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If fimbriectomy was performed, no treatment is available other than IVF. The bladder must be emptied 1 hour prior to sperm collection, and a second dose of sodium bicarbonate is taken along with 16 ounces of fluid. Sperm counts can fluctuate, so that several samples may be necessary.

The sperm is washed in a fluid and the best specimens are selected. National Collaborating Centre for Women's and Children's Health. Incidence and main causes of infertility in a resident population (1,850,000) of three French regions (1988–1989).

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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. Endometriosis may be treated through laparoscopic surgery. In general, ART involves surgically removing eggs from a woman’s ovaries, combining them with sperm in the laboratory, and returning them to the woman’s body. Additionally, surgery, radiation or chemotherapy to treat tumors can affect male fertility. IUI treatment, where the sperm is transferred into the uterus via the cervix, is commonly used in cases of low sperm count or quality. Microsurgical Epididymal Sperm Aspiration and Assisted Reproductive Techniques. (PDF, 4 MB) Frontiers in Human Reproduction, 1991.

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Blockage of the ejaculatory duct: Sperm can be extracted directly from the testicles and injected into an egg in the laboratory. Testosterone is a key hormone for male fertility, so problems with the testes that produce this hormone may lead to infertility. ARTs have made conception possible even for men with very low or abnormal sperm. Hypothyroidism has no effect on male libido or semen quality. It also tests for a luteal phase defect (inadequate level of progesterone). What decreases a man’s chance of impregnating a woman?

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A specimen is collected by masturbation into a clean, dry, sterile container or during coitus using special condoms (containing no spermicidal lubricants). For patients with a history of endometriosis, pelvic infections, or ectopic pregnancy, evaluation with hysteroscopy or laparoscopy is recommended. Leydig cell function is impaired, and most patients are infertile due to primary testicular failure. Your doctor will determine if you are at risk of having endometriosis based on a careful history, physical exam, and ultrasound. The enzyme aromatase is responsible for this conversion, and is found primarily in adipose tissue. If a weight gain greater than 2 lb occurs, the patient should be evaluated to determine if hospitalization is required. An estimated 28% of all couples seeking reproductive assistance may have normal findings on their clinical evaluation, making the unexplained infertility a more common provisional diagnosis. The main approach to correcting or removing these uterine abnormalities is by hysteroscopy, a surgical method by which a narrow scope with a camera is placed within the uterine cavity. In reproductive medicine, the most common surgical procedures are laparoscopy, hysteroscopy, and abdominal myomectomy (removal of uterine fibroids). This can be related to hormone issues, or to polycystic ovarian syndrome (PCOS). Women in group II include those with polycystic ovary syndrome and hyperprolactinemia. It is an approach to disseminate the recommended medical care of infertile couple to the practicing clinicians. The uterine cavity is distended with a gas or liquid, and the hysteroscope is introduced into the uterine cavity which can then be carefully inspected. Infection and Disease: Mumps, tuberculosis, brucellosis, gonorrhea, typhoid, influenza, smallpox, and syphilis can cause testicular atrophy.  A low sperm count and low sperm motility are indicators of this condition.  Also, elevated FSH levels and other hormonal problems are indicative of testicular damage.  Some STDs like gonorrhea and chlamydia can cause infertility by blocking the epididimis or tubes.  These conditions are usually treated by hormonal replacement therapy and surgery in the case of tubular blockage.


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