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Hypospadias: The urethral opening is under the penis, instead of its tip. The Most Common Causes of Male Sterility There are several causes of male sterility, including: Abnormal sperm production Impaired delivery of sperm Testosterone deficiency Genetic defects Undescended testes Also, erectile dysfunction or low libido can make the process of procreation that much more difficult. Other conditions Various other lesions and diseases, such as CNS tumors, temporal lobe seizures, and many drugs (eg, dopamine antagonists) may interrupt the hypothalamic-pituitary axis at the hypothalamus. Abnormal semen may not be able to carry the sperm effectively. Physical Problems A variety of physical problems can cause male infertility.  These problems either interfere with the sperm production process or disrupt the pathway down which sperm travel from the testes to the tip of the penis.  These problems are usually characterized by a low sperm count and/or abnormal sperm morphology.  The following is a list of the most common physical problems that cause male infertility: Variocoele: A varicocele is an enlargement of the internal spermatic veins that drain blood from the testicle to the abdomen (back to the heart) and are present in 15% of the general male population and 40% of infertile men.  These images show what a variocoele looks like externally and internally.  A varicocele develops when the one way valves in these spermatic veins are damaged causing an abnormal back flow of blood from the abdomen into the scrotum creating a hostile environment for sperm development.  Varicocoeles may cause reduced sperm count and abnormal sperm morphology which cause infertility.  Variococles can usually be diagnosed by a physical examination of the scrotum which can be aided by the Doppler stethoscope and scrotal ultrasound.  Varicocoele can be treated in many ways (see treatment section), but the most successful treatments involve corrective surgery.

A 3 to 5 days long sexual abstention is absolutely necessary for this. However, if the woman has previously been pregnant, regardless of the outcome (which may have been a premature or full-term delivery, spontaneous abortion, induced abortion or ectopic pregnancy), and is now unable to conceive, it is considered secondary infertility. Previous sterilization treatment: In women who have chosen to have their fallopian tubes blocked, the process can be reversed, but the chances of becoming fertile again are not high. A woman of reproductive age who is using artificial insemination to conceive (with either partner or donor sperm) after 6 failed trials. Consider earlier referral to infertility specialists where: - the woman is aged 36 years or over. - there is a known clinical cause of infertility or a history of predisposing factors for infertility. - treatment is planned that may result in infertility (such as treatment for cancer). - People who are concerned about their fertility and who are known to have chronic viral infections such as hepatitis B, hepatitis C or HIV. WHO Manual for the Standardized Investigation and Diagnosis of the Infertile Couple. If the woman is over the age of 35 years old, she may be infertile if she has not become pregnant after 6 months of trying.

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If a woman can get pregnant but keeps having miscarriages or stillbirths, that's also called infertility. 6 Accuracy may be improved by use on midday or evening urine specimens, which correlate better with the peak in serum luteinizing hormone levels.

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Sperm Retrieval for Azoospermia and Intracytoplasmic Sperm Injection Success Rates – A Personal Overview.(PDF, 1 MB) Human Fertility, 2010. The embryo is then placed in the uterus to begin a pregnancy. Germ cells (precursors to spermatozoa) are derived from the gonadal ridge and migrate to the testicle before testicular descent. If a woman needs an HCG injection to activate ovulation and ultrasound scans show that too many follicles have developed, it is possible to withhold the HCG injection.

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Luttjeboer F, Harada T, Hughes E, Johnson N, Lilford R, Mol BW. It is more successful in women who have previously been pregnant. ARTICLES FROM THE 1990s Microsurgery, Andrology, and Its Role in IVF. (PDF, 6 MB) Chapter in text book, Advances in Assisted Reproductive Technology, 1990. Normal Fertilization of Human Oocytes after Testicular Sperm Extraction and Intracytoplasmic Sperm Injection.(PDF, 2 MB) Fertility and Sterility, 1994. If you’ve been diagnosed with infertility, or fear you may have trouble conceiving in the future, you’re not alone. No role for: Post-coital testing for cervical mucous. Endometrial Biopsy. The epididymis is a coil-like structure in the testicles which helps store and transport sperm. Sign up for the free AFP email table of contents.Fertility Articles – PDF Archive | Infertility Center If you have any questions, you may call us at  (314) 576-1400. Fibroids Non-cancerous growths called fibroids in or around the womb can affect fertility.