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Hormonal Problems A small percentage of male infertility is caused by hormonal problems.  The hypothalamus-pituitary endocrine system regulates the chain of hormonal events that enables testes to produce and effectively disseminate sperm.  Several things can go wrong with the hypothalamus-pituitary endocrine system: · The brain can fail to release gonadotrophic-releasing hormone (GnRH) properly.  GnRH stimulates   the hormonal pathway that causes testosterone synthesis and sperm production.  A disruption in   GnRH release leads to a lack of testosterone and a cessation in sperm production. · The pituitary can fail to produce enough lutenizing hormone (LH) and follicle stimulating hormone   (FSH) to stimulate the testes and testosterone/sperm production.  LH and FSH are intermediates   in the hormonal pathway responsible for testosterone and sperm production. · The testes� Leydig cells may not produce testosterone in response to LH stimulation. · A male may produce other hormones and chemical compounds which interfere with the   sex-hormone balance. Techniques for the Resolution of Testicular Obstruction. (PDF, 8 MB) Chapter 78 from textbook, Reconstructive Urology, 1992.

A couple should see a healthcare provider if they have not been able to become pregnant after 12 months of having sex regularly without birth control. Lack of ovulation Patients with anovulation who did not ovulate after several cycles of CC at different doses of treatment are deemed clomiphene resistant. Microscopic Vasectomy Reversal 30 Years Later: A Summary of 4010 Cases by the Same Surgeon. (PDF, 295 KB)Journal of Andrology, 2004. Unexplained Even after a full fertility work-up, for one in five couples an exact cause of infertility cannot be determined. Clomiphene citrate (Clomid, Serophene) The chemical formula for clomiphene citrate (CC) is 2-[p -(2-chloro-1,2-difhenylvinyl) phenoxy] triethylamine dihydrogen citrate. Editorial: The Cure and Proliferation of Male Infertility. (PDF, 2 MB) The Journal of Urology, 1998.

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If an endocrinopathy, such as hyperprolactinemia, is diagnosed, the underlying cause should be treated. In patients with varicocele, there is insufficient evidence to suggest corrective surgery will increase live birth rates, despite improvement in semen analysis results. Females[edit] The following causes of infertility may only be found in females. Some uterine and tubal abnormalities, such as adhesions, uterine septum, or fibromyoma, may be corrected by surgical procedures.

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When the eggs are mature, your doctor collects them with a device called a vaginal ultrasound probe. Understanding the normal reproductive process is essential in knowing when to seek help. This pill generally is taken from menstrual cycle days 3 – 7. Infertility may be caused by blockage of the Fallopian tube due to malformations, infections such as chlamydia or scar tissue.

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Subsequently, Semm submitted a paper on laparoscopic appendectomy to the American Journal of Obstetrics and Gynecology, at first rejected as unacceptable for publication on the grounds that the technique reported on was "unethical," but finally published in the journal Endoscopy.[40] The abstract of his paper on endoscopic appendectomy can be found at here. 5) Endometrial polyps: Endometrial polyps are finger-like growths in the uterine cavity arising from the lining of the uterus, called the endometrium, These abnormalities are rarely associated with cancer (<1% in a woman before menopause), but polyps are can decrease fertility by up to 50% according to some studies. In most cases however, sperm function may not improve and therefore any attempts at pregnancy may require additional treatments or procedures performed by our clinic. If you suspect you are infertile, see your doctor. Medicines and drugs  The side effects of some types of medicines and drugs can affect your fertility.