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Seminal vesicle aspiration revealing numerous sperm or a dynamic test such as injection of indigo carmine into the seminal vesicle or ejaculatory duct may be necessary for diagnosis.[31] Ejaculation issues Anejaculation/retrograde ejaculation may be due to an open bladder neck or a lack of rhythmic contractions during ejaculation.Causes of Infertility A problem in any one of a number of key processes can result in infertility. Regression of Metastases after Nephrectomy for Renal Cell Carcinoma. (PDF, 1 MB) British Journal of Urology, 1975.

If a blockage is present, surgery may be necessary. 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. Women with anovulation may be treated in the primary care setting with clomiphene to induce ovulation.

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Genetics of Male Infertility: Evolution of the X and Y Chromosome and Transmission of Male Infertility to Future Generations. (PDF, 10 MB) Chapter 5 from Essential IVF, 2004. Opinion: Microsurgical TESE and the Distribution of Spermatogenesis in Non-obstructive Azoospermia. (PDF, 5 MB)Human Reproduction, 2000. If the epididymis is blocked, sperm may not be ejaculated properly. The application of artificial insemination usually is made after previous medicamentous treatment. Evaluation should be pursued by 6 months of attempted pregnancy in women with a known history of these abnormalities or a history of bleeding between menstrual cycles. Pregnancy after Vasovasostomy for Vasectomy Reversal: A Study of Factors Followed for 10 Years. (PDF, 3 MB)Human Reproduction, 1989.

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Some large breeds of dogs may not have their first estrus until they are ≥2 yr old, and some individuals and some breeds typically have only one estrous cycle each year. Surprisingly, the complete absence of sperm in the semen (a condition known as azoospermia), can be a good thing. Prolonged estrus may be caused by ovarian cysts that produce estrogen, functional ovarian tumors, or exogenous estrogens (including human transdermal hormone replacement therapy). Aetiology of Congenital Absence of Vas Deferens: Genetic Study of Three Generations. (PDF, 4 MB) Human Reproduction, 1993. The rising number of obese individuals may be due in part to an energy-rich diet as well as insufficient physical exercise.  In addition to other potential health risks, obesity can have a significant impact on male and female fertility. Ideally, using strict morphology criteria, a minimum of 5 – 15% normal forms leads to a better ability for sperm to fertilize the egg.

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Basal body temperatures are no longer considered a reliable indicator of ovulation, and are not recommended for evaluating ovulation. 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. Temporal relationship and reliability of the clinical, hormonal, and ultrasonographic indices of ovulation in infertile women. If the woman is over the age of 35 years old, she may be infertile if she has not become pregnant after 6 months of trying. ART techniques generally start with stimulating the ovaries to increase egg production. Analyses of the CFTR Gene in 67 Patients. (PDF, 4 MB) The American Journal of Human Genetics, 1995.