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Optimal sperm conditions Although only one sperm is needed to fertilise your partner’s egg, the enzymes from multiple sperm are needed to break down the egg’s protective barrier. In these cases the duration of the infertility is the best parameter by which to judge the chances of future natural conception; the longer the time of infertility then the sooner intervention should be considered.Summary Infertility is a term doctors use if a man hasn't been able to get a woman pregnant after at least one year of trying. Some methods may be used in concert with other methods. Infertility rates have increased by 4% since the 1980s, mostly from problems with fecundity due to an increase in age.[72] Fertility problems affect one in seven couples in the UK. If no improvement occurs, depending on the amount of functional sperm recovery after the sperm wash, the decision must be made to proceed with either intrauterine insemination or in vitro fertilization.

The agents most often associated with infertility are the alkylating agents such as cyclophosphamide. Ovulation should be documented by serum progesterone level measurement at cycle day 21. Histology reveals seminiferous tubules lined by Sertoli cells and a normal interstitium, although no germ cells are present. Showell MG, Brown J, Yazdani A, Stankiewicz MT, Hart RJ. It was broken down into male and female categories.

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There are also a number of sperm production problems that can contribute to infertility, including: Scrotal varicose veins (varicoceles)  Scrotal varicose veins (varicoceles) are swollen veins causing your testicles to get hotter and affect the production of sperm  These are treated with surgery  Testicular injury   Serious trauma to the testicles such as becoming twisted (torsion) can affect sperm production  Damage from playing sports or an accident can rupture the vessels that supply blood to the testicles  Previous injuries can’t be treated, but an ART treatment may help you to conceive Undescended testicles  In the uterus, baby boys’ testicles form in their abdomen and descend into their scrotum shortly before birth  Some men’s testicles don’t descend before they are born (cryptorchidism), although in these cases they usually drop in the first six months after birth  If left untreated, undescended testicles can affect fertility Testicular cancer  This happens when a malignant tumour in the testicle destroys testicular tissue  If undetected, testicular cancer can spread to other parts of the body  This is treated either by surgery, medication, radiotherapy or chemotherapy  However, cancer therapy can also damage sperm production  Genetic defects  Sometimes, genetic information on the Y chromosome (which is only present in men) is deleted (micro-deletions),6 which can reduce the production of sperm  Depending on where the micro-deletion is on the chromosome, this may be treated by surgically extracting sperm from part of your reproductive tract  However, some couples may need to consider using a donor sperm to conceive Mumps Contracting mumps (or mumps-related orchitis) after puberty may damage the sperm-producing cells in your testicles,  causing infertility or subfertility7 Usually, only one testicle is affected and if you have one functioning testicle you may not need treatment  However, some couples may need to use a sperm donor in order to conceive Anti-sperm antibodies  Anti-sperm antibodies are large proteins in your blood that are hostile to sperm  They can cause sperm to clump together and prevent them from swimming, or they may mistake sperm cells for an infection and try to destroy them  This can be treated using an ART treatment   Lifestyle   Sperm production can be affected by a range of lifestyle factors, including smoking, drinking, drugs, stress, overweight and unhealthy food Environmental factors can also affect your sperm quality, including overheating of your testicles, some sexual lubricants, the chemicals involved in certain manufacturing, painting or printing jobs   These factors are treated by making lifestyle changes, such as wearing loose clothing to avoid overheating Hormonal problems  Hormonal problems are rarely the cause of male infertility problems  However, some men have a natural deficiency in follicle-stimulating hormone (FSH) and luteinising hormone (LH), which prevents the testicles from producing testosterone or developing healthy sperm  Hormonal problems can usually be treated with medication Obstruction problems Blocked sperm ducts  Occasionally, male sperm ducts (epididymis and vas deferens) can become blocked, meaning that your semen doesn’t contain any sperm  This can be treated with surgery, or sperm may be surgically extracted from part of your reproductive tract  Vasectomy  Some men have had a previous vasectomy to stop them being able to conceive  This can sometimes be reversed using surgery  The procedure’s success depends on how long ago your vasectomy was performed  Previous infections  Infections can cause scarring or adhesions (organs sticking together) in your sperm ducts  This can usually be treated with surgery  Does age affect male fertility? Screening tests include increased plasma 17-hydroxylase and urine 17-ketosteroids. Obesity and increased risk for oligozoospermia and azoospermia. Medical treatments[edit] Medical treatment of infertility generally involves the use of fertility medication, medical device, surgery, or a combination of the following.

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Treatment of Tubal and Peritoneal Factors The treatment of tubal-factor infertility underwent major changes, especially during the last quarter of the century when microsurgery became available. [126, 127] Tubal reconstruction was the only hope for those patients before assisted reproductive therapy became available. Endometriosis: Cells that normally occur within the lining of the uterus start growing elsewhere in the body. CASA measures the following parameters: Curvilinear velocity – The average distance per unit time between successive sperm positions) Straight-line velocity – The speed of forward direction Linearity – The straight-line velocity divided by the curvilinear velocity In addition, the program measures the average path velocity, the amplitude of lateral head displacement, and the flagellar beat frequency, and it is used to evaluate for evidence of hyperactivation.

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For those interested, we offer a free class entitled, “The Couple’s Guide to IVF”, that meets twice monthly and is open to the public. Happily, many couples treated for infertility are able to have babies. Previous sterilization treatment: In women who have chosen to have their fallopian tubes blocked, the process can be reversed, but the chances of becoming fertile again are not high. BMI (body mass index) may be a significant factor in fertility, as an increase in BMI in the male by as little as three units can be associated with infertility. In this case, your doctor may recommend advanced fertility treatment — assisted reproductive technologies (ART) treatment. Some causes are more common in some countries than others, such as pelvic inflammatory diseases (PID) and sexually transmitted infections (STI) in Africa [10]. Congenital Absence of the Vas Deferens: The Fertilizing Capacity of Human Epididymal Sperm. (PDF, 3 MB) New England Journal of Medicine, 1990. The Effect of Female Age and Ovarian Reserve on Pregnancy Rate in Male Infertility: Treatment of Azoospermia with Sperm Retrieval and Intracytoplasmic Sperm Injection. (PDF, 66 KB) Human Reproduction, 1997. Surgeons who choose this hand-assist technique feel it reduces operative time significantly versus the straight laparoscopic approach. A sperm count of under 15 million is considered low. Postcoital testing and antisperm antibody testing are no longer considered useful in this evaluation.