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His first atlas, More Details on Pelviscopy and Hysteroscopy was published in 1976, a slide atlas on pelviscopy, hysteroscopy, and fetoscopy in 1979, and his books on gynecological endoscopic surgery in German, English, and many other languages in 1984, 1987, and 2002. Symptoms depend on what is causing the infertility.

Calcification of the Seminal Vesicles and Vas Deferens in a Uremic Patient. (PDF, 3 MB) The Journal of Urology, 1971. Damaged Sperm Ducts: Seven percent of infertile men cannot transport sperm from their testicles to out of their penis.  This pathway may be blocked by a number of conditions: · A genetic or developmental mistake may block or cause the absence of one or both tubes (which   transport the sperm from the testes to the penis). · Scarring from tuberculosis or some STDs may block the epididymis or tubes. · An elective or accidental vasectomy may interrupt tube continuity.

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Risk factors for male infertility include obesity, age (over 40 -- yes, men also have biological clocks), current or previous infection of an STD, smoking, or excessive drinking. Patients with a high number of immature sperm should be evaluated for excessive exposure to heat or radiation or for infectious processes. Affected individuals displayed more severe forms of infertility such as azoospermia and severe oligozoospermia.[27] Other causes[edit] Factors that can cause male as well as female infertility are: DNA damage DNA damage reduces fertility in female ovocytes, as caused by smoking,[28] other xenobiotic DNA damaging agents (such as radiation or chemotherapy)[29] or accumulation of the oxidative DNA damage 8-hydroxy-deoxyguanosine[30] DNA damage reduces fertility in male sperm, as caused by oxidative DNA damage,[31] smoking,[28] other xenobiotic DNA damaging agents (such as drugs or chemotherapy)[32] or other DNA damaging agents including reactive oxygen species, fever or high testicular temperature.[33] The damaged DNA related to infertility manifests itself by the increased susceptibility to denaturation inducible by heat or acid [34] or by the presence of double-strand breaks that can be detected by the TUNEL assay.[35] General factors Diabetes mellitus,[36][37] thyroid disorders,[38] undiagnosed and untreated coeliac disease,[39][40][41][42] adrenal disease[43] Hypothalamic-pituitary factors Hyperprolactinemia Hypopituitarism The presence of anti-thyroid antibodies is associated with an increased risk of unexplained subfertility with an odds ratio of 1.

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Also attached is a fiber optic cable system connected to a "cold" light source (halogen or xenon), to illuminate the operative field, which is inserted through a 5 mm or 10 mm cannula or trocar. A penile exam should detect atrophy, tumors, epididymal cysts, cryptorchidism (undescended testicles), vas thickening or absence of the vas deferens, hydrocele (fluid accumulation in the testis or along the spermatic cord) or varicocele. Specific surgical instruments used in a laparoscopic surgery include forceps, scissors, probes, dissectors, hooks, and retractors. Hence the ability to conceive a normal pregnancy decreases from when a woman is in her early 30s into her 40s.

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Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties. Reduced hormones may result, which could potentially translate into trouble conceiving. The medicalization of infertility has unwittingly led to a disregard for the emotional responses that couples experience, which include distress, loss of control, stigmatization, and a disruption in the developmental trajectory of adulthood.[16] Infertility may have psychological effects. 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.