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A small ejaculate volume may be observed in patients with retrograde ejaculation, absence of the vas deferens or seminal vesicles, ductal obstruction, hypogonadotropism, or poor sympathetic response. Affected individuals displayed more severe forms of infertility such as azoospermia and severe oligozoospermia.[27] Other causes[edit] Factors that can cause male as well as female infertility are: DNA damage DNA damage reduces fertility in female ovocytes, as caused by smoking,[28] other xenobiotic DNA damaging agents (such as radiation or chemotherapy)[29] or accumulation of the oxidative DNA damage 8-hydroxy-deoxyguanosine[30] DNA damage reduces fertility in male sperm, as caused by oxidative DNA damage,[31] smoking,[28] other xenobiotic DNA damaging agents (such as drugs or chemotherapy)[32] or other DNA damaging agents including reactive oxygen species, fever or high testicular temperature.[33] The damaged DNA related to infertility manifests itself by the increased susceptibility to denaturation inducible by heat or acid [34] or by the presence of double-strand breaks that can be detected by the TUNEL assay.[35] General factors Diabetes mellitus,[36][37] thyroid disorders,[38] undiagnosed and untreated coeliac disease,[39][40][41][42] adrenal disease[43] Hypothalamic-pituitary factors Hyperprolactinemia Hypopituitarism The presence of anti-thyroid antibodies is associated with an increased risk of unexplained subfertility with an odds ratio of 1. Several studies have reported different causes of infertility [7-9]. The physician or WHNP may also suggest using a conception cap cervical cap, which the patient uses at home by placing the sperm inside the cap and putting the conception device on the cervix, or intrauterine insemination (IUI), in which the doctor or WHNP introduces sperm into the uterus during ovulation, via a catheter.

Embryo Development after ICSI Using Testicular, Epididymal and Ejaculated Spermatozoa. (PDF, 2 MB) Frontiers in Endocrinology, 1995. 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. Most recommend dosing CC on cycle days 3-7 to improve response and ovulation around cycle day 14. Reversal of Vasectomy and the Treatment of Male Infertility. (PDF, 4 MB) Journal of Andrology, 1980. This test is performed early in the menstrual cycle after bleeding has stopped but prior to ovulation.

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Less than 50% motility may significantly affect the ability for sperm to fertilize the egg without therapy; and (4) morphology, or shape – there are three parts of the sperm that are analyzed for morphology: the head, midpeice, and tail. Afterward, the mucus specimen is phase-microscopically examined.

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Mental stress: This may affect female ovulation and male sperm production and can lead to reduced sexual activity. Moderate ovarian hyperstimulation syndrome is characterized by ovarian enlargement (5-12 cm in diameter) moderate ascites, nausea, vomiting, abdominal discomfort, and weight gain greater than 10 lb. Age, socio-economic, cultural and other environmental factors: Over the last few years, age has become the most common of these causes of infertility.

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The findings of the biopsy help determine whether the endometrium is adequately developed to support implantation and growth of a fertilized egg. Women older than 35 years or couples with known risk factors for infertility may warrant evaluation at six months. Low weight: Obesity is not the only way in which weight can impact fertility. This improves the chances that the embryo will implant at, or attach to, the wall of the uterus. This can be related to hormone issues, or to polycystic ovarian syndrome (PCOS). The sample should be processed within 1 hour, and 2-3 samples (at a minimum of 2-3 days apart) should be evaluated because of daily variations in sperm number and quality. Cervical surgery can sometimes cause scarring or shortening of the cervix. In some cases, the reproductive urologist can improve semen function by recommending certain lifestyle changes, by hormonal treatments, or by surgery. Submucosal fibroids: Benign or non-cancerous tumors occur in the muscular wall of the uterus. The vas deferens carries sperm from the epididymis to the ejaculatory duct and the urethra. Effect of male age on fertility: evidence for the decline in male fertility with increasing age. The chance of a multiple birth is lower with an oral fertility drug. Successful Vitrification of Bovine and Human Ovarian Tissue. (PDF, 3 MB) Reproductive BioMedicine Online, 2009. The search included meta-analyses, randomized controlled trials, clinical trials, and systematic reviews. 33 Use of antioxidants such as zinc, vitamin E, or l-carnitine showed increased live birth rates in three small randomized controlled trials in couples undergoing assisted reproductive technology.