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Unexplained infertility in women or men may be managed with another year of unprotected intercourse, or may proceed to assisted reproductive technologies, such as intrauterine insemination or in vitro fertilization. Testing for Men In the case of men, a general physical examination will be performed, with discussions concerning medical history, illnesses, disabilities, medications and sexual habits.

To Transplant or Not to Transplant – That Is the Question. (PDF, 3 MB) 2010. New Concepts in Operative Andrology: A Review. (PDF, 7 MB) International Journal of Andrology, 2000. If a blockage is present, surgery may be necessary.

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Endometriosis Endometriosis is when the tissue of the uterine lining grows outside of the uterus. BMI (body mass index) may be a significant factor in fertility, as an increase in BMI in the male by as little as three units can be associated with infertility.

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10 Data Sources: A PubMed search was completed using the key terms infertility, subfertility, treatment, etiology, and diagnosis. The diagnostic charts, which may be photocopied, provide an unambiguous route to diagnosis of the underlying cause of infertility, whilst the text fully explains and describes the essential clinical tests. Sterility is an emotional journey for the couple trying to become pregnant, and feelings of anger, guilt, and depression are not uncommon. However, its value has been questioned because some studies have found no correlation between the presence or absence of viable sperm in the mucus and subsequent fertility. Men with this type of male infertility have normal sperm in the testicles. There are also a number of sperm production problems that can contribute to infertility, including: Scrotal varicose veins (varicoceles)  Scrotal varicose veins (varicoceles) are swollen veins causing your testicles to get hotter and affect the production of sperm  These are treated with surgery  Testicular injury   Serious trauma to the testicles such as becoming twisted (torsion) can affect sperm production  Damage from playing sports or an accident can rupture the vessels that supply blood to the testicles  Previous injuries can’t be treated, but an ART treatment may help you to conceive Undescended testicles  In the uterus, baby boys’ testicles form in their abdomen and descend into their scrotum shortly before birth  Some men’s testicles don’t descend before they are born (cryptorchidism), although in these cases they usually drop in the first six months after birth  If left untreated, undescended testicles can affect fertility Testicular cancer  This happens when a malignant tumour in the testicle destroys testicular tissue  If undetected, testicular cancer can spread to other parts of the body  This is treated either by surgery, medication, radiotherapy or chemotherapy  However, cancer therapy can also damage sperm production  Genetic defects  Sometimes, genetic information on the Y chromosome (which is only present in men) is deleted (micro-deletions),6 which can reduce the production of sperm  Depending on where the micro-deletion is on the chromosome, this may be treated by surgically extracting sperm from part of your reproductive tract  However, some couples may need to consider using a donor sperm to conceive Mumps Contracting mumps (or mumps-related orchitis) after puberty may damage the sperm-producing cells in your testicles,  causing infertility or subfertility7 Usually, only one testicle is affected and if you have one functioning testicle you may not need treatment  However, some couples may need to use a sperm donor in order to conceive Anti-sperm antibodies  Anti-sperm antibodies are large proteins in your blood that are hostile to sperm  They can cause sperm to clump together and prevent them from swimming, or they may mistake sperm cells for an infection and try to destroy them  This can be treated using an ART treatment   Lifestyle   Sperm production can be affected by a range of lifestyle factors, including smoking, drinking, drugs, stress, overweight and unhealthy food Environmental factors can also affect your sperm quality, including overheating of your testicles, some sexual lubricants, the chemicals involved in certain manufacturing, painting or printing jobs   These factors are treated by making lifestyle changes, such as wearing loose clothing to avoid overheating Hormonal problems  Hormonal problems are rarely the cause of male infertility problems  However, some men have a natural deficiency in follicle-stimulating hormone (FSH) and luteinising hormone (LH), which prevents the testicles from producing testosterone or developing healthy sperm  Hormonal problems can usually be treated with medication Obstruction problems Blocked sperm ducts  Occasionally, male sperm ducts (epididymis and vas deferens) can become blocked, meaning that your semen doesn’t contain any sperm  This can be treated with surgery, or sperm may be surgically extracted from part of your reproductive tract  Vasectomy  Some men have had a previous vasectomy to stop them being able to conceive  This can sometimes be reversed using surgery  The procedure’s success depends on how long ago your vasectomy was performed  Previous infections  Infections can cause scarring or adhesions (organs sticking together) in your sperm ducts  This can usually be treated with surgery  Does age affect male fertility?

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Once a diagnosis has been made, you and your partner can consider the various treatment options. In-vitro fertilization (IVF.)Sperm are mixed with multiple eggs collected from the woman in a “test tube” (actually just a plastic dish.). Problems maintaining erection A man’s ability to maintain an erection is often linked to his hormone levels. A small incision is made in the abdomen, and a thin, flexible microscope with a light at the end, called a laparoscope, is inserted through it. Make an appointment with your doctor and go over your concerns. Furthermore, myomas in the uterus lead to occlusions of the lumen and so cause sterility. Reproductive Biology. (PDF, 147 KB) The Scientist, 1996. Stem cell therapy[edit] Nowadays, there are several treatments (still in experimentation) related with stem cell therapy. ART: Intracytoplasmic Sperm Injection (ICSI) (Continued) Once an egg is injected, it is observed for approximately 14 hours to see if fertilization has occurred (average fertilization rate is about 65%), and for 24 hours to ensure that cell division has started. Advising surgery in cases of primary infertility is difficult. Reversal of Vasectomy and the Treatment of Male Infertility. (PDF, 4 MB) Journal of Andrology, 1980. Gonadotropins can trigger ovulation when Clomid or Serophene don't work.