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10 Data Sources: A PubMed search was completed using the key terms infertility, subfertility, treatment, etiology, and diagnosis. Epididymal Surgery. (PDF, 8 MB) Chapter 8 from textbook, Infertility, 1992. The results of these tests help determine the best fertility treatment. Inhibin B levels have been reported to decrease with increasing weight, which results in decreased Sertoli cells and sperm production. Clomiphene citrate for unexplained subfertility in women. Live Birth Following Day Surgery Reversal of Female Sterilisation in Women Older then 40 Year: A Realistic Option in Australia? (PDF, 156 KB) Medical Journal of Australia, 2007.

The epididymis is a coil-like structure in the testicles which helps store and transport sperm. This can help a man who cannot ejaculate normally, for example, because of a spinal cord injury. Aromatase inhibitors Aromatase inhibitors (letrozole, anastrozole) inhibit the action of the enzyme aromatase, which converts androgens into estrogens by a process called aromatization. Polyps and submucous fibroids can be removed during this procedure.

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Sperm count often returns to normal after stopping the medication. Long-term Economic Benefits Attributed to IVF-conceived Children: A Lifetime Tax Calculation. (PDF, 225 KB) The American Journal of Managed Care, 2008. Investigations Infertile couples are usually adviced to start their investigations after 12 months of trying to conceive or after 6 months if the female partner is more than 35 years old or immediately if there is an obvious cause for their infertility or subfertility [16]. Egg donation. This can help you if you have ovaries that don't work right but you have a normal uterus.

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Large polyps or multiple polyps can impact fertility by interfering with the ability of embryo to implant and should be removed. Ovarian Transplantation in a Series of Monozygotic Twins Discordant for Ovarian Failure. (PDF, 188 KB) The New England Journal of Medicine, 2007. Vasectomy and Vasectomy Reversal. (PDF, 7 MB) Fertility and Sterility, 1978. A variety of disorders ranging from hormonal disturbances to physical problems, to psychological problems can cause male infertility.  Although many treatment options are now available, in many cases treatment will not work.  In many instances, male infertility is caused by testicular damage resulting in an inability of the testicle to produce sperm.  Once damaged, the testicle will not usually regain its sperm-making capabilities; this aspect of male infertility is analogous to menopause (though not natural like menopause) for women and cannot usually be treated.  Despite medicine�s limited ability to treat male infertility, many successful treatment options are available for its many causes.  Besides testicular damage, the main causes of male infertility are low sperm production and poor sperm quality.   The Causes of Male Infertility Male infertility has many causes--from hormonal imbalances, to physical problems, to psychological and/or behavioral problems.  Moreover, fertility reflects a man�s �overall� health.  Men who live a healthy lifestyle are more likely to produce healthy sperm.  The following list highlights some lifestyle choices that negatively impact male fertility--it is not all-inclusive: · Smoking--significantly decreases both sperm count and sperm cell motility. · Prolonged use of marijuana and other recreational drugs. · Chronic alcohol abuse. · Anabolic steroid use--causes testicular shrinkage and infertility. · Overly intense exercise--produces high levels of adrenal steroid hormones which cause a    testosterone deficiency resulting in infertility. · Inadequate vitamin C and Zinc in the diet. · Tight underwear--increases scrotal temperature which results in decreased sperm production. · Exposure to environmental hazards and toxins such as pesticides, lead, paint, radiation, radioactive   substances, mercury,  benzene, boron, and heavy metals · Malnutrition and anemia. · Excessive stress! Absence of the main sperm pipeline known as the vas deferens.

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Some respond by actively avoiding the issue altogether; middle-class men are the most likely to respond in this way.[21] In the United States some treatments for infertility, including diagnostic tests, surgery and therapy for depression, can qualify one for Family and Medical Leave Act leave. Other causes include Y chromosome microdeletion, a depletion of chromosome material that impedes or severely decreases spermatozoa production. When the eggs are mature, your doctor collects them with a device called a vaginal ultrasound probe. This technique involves an injection of a single healthy sperm directly injected into mature egg. This can be made laparoscopically as well as sonographically. Unlike IVF, in which actual fertilization is observed and confirmed in the laboratory, GIFT does not allow visual confirmation of fertilization. Medication. If you have ovulation problems, you may be prescribed drugs such as clomiphene citrate (Clomid, Serophene), gonadotropins (such as Gonal-F, Follistim, Humegon and Pregnyl), or letrozole. Then, generally one or two embryos, which have demonstrated appropriate development, are carefully and gently transferred into the uterine cavity. Ultrastructure of Human Sperm in Men with Congenital Absence of the Vas Deferens: Clinical Implications. (PDF, 2 MB) Fertility and Sterility, 1992.