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Fertility Evaluation: General and Sexual History A detailed history includes: General history  This includes occupation and background, use of tobacco, alcohol and drugs, earlier diseases, history of abdominal surgery and earlier infections. It varies with the age (the optimal female age is between 23 and 39 years) and with body weight (the ideal body mass index is between 19 and 30). 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. Evaluation of cervical mucus is unreliable; therefore, investigation is not helpful with the management of infertility. Primary infertility When a woman is unable to ever bear a child, either due to the inability to become pregnant or the inability to carry a pregnancy to a live birth she would be classified as having primary infertility. Around one third of couples have difficulty conceiving due to a low sperm count.

Dealing with Fertility Problems After Vasectomy Reversal. (PDF, 7 MB) Contemporary OB/GYN, 1978. NIH: National Institute of Child Health and Human Development Start Here How Common is Male Infertility, and What Are Its Causes? (National Institute of Child Health and Human Development) Male Infertility (American Academy of Family Physicians) Also in Spanish Male Infertility (Mayo Foundation for Medical Education and Research) Also in Spanish Diagnosis and Tests Diagnostic Testing for Male Factor Infertility (American Society for Reproductive Medicine) - PDF Also in Spanish Semen Analysis (National Library of Medicine) Also in Spanish Testosterone Levels Test (National Library of Medicine) Also in Spanish Treatments and Therapies Assisted Reproductive Technology: MedlinePlus Health Topic (National Library of Medicine) Also in Spanish Healthy Sperm: Improving Your Fertility (Mayo Foundation for Medical Education and Research) Also in Spanish Intracytoplasmic Sperm Injection (ICSI) (American Society for Reproductive Medicine) Also in Spanish Intrauterine Insemination (IUI) (Mayo Foundation for Medical Education and Research) Also in Spanish What Treatment Options Are Available for Male Infertility? (National Institute of Child Health and Human Development) Living With Foods That Can Affect Fertility (Academy of Nutrition and Dietetics) Related Issues Fertility Issues in Boys and Men with Cancer (National Cancer Institute) Finasteride (Propecia/Proscar) and Pregnancy (Organization of Teratology Information Specialists) - PDF Low Testosterone and Men's Health (Hormone Health Network) Also in Spanish Optimizing Male Fertility (American Society for Reproductive Medicine) Specifics Dry Orgasm (Orgasm without Discharge of Semen) (Mayo Foundation for Medical Education and Research) Also in Spanish Low Sperm Count (Mayo Foundation for Medical Education and Research) Also in Spanish Sperm Shape (Morphology): Does It Affect Fertility? (American Society for Reproductive Medicine) Also in Spanish Genetics Genetics Home Reference: 48,XXYY syndrome (National Library of Medicine) Genetics Home Reference: CATSPER1-related nonsyndromic male infertility (National Library of Medicine) Genetics Home Reference: congenital bilateral absence of the vas deferens (National Library of Medicine) Genetics Home Reference: globozoospermia (National Library of Medicine) Genetics Home Reference: macrozoospermia (National Library of Medicine) Genetics Home Reference: sensorineural deafness and male infertility (National Library of Medicine) Genetics Home Reference: X-linked adrenal hypoplasia congenita (National Library of Medicine) Genetics Home Reference: Y chromosome infertility (National Library of Medicine) Learning about Klinefelter Syndrome (National Human Genome Research Institute) Videos and Tutorials Causes of Male Infertility (American Society for Reproductive Medicine) Sperm release pathway (Medical Encyclopedia) Also in Spanish Statistics and Research High Plasticizer Levels In Males Linked to Delayed Pregnancy for Female Partners (National Institute of Child Health and Human Development) Infertility Research at the NICHD (National Institute of Child Health and Human Development) Clinical Trials ClinicalTrials.gov: Infertility, Male (National Institutes of Health) ClinicalTrials.Differences between sterility and infertility (primary and secondary) ARE STERILITY AND INFERTILITY THE SAME? Primary vs. secondary infertility[edit] Primary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months, during which they have not used any contraceptives.[14] The World Health Organisation also adds that 'women whose pregnancy spontaneously miscarries, or whose pregnancy results in a still born child, without ever having had a live birth would present with primarily infertility'.[15] Secondary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months since their last live birth, during which they did not use any contraceptives.[15] Thus the distinguishing feature is whether or not the couple have ever had a pregnancy which led to a live birth.

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It involves removing eggs from the ovary of a donor who has taken fertility drugs. If this becomes a regular occurrence, it may interfere with sexual intercourse or be a sign of an underlying issue. 8,33,35,36 Lastly, in vitro fertilization, with or without intracytoplasmic sperm injection, is the mainstay of assisted reproductive technology for male factor infertility. A Physical Map of the Human Y Chromosome. (PDF, 160 KB) Nature, 2001. Hysterosalpingography: Fluid is injected into the woman's uterus and X-rays are taken to determine whether the fluid travels properly out of the uterus and into the fallopian tubes. Tubal occlusion is a cause of infertility because an ovulated egg is unable to be fertilized by sperm or to reach the endometrial cavity.

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Obese women have a higher rate of recurrent, early miscarriage compared to non-obese women. This method takes several weeks and daily hormone injections are needed to ensure successful implantation. Typical drugs are clomifene, cyclofenil, tamoxifen, and epimestrol among others. Products include enzymes and proteases to liquefy the seminal coagulum. IVF/ICSI 38. Controlled ovarian stimulation: - By urinary or recombinant FSH and/or HMG. - Dose depends on age, BMI, presence of PCO and ovarian reserve. - Monitoring of folliculometry by USS and E2. Triggering of ovulation: - By urinary of recombinant HCG, 36 before oocyte retrieval. If both tubes are blocked, then in vitro fertilization (IVF) is required.

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Ovarian Transplantation between Monozygotic Twins Discordant for Premature Ovarian Failure. (PDF, 315 KB) The New England Journal of Medicine, 2005. Intrauterine insemination. For this procedure, after semen gets rinsed with a special solution, a doctor places it into your uterus when you're ovulating. The treating doctor may feel inadequacy and the trust between the doctor and patient breaks down [43]. Urofollitropin (eg, Bravelle) contains 75 U of FSH. 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. Patients who do not ovulate because of a fault in the pituitary gland may receive this drug as an injection. 1 Infertility is medically defined as the inability to conceive after 12 months of unprotected sex. Some physical effects may also result from treatment. Clinical Characterization of 42 Oligospermic or Azoospermic Men with Microdeletion of the AZFc Region of the Y Chromosome, and of 18 Children Conceived via ICSI. (PDF, 606 KB) Human Reproduction, 2002.