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3) Insemination: Intrauterine insemination, also known as IUI, is a process by which sperm is washed and prepared for placement into the uterine cavity, therefore bypassing the cervix and bringing a higher concentration of motile sperm closer to the tubes and ovulated egg. This process has revolutionized assisted reproductive technology and the way reproductive endocrinologists can help people in having a baby. 3,4  Infertility may arise from male factors, female factors, or a combination of these (Table 15–8). The seminal vesicles provide 40-80% of the semen volume, which includes fructose for sperm nutrition, prostaglandins and other coagulating substances, and bicarbonate to buffer the acidic vaginal vault. Counseling Fertility clinics should address the psycho-social and emotional needs of infertile couples as well as their medical needs.

Ovarian Transplantation in a Series of Monozygotic Twins Discordant for Ovarian Failure. (PDF, 188 KB) The New England Journal of Medicine, 2007. Possible problems could be that the egg is not released at the optimum time for fertilization, that it may not enter the fallopian tube, sperm may not be able to reach the egg, fertilization may fail to occur, transport of the zygote may be disturbed, or implantation fails. Reversal of Vasectomy and the Treatment of Male Infertility. (PDF, 4 MB) Urologic Clinics of North America, 1981. Symptoms can also depend on what is causing the infertility. You take gonadotropins that trigger the development of more than one egg.

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Most couples (about 84%) who have regular sexual intercourse (that is, every two to three days) and who do not use contraception get pregnant within a year. Ovulation should be documented by serum progesterone level measurement at cycle day 21. Success rates with IVF procedure are approximately 20% per egg retrieval (approximately 20 couples out of every 100 who try one retrieval with IVF are likely to achieve pregnancy and delivery). Endometriosis: Cells that normally occur within the lining of the uterus start growing elsewhere in the body. Benefits of laparoscopy are especially the possibility to simultaneously remove adhesions in one session. Male infertility refers to a male’s inability to cause a pregnancy in a fertile female.   Causes vary.   Testing is available.   Medication or surgery.

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Exercise: Both too much and too little exercise can lead to fertility problems. Gonadotropin-releasing hormone Synthetic GnRH (gonadorelin) has a chemical composition similar to native GnRH and is indicated for patients with hypothalamic dysfunction, especially those who do not respond to CC. [200, 201] Although quite effective, it is not available in the United States due to lack of use and low demand. 17 Evaluation of male infertility starts with a history and physical examination focusing on previous fertility, pelvic or inguinal surgeries, systemic diseases, and exposures. The pituitary gland controls most other hormonal glands in the human body.

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Other considerations include preconception screening and vaccination for preventable diseases such as rubella and varicella, sexually transmitted infections, and cervical cancer, based on appropriate guidelines and risk. Endometriosis causes infertility by producing inflammation and scarring, which can result in not only pain but also potentially detrimental effects on egg, sperm or embryo. PID leads to a blockage of the fallopian tubes, which prevents fertilization. The most common of these tests include measurements of blood levels of certain hormones such as estradiol and FSH, which are related to ovarian function and overall egg numbers; TSH, which assesses thyroid function; and prolactin, a hormone that can affect menstrual function if elevated. Options include intrauterine insemination (also known as IUI) or IVF with intracytoplasmic sperm injection (also known as ICSI). Immunohistochemical stains are performed if more than 5-10 round cells/HPF are present.  Other tests Semen may be analyzed for levels of zinc, citric acid, acid phosphatase, and alpha-glucosidase. Frequency of intercourse The couple may be advised to have sexual intercourse more often around the time of ovulation. The Intra-abdominal Testes: Microvascular Autotransplantation. (PDF, 4 MB) The Journal of Urology, 1981. The relation between daily activities and scrotal temperature. Surgical Management of Male Infertility. (PDF, 2 MB) Chapter 12 from textbook, Male Infertility, 1992. Women who are at risk, including those on a vegan diet, should ask the doctor about supplements.