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Histologically, Leydig cells are polygonal with eosinophilic cytoplasm. Ejaculation disorders Some men experience ejaculation problems that can make it difficult for them to release semen during sex (ejaculate). If the correction is not done, it may be harder for the sperm to get to the female's cervix. In such circumstances, it is recommended not to prescribe any medication until all basic investigations are done and its results received. Sperm or egg donation: If necessary, sperm or eggs can be received from a donor.

The FAST study: fertility assessment and advice targeting lifestyle choices and behaviours: a pilot study. This can be made laparoscopically as well as sonographically. Thankfully, even when the cause of infertility is not known, various fertility treatments can eventually lead to delivery of a healthy baby. Unexplained infertility is not the same thing as having no explanation, but rather reflects the fact that the tests performed have been normal. Lack of pregnancy Lack of pregnancy can be related to disruption of the cervical mucus, inadequate follicular development, presence of luteinized unruptured follicle syndrome, progesterone deficiency, and premature administration of hCG to trigger ovulation. Ongoing Pregnancies and Birth after Intracytoplasmic Sperm Injection with Frozen-thawed Epididymal Spermatozoa. (PDF, 442 KB) Human Reproduction, 1995.

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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? A luteal phase defect results in low production of the hormone progesterone, which is necessary for maintaining a pregnancy. The eggs may never be released or they may only be released in some cycles. Perfect Anatomical Reconstruction of Vas Deferens with a new Microscopic Surgical Technique. (PDF, 19 MB)Fertility and Sterility, 1977. Evaluation of the uterus and fallopian tubes can be performed by hysterosalpingography in women with no risk of obstruction. WHAT'S THE DIFFERENCE BETWEEN PRIMARY AND SECONDARY INFERTILITY?

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Transrectal ultrasonography (TRUS) may reveal enlarged seminal vesicles, but this is not universal. WHAT'S THE DIFFERENCE BETWEEN PRIMARY AND SECONDARY INFERTILITY? Chromosomal defects Hereditary disorders, such as Klinefelter’s syndrome (when a male is born with two X chromosomes and one Y chromosome instead of one X and one Y) impacts the normal development of the male reproductive organs. Effect of metformin on ovulation and reproductive outcomes in women with polycystic ovary syndrome: a meta-analysis of randomized controlled trials. It does not induce ovulation, but reduces the production of prolactin by the pituitary.[20] Bromocriptine is only prescribed in cases of overproduction of prolactin (hyperprolactinemia). Peritubaric adhesions can be caused by endometriosis.

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Both pituitary insufficiency and pituitary excess cause infertility. ARTICLES FROM THE 2010s Ovarian Function 6 Years after Cryopreservation and Transplantation of Whole Sheep Ovaries. (PDF, 496 KB)Reproductive BioMedicine Online, 2010. Close Testing for Women Women should track their ovulation by recording their basal body temperature for several months, checking their cervical mucus using a home ovulation test kit. In some cases this can also cause considerable pain when breathing. Many infertile couples have had some previous assessment for their infertility and this data should be cautiously reviewed. Microscopic Technique for Reversal of Vasectomy. (PDF, 3 MB) Surgery, gynecology & obstetrics, 1976. One of such conditions is a varicocele – one of the major causes of male infertility – that occurs when a vein that carries blood out of the scrotum dilates. They may benefit from referral to a physician comfortable with prescribing pulsatile administration of gonadotropin-releasing hormone or gonadotropins with luteinizing hormone activity to induce ovulation. Thus, pelvic ultrasonography has become an important tool for monitoring ovulation induction. A high serum estradiol level (greater than 60 to 80 pg per mL [220 to 294 pmol per L]) in conjunction with a normal FSH level has also been associated with lower pregnancy rates. Intracytoplasmic sperm injection (ICSI.)A single sperm is injected through a tiny needle into an egg. 8,46 Obesity impairs fertility and the response to fertility treatments, including in vitro fertilization; therefore, it is advisable to counsel patients who are obese to lose weight before conception or infertility treatments. Endometriosis is usually more common in women in their mid-twenties and older, especially when postponed childbirth has taken place.[55] Another major cause of infertility in women may be the inability to ovulate.