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Etiologies include cysts (midline and eccentric), ductal calcification and stones, postinfectious, and postoperative. Other testing may be needed based on circumstances, including testicular biopsy, genetic testing, and imaging (Table 36–8,10,19,20). Theoretically, with this therapy, we can get artificial gamets in vitro. Varicocele: Surgically removing a varicose vein in the scrotum may help.

Unexplained infertility[edit] In the US, up to 20% of infertile couples have unexplained infertility.[61] In these cases abnormalities are likely to be present but not detected by current methods. Round Spermatid Injection. (PDF, 422 KB) Fertility and Sterility, 2000. This can reveal signs of endometriosis, scarring, blockages, and some irregularities of the uterus and fallopian tubes. 6-Mb Deletion of the Human Y Chromosome Persists Through Balance Between Recurrent Mutation and Haploid Selection. (PDF, 295 KB) Nature Genetics, 2003.

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38,39 Family physicians may choose to attempt ovulation induction in anovulatory women (WHO group II) with clomiphene. Ovarian Transplantation in a Series of Monozygotic Twins Discordant for Ovarian Failure. (PDF, 188 KB) The New England Journal of Medicine, 2007. Veltman-Verhulst SM, Cohlen BJ, Hughes E, Heineman MJ. Advances in assisted reproductive technologies, such as IVF, can offer hope to many couples where treatment is available, although barriers exist in terms of medical coverage and affordability. If a woman needs an HCG injection to activate ovulation and ultrasound scans show that too many follicles have developed, it is possible to withhold the HCG injection. In women, both smoking and alcohol use are associated with lower rates of conception and increased rates of spontaneous abortion.

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Anabolic steroids: Popular with bodybuilders and athletes, long-term use can seriously reduce sperm count and mobility. The sperm must provide the zygote with DNA, centrioles, and activation factor for the embryo to develop.

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Microsurgery in Clinical Urology. (PDF, 5 MB) Urology, 1975. Periparturient Problems in Small Animals Was This Page Helpful?Infertility definitions and terminology A couple sits at the bank of a lake in Ahmedabad, India. Reproductive Biology. (PDF, 147 KB) The Scientist, 1996. Microsurgery for the Undescended Testicle. (PDF, 5 MB) Urologic Clinics of North America, 1982. 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! The likelihood of fertilization improves significantly for men with low sperm concentrations. Bromocriptine (Parlodel): This drug inhibits prolactin production. Some people find that joining a support group helps, as it offers the chance to talk to others in a similar situation.