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Postcoital testing and antisperm antibody testing are no longer considered useful in this evaluation. According to ESHRE recommendations, couples with an estimated live birth rate of 40% or higher per year are encouraged to continue aiming for a spontaneous pregnancy.[66] Treatment methods for infertility may be grouped as medical or complementary and alternative treatments. Infection An increased number of white blood cells in the semen may be observed in patients with infectious or inflammatory processes of the genital tract. It can also help if a man has severe erectile dysfunction.

Tubal occlusion A tubal occlusion means there is a blockage in the fallopian tube. Prolonged anestrus may be congenital or acquired. Undescended testicle may be isolated or may be observed as part of a syndrome such as prune belly syndrome. Structural abnormalities in the uterus: these can affect the cervix or the uterine corpus.  Anomalies can be anatomical (septate uterus, T-shaped uterus, etc.) or pathologies that generate embryo implantation issues or issues with how the pregnancy progresses: polyps, endometritis, Asherman's syndrome - synechiae or adherences of the walls of the uterine cavity - or myomas, a benign tumour that generates anatomical distortion and makes getting pregnant complicated (this is one of the most common pathologies but does not necessarily cause fertility issues). Endometrial biopsy should be performed only in women with suspected pathology (chronic endometritis or neoplasia). It has not been shown to improve patient outcomes but, rather, is helpful for research purposes.

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Opinion: Microsurgical TESE and the Distribution of Spermatogenesis in Non-obstructive Azoospermia. (PDF, 5 MB)Human Reproduction, 2000. Cervical factors are also thought to play a minor role, although they are rarely the sole cause. Your doctor will carry out a series of tests to diagnose what’s causing your fertility difficulties.  There are many reasons why you may have problems conceiving, including:  Your sperm does not have the concentration, motility or shape required to conceive Existing medical conditions that affect your fertility, such as issues with sperm production or duct obstructions  Your sperm may not be strong or healthy enough to fertilise your partner’s egg  As your partner gets older, her fertility quickly declines3 Depending on the cause, your doctor will recommend a treatment path for you. Causes of Male Infertility Male infertility may be a result of some conditions that affect the quality of sperm, lead to low sperm production (oligospermia), or lead to the absence of sperm production (azoospermia).

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Modifying these behaviors can improve a man�s fertility and should be considered when a couple is trying to achieve pregnancy. This can happen as a result of: an infection of your testicles testicular cancer  testicular surgery a problem with your testicles you were born with (a congenital defect) when one or both testicles hasn't descended into the scrotum, the loose sac of skin that contains your testicles (undescended testicles) injury to your testicles Sterilisation Some men choose to have a vasectomy if they don't want children or any more children.  It involves cutting and sealing off the tubes that carry sperm out of your testicles (the vas deferens) so your semen will no longer contain any sperm. A luteal phase defect results in low production of the hormone progesterone, which is necessary for maintaining a pregnancy. Assisted Reproductive Technology: Using Ejaculated, Fresh, and Frozen-thawed Epididymal and Testicular Spermatozoa Gives Rise to Comparable Results after Intracytoplasmic Sperm Injection. (PDF, 5 MB) Fertility and Sterility, 1995.

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The doctor may ask about the couple's sexual habits and make recommendations regarding these. As there is surplus medical information everyday that can not be cached by healthcare providers, clinical guidelines created to endorse up-to-date evidence-based practice to improve patients' outcome [6]. Worldwide, 8 to 12 percent of couples experience fertility problems. Recovery of Spermatogenesis after Testicle Autotransplantation in an Adult Male. (PDF, 2 MB) Fertility and Sterility, 1982. BMI (body mass index) may be a significant factor in fertility, as an increase in BMI in the male by as little as three units can be associated with infertility. There is more controversy regarding intramural fibroids, where larger ones may have an impact and may necessitate removal. If abundant good sperm are found in the testicle, there's likely a blockage somewhere. Risk factors for the formation of antisperm antibodies in men include the breakdown of the blood‑testis barrier, trauma and surgery, orchitis, varicocele, infections, prostatitis, testicular cancer, failure of immunosuppression and unprotected receptive anal or oral sex with men.[23][24] Sexually transmitted infections[edit] Infections with the following sexually transmitted pathogens have a negative effect on fertility: Chlamydia trachomatis and Neisseria gonorrhoeae.