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Human chorionic gonadotropin (Ovidrel, Pregnyl): Used together with clomiphene, hMG, and FSH, this can stimulate the follicle to ovulate. Treatment of hydrosalpinx (distal tubal obstruction) with salpingostomy can be performed through microsurgery or operative laparoscopy. Some physical effects may also result from treatment. In this treatment, millions of healthy sperm are injected into the woman’s uterus at the time of ovulation.  IVF: The most effective assisted reproductive treatment is in vitro fertilization or IVF. These numbers are comparable to those of other industrialized nations.

Most typical are decreased libido, erectile dysfunction, orgasmic dysfunction, and ejaculatory dysfunction. For men, a visual inspection of sexual characteristics can identify such endocrinopathies as hypogonadism (a condition resulting in atrophy or deficient development of secondary sexual characteristics) or Klinefelter’s syndrome (a genetic anomaly often associated with infertility). In addition to the components already listed, semen is also composed of secretions from the bulbourethral (Cowper) glands and the (periurethral) glands of Litre, each producing 2-5% of the ejaculate volume, serving mainly to lubricate the urethra and to buffer the acidity of the residual urine. This is obviously extremely distressing for the couples involved. Clean, Intermittent Self-catheterization in the Treatment of Urinary Tract Disease. (PDF, 2 MB) The Journal of Urology, 1972. Smoking during pregnancy increases the chance of pregnancy loss.

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Several studies have demonstrated that an increase in BMI is correlated with a decrease in sperm concentration, a decrease in motility and an increase DNA damage in sperm. No Differences in Outcome after Intracytoplasmic Sperm Injection with Fresh or with Frozen-thawed Epididymal Spermatozoa. (PDF, 66 KB) Human Reproduction, 1999. In GIFT, the sperm and eggs are mixed together before a doctor inserts them. Surgical sperm aspiration: The sperm is removed from part of the male reproductive tract, such as the vas deferens, testicle, or epididymis. It is also important to increase the frequency of intercourse by having well-timed sex regularly to improve fertility. 38,39 Family physicians may choose to attempt ovulation induction in anovulatory women (WHO group II) with clomiphene.

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Panhypopituitafism: Complete pituitary gland failure--lowers growth hormone, thyroid-stimulating hormone, and LH and FSH levels.  Symptoms include:  lethargy, impotence, decreased libido, loss of secondary sex characteristics, and normal or undersized testicles.  Supplementing the missing pituitary hormones may restore vigor and a hormone called hCG may stimulate testosterone and sperm production. Seminoma Discovered in Two Males Undergoing Successful Testicular Sperm Extraction for Intracytoplasmic Sperm Injection. (PDF, 807 KB) Human Reproduction, 1995. Electric or vibratory stimulation to achieve ejaculation: Ejaculation is achieved with electric or vibratory stimulation. As new technology becomes available, fertility treatment is now accessible to more people, and success rates and safety are improving all the time. It's sometimes done while you're taking meds that help trigger the release of an egg. Live Birth Following Day Surgery Reversal of Female Sterilisation in Women Older then 40 Year: A Realistic Option in Australia? (PDF, 156 KB) Medical Journal of Australia, 2007.

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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. The vas deferens carries sperm from the epididymis to the ejaculatory duct and the urethra. To prevent further polyp development associated with anovulation, the patient should have withdrawal bleeding at least every 6 weeks. GIFT (gamete intrafallopian tube transfer) and ZIFT (zygote intrafallopian transfer).  Like IVF, these procedures involve retrieving an egg, combining it with sperm in a lab, and then transferring it back to your body. Infertility: Female and Male Factors It is very important to note that infertility can occur as a result of one or more male or female factors. The doctor may ask about the couple's sexual habits and make recommendations regarding these. Although many of these can be treated through surgery or hormonal substitutions, some may be indefinite.[59] Infertility associated with viable, but immotile sperm may be caused by primary ciliary dyskinesia. The AZFc Region of the Y Chromosome Features Massive Palindromes and Uniform Recurrent Deletions in Infertile Men. (PDF, 5 MB) Nature Genetics, 2001. Low sperm mobility (motility): The sperm cannot "swim" as well as they should to reach the egg.