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The most common cause of male infertility is varicoceles. Although CASA produces good qualitative data, it is a labor-intensive procedure with a high initial cost and is plagued with inaccuracies when sperm concentrations are very high or very low.

4) In Vitro Fertilization (IVF): In vitro means “outside the body.” IVF is a process whereby eggs are collected and then fertilized by sperm outside the body, in an embryology laboratory. Earn up to 6 CME credits per issue.     To see the full article, log in or purchase access. A uterus capable of developing and sustaining the conceptus to maturity. Laparotomy is indicated in patients with severe pelvic adhesions that compromise the bowel, ovaries, and tubes, with obliteration of the cul-de-sac. [129] The aim of the procedure is to correct what is necessary to allow the normal transport of the gametes; complete restoration of the anatomy is not intended. [130] Lysis of adhesions should be meticulous, using hydrodissection and fine instruments.

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Microsurgical Reversal of Tubal Sterilization: Factors Affecting Pregnancy Rate, with Long-term Follow-up. (PDF, 2 MB) Obstetrics & Gynecology, 1984. If the sperm are of good quality and the mechanics of the woman's reproductive structures are good (patent fallopian tubes, no adhesions or scarring), a course of ovulation induction maybe used.

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Sterilisation Some women choose to be sterilised if they don't want to have any more children. Illegal drugs: Some women who use marijuana or cocaine may have fertility problems.

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IUI increases the number of the sperm in the fallopian tubes, where fertilization takes place. In vitro fertilization[edit] IVF is the most commonly used ART. Hysteroscopy is the inspection of the uterine cavity through the cervix by a hysteroscope attached to a camera which projects to a screen. Outlook For couples who experience fertility problems and those who wish to have children at an older age, there are more options available than ever before. These endometrial cells can extend as far as the outside of the fallopian tubes, the ovaries and the bladder. In patients with obstructive azoospermia and normal gonadotropin levels, sperm can be obtained through microsurgical epididymal sperm aspiration or testicular biopsy. [213] Fertilization of the oocytes is performed using IVF/intracytoplasmic sperm injection. A Modern View of Male Infertility. (PDF, 7 MB) From The Infertile Male: Advanced Assisted Reproductive Technology, 1994. Ovulation induction in polycystic ovary syndrome [published corrections appear in J Obstet Gynaecol Can. 37,38 The addition of 1,500 to 1,700 mg of metformin (Glucophage) daily may increase ovulation and pregnancy rates, but it does not significantly improve live birth rates over clomiphene alone. Sperm Granuloma and Reversibility of Vasectomy. (PDF, 11 MB) Lancet, 1977. If the obstruction is caused by salpingitis isthmica nodosa or fibrosis, the best results are achieved through IVF. [142] Surgical preparation for IVF While the surgeon should be as conservative as possible, he or she should consider that the patient is better served with a single well-functioning fallopian tube than with 2 defective tubes, which elicits an increased risk for ectopic pregnancy or recurrence of pelvic adhesions. Endometriosis: Cells that normally occur within the lining of the uterus start growing elsewhere in the body.