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Exposure to toxic agents can occur from occupational hazards or contaminated air, water, food supply or other exposures. The normal working of the male reproductive system involves first the production of sufficient numbers of functional sperm cells and then the delivery of these sperm to the ejaculate. Thyroid problems: An overactive or underactive thyroid gland can lead to a hormonal imbalance. The Varicocele Dilemma. (PDF, 139 KB) Human Reproduction, 2001. Your doctor may ask you many of the following questions: How long have you been trying to get pregnant?

If he has two X chromosomes and one Y chromosome, as in Klinefelter's syndrome, the testicles will develop abnormally and there will be low testosterone and a low sperm count or no sperm. An Azoospermic Man with a do novo Point Mutation in the Y-chromosome Gene USP9Y. (PDF, 381 KB) Nature Genetics, 1999. It delivers a constant supply of Gn-RH to the pituitary gland, which alters the production of hormone, allowing the doctor to induce follicle growth with FSH. Causes Potential causes of male infertility are: The complete absence of sperm (azoospermia) Low sperm count (oligospermia) Abnormal sperm shape (teratozoospermia) Problems with sperm movement (asthenozoospermia) Sperm that is completely immobile (necrozoospermia); the sperm may be alive and not moving, or they may be dead Problems with sperm delivery, due to sexual dysfunction, an obstruction, previous vasectomy, or retrograde ejaculation Problems with erections or other sexual problems There are a variety of conditions that may lead to male infertility. This can be related to hormone issues, or to polycystic ovarian syndrome (PCOS). The feelings experienced by the infertile couples include depression, grief, guilt, shame, and inadequacy with social isolation.

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Sexual history – One of the purposes of obtaining a sexual history is to determine whether the partners have any sexual disturbance or dysfunction. Cabergoline is associated with fewer side effects but is more expensive. In this case synthetic FSH by injection or Clomid (Clomiphene citrate) via a pill can be given to stimulate follicles to mature in the ovaries. In fact, the “window of opportunity” for fertilization is thought to last only a few hours, thus requiring sperm availability in the female genital tract at or shortly before ovulation. In addition, her reproductive tract must allow the eggs and sperm to pass into her fallopian tubes to become fertilized and implanted in the uterus. Microsurgery of the Male Genitalia for Infertility. (PDF, 8 MB) Chapter 59 from Reconstructive Urologic Surgery, 1994.

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Semen that is not initially a coagulum is often an indication of an ejaculatory duct obstruction or the absence of seminal vesicles. Controversies in OB/GYN: Is Varicocelectomy Useful for Treatment of Male-factor Infertility? (PDF, 4 MB)Contemporary OB/GYN, 2001. For women, being underweight and having extremely low amounts of body fat are associated with ovarian dysfunction and infertility and they have a higher risk for preterm birth.

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Treatment Possibilities: Male Infertility Surgical treatment may be successful in some cases, such as varicocele. Microsurgical Solutions to Male Infertility. (PDF, 2 MB) Contemporary OB/GYN, 2005. Sperm can survive inside the female for up to 5 days, while an egg can be fertilized for up to 1 day after ovulation. The use of Epididymal and Testicular Sperm for ICSI. (PDF, 1 MB) From IX World Congress on In Vitro Fertilization and Alternated Assisted Reproduction, 1995. The presence of antibodies in serum or seminal plasma is less prognostic than antibodies bound to sperm. Post-ejaculatory urinalysis (urine testing), to check for retrograde ejaculation. Specific surgical instruments used in a laparoscopic surgery include forceps, scissors, probes, dissectors, hooks, and retractors. PPT Presentation Summary : Embryo cryopreservation (via ovulation induction) Oocyte cryopreservation. The testicles will be checked for lumps or deformities, and the shape and structure of the penis will be examined for abnormalities. Testicular Neoplasm in Father and Son. (PDF, 561 KB) The Journal of Urology, 1972. The ideal response is one in which only 2-3 follicles develop. Infertility may be caused by blockage of the Fallopian tube due to malformations, infections such as chlamydia or scar tissue. Fresh Ovarian Tissue and Whole Ovary Transplantation. (PDF, 373 KB) Seminars in Reproductive Medicine, 2009. Approximately 4 million (9%) men aged 25–44 years reported that they or their partner had consulted a doctor for advice, testing, or treatment for infertility during their lifetime (4). Prevalence of Premature Ovarian Failure in Monozygotic and Dizygotic Twins. (PDF, 90 KB) Human Reproduction, 2007. Women trying to conceive often have depression rates similar to women who have heart disease or cancer.[18] Emotional stress and marital difficulties are greater in couples where the infertility lies with the man.[19] Older people with adult children appear to live longer.[20] Why this is the case is unclear and may dependent in part on those who have children adopting a healthier lifestyle, support from children, or the circumstances that led to not having children.[20] [edit] In many cultures, inability to conceive bears a stigma.