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A diagnosis of male infertility can be one of the hardest challenges a man can face. One of the requirements for this procedure is that a woman should have at least 1 undamaged fallopian tube. Sherman Silber: Be Fruitful and Multiply. (PDF, 6 MB) Lifestyles Magazine, 1999. Hysteroscopy can also be combined with laparoscopy when necessary.

The principal indications for CC use are oligomenorrhea, especially polycystic ovarian syndrome (PCOS), and for patients with slight menstrual irregularities. 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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Thus one of the requirements is normal spermatogenesis – normal sperm count, motility and biologic structure and function. 0.[44] Environmental factors Toxins such as glues, volatile organic solvents or silicones, physical agents, chemical dusts, and pesticides.[45][46] Tobacco smokers are 60% more likely to be infertile than non-smokers.[47] German scientists have reported that a virus called adeno-associated virus might have a role in male infertility,[48] though it is otherwise not harmful.[49] Other diseases such as chlamydia, and gonorrhea can also cause infertility, due to internal scarring (fallopian tube obstruction).[50][51][52] Alimentary habits[53] Obesity: The obesity epidemic has recently become is a serious issue, particularly in industrialized nations. Uterine fibroid embolization (UFE) consists of catheterization of the uterine artery and the injection of microbeads of polyvinyl alcohol to selectively occlude the circulation of the fibroid. The Treatment of Azoospermia with Surgery and ICSI. (PDF, 4 MB) Chapter 10 from Male Fertility & Infertility, 1998. Trauma, previous attempts at sperm aspiration, and inguinal surgery may also result in ductal blockage.

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Anabolic steroids: Popular with bodybuilders and athletes, long-term use can seriously reduce sperm count and mobility. About a third of the time, infertility can be traced to the woman. They can include: Changes in hair growth Changes in sexual desire Pain, lump, or swelling in the testicles Problems with erections and ejaculation Small, firm testicles   When to See the Doctor If you are under 35 and have been trying to get pregnant without success for a year, see your doctor. Transvaginal ultrasound – Ultrasound is an important tool in evaluating the structure of the uterus, tubes, and ovaries. In some women, and especially with age, the membrane becomes harder.

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When Predictions Don’t Predict. (PDF, 549 KB) The Australian and New Zealand Journal of Obstetrics and Gynaecology, 1991. If the E2 and FSH levels are in the normal range, clomiphene citrate is the drug of choice, as previously described. Other medical techniques are e.g. tuboplasty, assisted hatching, and preimplantation genetic diagnosis. Women trying to conceive often have depression rates similar to women who have heart disease or cancer.[18] Emotional stress and marital difficulties are greater in couples where the infertility lies with the man.[19] Older people with adult children appear to live longer.[20] Why this is the case is unclear and may dependent in part on those who have children adopting a healthier lifestyle, support from children, or the circumstances that led to not having children.[20] [edit] In many cultures, inability to conceive bears a stigma. To help objectify sperm morphology and therefore enhance the consistency and reproducibility among laboratories, Kruger introduced a definition of "strict criteria" in 1986. A woman with a suspicion of chronic anovulation most probably due to polycystic ovary (PCO) syndrome, as there is a long history of irregular cycles and clinical presentation with hirsutism, her serum levels of testosterone hormone, sex hormone binding globulin (SHBG), dihydroepiandrostenedione (DHEA), dihydroepiandrostenedione-sulfate (DHEAS) and prolactin should be evaluated to prove the provisional diagnosis and to detect the source of excess androgens. Primary Lymphoma of Kidney. (PDF, 586 KB) The Journal of Urology, 1973. Perspectives on infertility consultations in primary care: a qualitative study. A specimen is collected by masturbation into a clean, dry, sterile container or during coitus using special condoms (containing no spermicidal lubricants). It can also help if a man has severe erectile dysfunction. 6,8 It is important for primary care physicians to be familiar with the workup and prognosis for infertile couples. They can also carry out some basic tests on both partners to see if there is an identifiable reason for not having achieved a pregnancy.