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Unlike female infertility (where irregular periods may hint at a problem), obvious symptoms are not common with male infertility. Treatment of Anovulatory Conditions Jump to section + Women with WHO group I ovulatory disorders should be counseled to achieve a normal body weight. The dynamics of stress in fertile and infertile couples. In the testicle, germ cells (especially up to the preleptotene stage) are especially at risk.

Treatment of Male-factor Infertility. (PDF, 10 MB) Chapter 9 from Progress in Infertility, 1993. Several studies have reported different causes of infertility [7-9]. A lower concentration may lead to a lower chance for conception without treatment; 3) sperm motility or movement – a normal motility should be at least 50%. 8,37 Women in WHO group II, including those who are overweight and who have polycystic ovary syndrome, can benefit from weight loss, exercise, and lifestyle modifications to restore ovulatory cycles and achieve pregnancy. Microsurgery for the Undescended Testicle. (PDF, 5 MB) Urologic Clinics of North America, 1982.

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Erectile dysfunction or premature ejaculation: Medication, behavioral approaches, or both may help improve fertility. When the syndrome occurs, the treatment is to be made symptomatically. Submucosal fibroids are the type if fibroid that has clearly been demonstrated to reduce pregnancy rate, roughly by 50%, and removal of which will double pregnancy rate. If the correction is not done, it may be harder for the sperm to get to the female's cervix. Other tests include: ovarian reserve testing, to find out how effective the eggs are after ovulation genetic testing, to see if a genetic abnormality is interfering with fertility pelvic ultrasound, to produce an image of the uterus, fallopian tubes, and ovaries Chlamydia test, which may indicate the need for antibiotic treatment thyroid function test, as this may affect the hormonal balance Complications Some complications can result from infertility and its treatment. A woman of reproductive age who has not conceived after 1 year of unprotected vaginal sexual intercourse, in the absence of any known cause of infertility.

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The procedure is done during the premenstrual phase, approximately 12 days after presumed ovulation to see if the endometrium undergoes expected changes. If too many embryos develop, one or more can be removed. Graft-versus-host Reactivity and Renal Allograft Survival in Rats Given Allogeneic Spleen Cells or Spleen Allografts.(PDF, 2 MB) Transplantation, 1976. The Three-kidney Rat Model. (PDF, 2 MB) Investigative Urology, 1974. Surgical ablation: - In minimal or mild endometriosis; surgical ablation or resection of endometriosis plus laparoscopic adhesiolysis improves the chance of pregnancy. - Laparoscopic resection of endometriomas may be beneficial, however recent RCTs suggest intervention only in endometriomas > 4cm. - In moderate or sever endometriosis; surgical treatment should be offered. (Debatable) - Post-operative medical treatment does not improve pregnancy rates. Vasectomy. (PDF, 5 MB) From the Encyclopedia of Reproduction, 1999.

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A prolactin level of more than 150 mcg/L suggests a pituitary adenoma, while levels greater than 300 mcg/L are nearly diagnostic. Human menopausal gonadotropins Crowe discovered that the gonads were under the control of the anterior hypophysis. [175] Zondek and Aschheim discovered that FSH and LH were responsible for the development of the gonads in immature animals and confirmed Crowe's work. [135, 136] In the 1930s, ovulation induction was attempted by using gonadotropins from a mare, but its use was discontinued because of the development of antibodies. [176, 177] Borth et al demonstrated the effect of FSH and LH extracted from menopausal urine. [178, 179] Gemzell reported the first ovulation induction using human pituitary gonadotropin in 1958, and the first pregnancy was reported in 1960. [180, 181] Lunenfeld reported preliminary results using hMG; however, in 1963, it was definitely established as a real ovulation induction agent. [182, 183, 184] Human menopausal gonadotropin (hMG [eg, Repronex, Menopur]) contains 75 U of FSH and 75 U of LH per mL, although the concentration may vary among batches (ranges from FSH at 60-90 U and LH at 60-120 U). Effectiveness of the postcoital test: randomised controlled trial. As the major causes of infertility are sperm abnormalities, ovulation dysfunction, and fallopian tube obstruction, the preliminary adviced investigations for the infertile couple should be focused on semen analysis (to be compared with the WHO reference values [27]), detection of ovarian function by hormonal assay (early follicular FSH and LH levels, and mid-luteal progesterone), and evaluation of tubal patency by hysterosalpingography (HSG) [17-32], (Appendix 3). Testing for tubal patency and normalcy of the uterine cavity with a hysterosalpingogram The hysterosalpingogram, or HSG is done in order to assess the anatomy of the endometrial cavity of the uterus and the fallopian tubes. The sample should be processed within 1 hour, and 2-3 samples (at a minimum of 2-3 days apart) should be evaluated because of daily variations in sperm number and quality.