with menstrual periods or intercourse? Hypothyroidism: Low thyroid hormone levels--can cause poor semen quality, poor testicular function and may disturb libido.  May be caused by a diet high in iodine.  Reducing iodine intake or beginning thyroid hormone replacement therapy can elevate sperm count.  This condition is found in only 1 percent of infertile men. It plays a central role in the multiple imbalances and dysfunctions of polycystic ovary syndrome. When the big veins heat the testes too much, the heat damages the sperm. Primary Lymphoma of Kidney. (PDF, 586 KB) The Journal of Urology, 1973.

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If there is a history of recurrent miscarriages (2 or more) a lupus anticoagulant (LAC) and anti-cardiolipin antibody (ACL) are often done, as well as other tests. Surgical procedures for women If the fallopian tubes are blocked or scarred, surgical repair may make it easier for eggs to pass through. A prolactin level of more than 150 mcg/L suggests a pituitary adenoma, while levels greater than 300 mcg/L are nearly diagnostic.

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The final third may be due to a combination of both, other factors, or unknown causes. Low sperm mobility (motility): The sperm cannot "swim" as well as they should to reach the egg. This produces a sensation of pain that may extend to the patient's shoulders. If the sperm do not have the right shape, or they cannot travel rapidly and accurately towards the egg, conception may be difficult. What’s on the Mind of IVF Consumers? (PDF, 627 KB) Reproductive BioMedicine Online, 2009. IVF and other fertility treatments have resulted in an increase in multiple births, provoking ethical analysis because of the link between multiple pregnancies, premature birth, and a host of health problems.

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Sperm are then collected, washed, and added to the eggs in the dish. Weight loss in obese infertile women results in improvement in reproductive outcome for all forms of fertility treatment. 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. The virus may either directly damage the seminiferous tubules or indirectly cause ischemic damage as the intense swelling leads to compression against the tough tunica albuginea. 8 If a woman has irregular cycles, the testing should be conducted later in the cycle, starting seven days before presumed onset of menses, and repeated weekly until menses. Transplantation of a Human Testis for Anorchia. (PDF, 19 MB) Fertility and Sterility, 1978. Based on numerous prospective randomized controlled trials, the approach has proven to be beneficial in reducing post-operative morbidities such as wound infections and incisional hernias (especially in morbidly obese patients), and is now deemed safe when applied to surgery for cancers such as cancer of colon.[6][7] Laparoscopic instruments. Infertility in Men Below you will find a list of some of the most common causes of infertility in men. Tubal occlusion A tubal occlusion means there is a blockage in the fallopian tube. Zygote Intrafallopian Transfer (ZIFT) Zygote Intrafallopian Transfer (ZIFT) is another variation of IVF. Hysterosalpingogram (HSG) – This test is essential for evaluating fallopian tubal patency, uterine filling defects such as fibroids and polyps, and scarring of the uterine cavity (Asherman syndrome). The good news is that most cases of male infertility can be resolved either by treating the problem or using fertility treatments. 8–16 One retrospective case-control study of 650 men with infertility and 698 control participants questioned the role of environmental risk; no association could be determined after assessing for multiple factors including shift work, stress, and pesticides.