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Fertilizing Capacity of Epididymal and Testicular Sperm using Intracytoplasmic Sperm Injection (ICSI). (PDF, 7 MB)Reproduction, Fertility and Development, 1995. Histology reveals seminiferous tubules lined by Sertoli cells and a normal interstitium, although no germ cells are present. With the fast progression in reproductive medicine and the experiences gained through infertility management, a wider range of treatment options have become available to infertile couples [17-19,21-26,31,36], (Appendix 4). Recombination Between Palindromes P5 and P1 on the HUman Y Chromosome Causes Massive Deletions and Spermatogenic Failure. (PDF, 786 KB) The American Journal of Human Genetics, 2002. 3,4  Infertility may arise from male factors, female factors, or a combination of these (Table 15–8). Clinical diagnostic testing for the cytogenetic and molecular causes of male infertility: the Mayo Clinic experience.

Medicines and drugs  The side effects of some types of medicines and drugs can affect your fertility. Factors Affecting Fertility (Continued) Various toxic agents, smoking and alcohol may contribute to fertility problems. The more fetuses there are, the higher the risk of premature labor.

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Passive smoking has also been linked to lower fertility. 42 However, none of these methods has been proven to increase pregnancy rates when used to predict timing of intercourse. The starting dose is 5 mcg per pulse intravenously or 5-25 mcg subcutaneously. It's sometimes done while you're taking meds that help trigger the release of an egg. CI or intrauterine insemination is the treatment of choice if more than 2 million sperm are recovered after the sperm wash. (See Treatment of Cervical Factors). [106, 109] Patients whose reproductive tract, FSH, LH, and testosterone levels are determined to be normal or those who have low testosterone in the absence of any other hormonal abnormalities can be treated empirically with cycles of CC (25 mg PO qd for at least 6-12 mo).

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The embryo is then placed in the uterus to begin a pregnancy. 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. If too many embryos develop, one or more can be removed.

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Duration of Fertility after Fresh and Frozen Ovary Transplantation. (PDF, 606 KB) Fertility and Sterility, 2010. 8,26,27 As opposed to laparoscopy or hysteroscopy, hysterosalpingography is a minimally invasive procedure with potentially therapeutic effects and should be considered before more invasive methods of assessing tubal patency. Your doctor may ask you many of the following questions: How long have you been trying to get pregnant? Surgical procedures for women If the fallopian tubes are blocked or scarred, surgical repair may make it easier for eggs to pass through. Nonfunctional pituitary tumors may compress the pituitary stalk or the gonadotropic cells, interrupting the proper chain of signals leading to pituitary failure. There's a link between increased temperature of the scrotum and reduced semen quality, but it's uncertain whether wearing loose-fitting underwear improves fertility.  Testicles The testicles produce and store sperm. Continued First, sperm are collected either from ejaculated semen or by a needle from the testicle. The following is a list of hormonal disorders which can disrupt male infertility: Hyperprolactinemia: Elevated prolactin--a hormone associated with nursing mothers, is found in 10 to 40 percent of infertile males.  Mild elevation of prolactin levels produces no symptoms, but greater elevations of the hormone reduces sperm production, reduces libido and may cause impotence.  This condition responds well to the drug Parlodel (bromocriptine). Since the gallbladder is similar to a small balloon that stores and releases bile, it can usually be removed from the abdomen by suctioning out the bile and then removing the deflated gallbladder through the 1 cm incision at the patient's navel. ARTICLES FROM THE 1990s Microsurgery, Andrology, and Its Role in IVF. (PDF, 6 MB) Chapter in text book, Advances in Assisted Reproductive Technology, 1990. Cervical mucus problems impairing conception may be treated with intrauterine insemination (IUI) or uterine instillation of specially prepared sperm. This process has revolutionized assisted reproductive technology and the way reproductive endocrinologists can help people in having a baby. The following hormones can be identified in the blood among others: FSH, LH, estradiol, prolactin, testosterone, DHEA-S and the thyroid hormones. As the major causes of infertility are sperm abnormalities, ovulation dysfunction, and fallopian tube obstruction, the preliminary adviced investigations for the infertile couple should be focused on semen analysis (to be compared with the WHO reference values [27]), detection of ovarian function by hormonal assay (early follicular FSH and LH levels, and mid-luteal progesterone), and evaluation of tubal patency by hysterosalpingography (HSG) [17-32], (Appendix 3).