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If he has two X chromosomes and one Y chromosome, as in Klinefelter's syndrome, the testicles will develop abnormally and there will be low testosterone and a low sperm count or no sperm. Prolactin stimulates milk production during breastfeeding. Endometriosis: Cells that normally occur within the lining of the uterus start growing elsewhere in the body. Apparent Fertility of Human Spermatozoa from the Caput Epididymidis. (PDF, 4 MB) Journal of Andrology, 1989. This should be followed by documentation of ovulation via serum progesterone. Controversies in OB/GYN: Is Varicocelectomy Useful for Treatment of Male-factor Infertility? (PDF, 4 MB)Contemporary OB/GYN, 2001.

8 Patients should be counseled that 50% of couples who have not conceived in the first year of trying will conceive in the second year. In 1985, Erich Mühe performed the first laparoscopic cholecystectomy. Diverse Spermatogenic Defects in Humans Caused by Y Chromosome Deletions Encompassing a Novel RNA-binding Protein Gene. (PDF, 7 MB) Nature Genetics, 1995. If a semen analysis is found to be abnormal, generally it is first repeated to confirm the abnormality. There are other hormonal anomalies with no direct link to the ones mentioned above that can affect ovulation.

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Low weight: Obesity is not the only way in which weight can impact fertility. If oligospermia or azoospermia is noted, hypogonadism should be suspected.

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Acquired anestrus may result from previous oophorectomy, exogenous hormonal treatment (including glucocorticoids), profound hypothyroidism, or ovarian disease (cysts or neoplasia). A Modern View of Male Infertility. (PDF, 7 MB) From The Infertile Male: Advanced Assisted Reproductive Technology, 1994. Many uterine and tubal abnormalities detected by the HSG can be surgically corrected. Treatment of Endometriosis Endometriosis treatment may be divided according to the severity of the disease and patient needs.

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Diagnosis Most people will visit a physician if there is no pregnancy after 12 months of trying. Testicular Transplantation and Autotransplantation. (PDF, 8 MB) Chapter 22 of textbook, Extracorporeal and Microvascular Surgery, 1982. This prevents the sperm from fertilizing the egg. The treating doctor may feel inadequacy and the trust between the doctor and patient breaks down [43]. The patients are classified as WHO1 (15%) - hypo-gonadotropic, hypo-estrogenic, WHO2 (80%) - normo-gonadotropic, normo-estrogenic, and WHO3 (5%) - hyper-gonadotropic, hypo-estrogenic.