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Medical treatment for minimal to mild disease has not been shown to be of benefit. Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility.

6,23 Anovulatory women should have further investigation to determine treatable causes such as thyroid disorders or hyperprolactinemia based on symptoms. Further investigations Investigation of suspected tubal and uterine abnormalities: 1. Role of Semen Analysis in Subfertile Couples. (PDF, 250 KB) Fertility and Sterility, 2010. Abnormalities may be a sign of a primary hypothalamic, pituitary, or testicular problem.Causes Causes generally can be divided into pretesticular, testicular, and post-testicular. Erectile dysfunction or premature ejaculation: Medication, behavioral approaches, or both may help improve fertility.

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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? Coital frequency is positively correlated with pregnancy rates. Weight loss in obese infertile women results in improvement in reproductive outcome for all forms of fertility treatment.

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Diagnosis of Sterility An important part of the diagnosis is a detailed anamnesis and the routine gynecologic examination. If a cause for your fertility problems hasn't been identified, talk to your doctor about the next steps. Clinical Characterization of 42 Oligospermic or Azoospermic Men with Microdeletion of the AZFc Region of the Y Chromosome, and of 18 Children Conceived via ICSI. (PDF, 606 KB) Human Reproduction, 2002. Carcinoma in the Bladder Left Behind. (PDF, 3 MB) The Journal of Urology, 1973. Women with regular menstrual cycles are likely to be ovulating and should be offered serum progesterone testing at day 21 to confirm ovulation. Any of the following can cause a man to have a low sperm count or abnormal sperm: Varicocele — an abnormal collection of bulging veins above the testicle; they’re the most common cause of correctable male infertility, accounting for 38% of cases Undescended testicle Infections in the testicle (orchitis), the prostate (prostatitis), or elsewhere in the body that causes a fever Chemotherapy for cancer Medicines such as anabolic steroids or anti-seizure medicines Genetic abnormalities Hormone problems In some cases, these problems can be reversed, but other times they can’t.

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Experts differ in their approach, but here are some of the tests you can expect: Continued Sperm and semen analysis. Other causes of infertility affecting both partners include immunological incompatibility between sperm and the cervical mucus, which may in some instances cause sperm agglutination. Females[edit] The following causes of infertility may only be found in females. Epidemiological definition of infertility (for monitoring and surveillance) Women of reproductive age (15–49 years) at risk of becoming pregnant (not pregnant, sexually active, not using contraception and not lactating) who report trying unsuccessfully for a pregnancy for two years or more. (Reproductive Health Indicators) Infertility as a disability Disability: Infertility generates disability (an impairment of function), and thus access to health care falls under the Convention on the Rights of Persons with Disability. Medical treatment is a temporary treatment, ideally used for patients who are close to menopause or who are risky surgical candidates. Microsurgical Reversal of Tubal Sterilization: Factors Affecting Pregnancy Rate, with Long-term Follow-up. (PDF, 2 MB) Obstetrics & Gynecology, 1984. Here, the hormones FSH (= follicle stimulating hormone) and LH (= luteinizing hormone) play an important role. Carcinoma in the Bladder Left Behind. (PDF, 3 MB) The Journal of Urology, 1973. Central Ave Suite 2C Chicago, IL 60630 Phone: (773) 794-1818 Fax: (773) 794-1819 GURNEE 30 Tower Court Suite F Gurnee, IL 60031 Phone: (847) 662-1818 Fax: (847) 662-3001 CRYSTAL LAKE 820 E. Those with a varicocele diagnosable only on scrotal ultrasonography have subclinical varicoceles and will likely not benefit from repair. Polycystic ovary syndrome (PCOS): The ovaries function abnormally and ovulation may not occur. Large submucosal uterine fibroids may make the uterus' cavity bigger, increasing the distance the sperm has to travel. Non-steroidal anti-inflammatory drugs (NSAIDs): Long-term use of aspirin or ibuprofen may make it harder to conceive. Although 60% of patients have evidence of antisperm antibodies after vasectomy, the clinical significance has not been completely elucidated. Listen to Mr Brook talk about male infertility Find out more about ICSI. If necessary, they refer patients to a fertility clinic or local hospital for more specialized tests.