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After recovery, the testicle may return to normal or may atrophy. Excess alcohol consumption: This may lower male fertility. ARTICLES FROM THE 2000s Evaluation and Treatment of Male Infertility. (PDF, 17 MB) Clinical Obstetrics and Gynecology, 2000. Testicular histology typically reveals a decreased number of Leydig cells and decreased spermatogenesis. Practice Committee of the American Society for Reproductive Medicine in collaboration with the Society for Reproductive Endocrinology and Infertility. (2008).

If the E2 and FSH levels are in the normal range, clomiphene citrate is the drug of choice, as previously described. However, until approximately age 64, a man’s age does not affect sperm or the ability to fertilize eggs.

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24 Other tests of ovarian reserve, such as the clomiphene (Clomid) challenge test, antral follicle count, and antimüllerian hormone level, are also generally performed to predict response to ovarian stimulation with exogenous gonadotropins and assisted reproductive technology. Peritubaric adhesions can be caused by endometriosis.

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The chance of a live birth following treatment is nearly 50% [25]. Because 85% of couples conceive spontaneously within 12 months if having intercourse regularly,5 it is important to identify those who will benefit from infertility evaluation.

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Causes Potential causes of male infertility are: The complete absence of sperm (azoospermia) Low sperm count (oligospermia) Abnormal sperm shape (teratozoospermia) Problems with sperm movement (asthenozoospermia) Sperm that is completely immobile (necrozoospermia); the sperm may be alive and not moving, or they may be dead Problems with sperm delivery, due to sexual dysfunction, an obstruction, previous vasectomy, or retrograde ejaculation Problems with erections or other sexual problems There are a variety of conditions that may lead to male infertility. Fertilized eggs are then transferred several days later into the woman’s uterus, where implantation and embryo development will hopefully occur as in a normal pregnancy. However, about one in five cases of infertility has no clear diagnosed cause.[73] In Britain, male factor infertility accounts for 25% of infertile couples, while 25% remain unexplained. Estrogen causes negative feedback on the pituitary gland, inhibiting LH and FSH release. Couples will have to consider the ethical and emotional aspects of this procedure. Although obesity is well known to be associated with insulin resistance, women with PCOS are even more resistant to insulin than other patients who are obese. 8 Couples with unexplained infertility may want to consider another year of intercourse before moving to more costly and invasive therapies, such as assisted reproductive technology.