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Conventional IVF vs ICSI (Intra Cytoplasmic Sperm Injection) for Patients Requiring Microsurgical Epididymal Sperm Aspiration (MESA). (PDF, 4 MB) Chapter from textbook, Frontiers in Endocrinology: Perspectives on Assisted Reproduction, 1994. Blockage of the ejaculatory duct: Sperm can be extracted directly from the testicles and injected into an egg in the laboratory.

Surgical Management of Male Infertility. (PDF, 2 MB) Chapter 12 from textbook, Male Infertility, 1992. Infertility tests for women A woman will undergo a general physical examination, and the doctor will ask about her medical history, medications, menstruation cycle, and sexual habits. In humans, infertility is the inability to become pregnant after one year of intercourse without contraception involving a male and female partner.[2] There are many causes of infertility, including some that medical intervention can treat.[3] Estimates from 1997 suggest that worldwide about five percent of all heterosexual couples have an unresolved problem with infertility. Hypogonadism Hypogonadism is an abnormally low level of testosterone, the male sex hormone involved in making sperm.

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Prolactinomas or the intakes of dopamine antagonists (typical antipsychotics for example) cause hyperprolactinemia. Sherman Silber: Be Fruitful and Multiply. (PDF, 6 MB) Lifestyles Magazine, 1999.

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Surgeons who choose this hand-assist technique feel it reduces operative time significantly versus the straight laparoscopic approach. They include: Clomifene (Clomid, Serophene): This encourages ovulation in those who ovulate either irregularly or not at all, because of PCOS or another disorder. In addition to stimulation by FSH, Sertoli cell function is modulated by intratesticular testosterone and signals from peritubular myoid cells. Sterility is the inability to conceive after two years of regular intercourse. Fallopian tube factor: in vivo fertilisation takes place inside the fallopian tubes. As the rate of getting spontaneous pregnancy among infertile or subfertile couples is lower than that among normal fertile population, it is recommended to carry out the following diagnostic, evidence-based, work-up to detect any hidden treatable cause.

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Most couples skip the invasive laparoscopic surgery and do treatments with intrauterine inseminations and then IVF if inseminations are not successful. 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. In these methods, fertilization occurs inside the body. 37,38 The addition of 1,500 to 1,700 mg of metformin (Glucophage) daily may increase ovulation and pregnancy rates, but it does not significantly improve live birth rates over clomiphene alone. Abnormalities of sperm may be treated with gonadotropin therapy, intrauterine insemination, or in vitro fertilization. Symptoms of hormone fluctuations Signs of hormone fluctuations in women could indicate potential issues with fertility. 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. 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. The Treatment of Azoospermia with Surgery and ICSI. (PDF, 4 MB) Chapter 10 from Male Fertility & Infertility, 1998. Often, in vitro fertilization (IVF) can reveal abnormalities in egg quality, sperm function, or embryo development that would not have been determined from standard testing. Helping our patients develop a deep understanding of their fertility options will make the process smoother. Normal seminal fructose concentration is 120-450 mg/dL, with lower levels suggesting ejaculatory duct obstruction or absence of the seminal vesicles.