Previous Vasectomy

A vasectomy is a voluntary surgery to block the sperm ducts for the purpose of contraception. Sometimes, for various personal reasons, the man wishes to have his vasectomy reversed. In fact, approximately 10 percent of vasectomized men eventually request vasectomy reversal in the United States.

While it is usually possible to surgically reconnect the tubes after vasectomy, some men remain infertile because their body has developed an immune reaction against their own sperm. That means they develop antibodies that automatically destroy or immobilize their own sperm. This is more often the case when the vasec-tomy occurred more than 10 years earlier.

Additionally, the average patency (openness) rate of vasectomy reversal is about 90 percent, but the pregnancy rate is closer to 60 percent. This means that 90 percent of the time the sperm flow in the vas tube is restored, but pregnancy successfully occurs only 60 percent of the time because of antibodies and various other unrelated fertility problems.


Unfortunately, it is not just DES daughters who are affected; if the woman who took the DES was pregnant with a male child, her son may experience fertility difficulties as well. According to the Centers for Disease Control and Prevention (CDC), the most common research finding for DES sons is that they have an increased risk for benign (noncancerous) growths on their testicles. Sons of women who took this drug have been found to have abnormal sperm type and motility. They also occasionally have testicular abnormalities. If you suspect that your partner has been exposed to DES, please alert your fertility specialist.


In rare cases, male infertility may be inherited. This is usually diagnosed through blood samples and by performing chromosomal analysis. For example, a man with cystic fibrosis may have missing or obstructed vas deferens, the tubes that carry sperm. Another example is Klinefelter's syndrome, where the man is born with two X and one Y chromosomes (the normal is one X and one Y). In this situation, the man has had abnormally developed testicles since puberty but possesses other normal male physical characteristics. A more common genetic disorder is polycystic kidney disease, a condition where large cysts form on the kidneys and other organs and may cause infertility if a cyst develops in the man's reproductive tract.

Treatment is difficult and must be tailored to the particular problem, such as surgical repair or specific medical therapy.

Unexplained Infertility

For 10 to 15 percent of all infertile couples, a definite cause of the infertility cannot be identified. Such cases are referred to as unexplained infertility. However, some good news is that as many as 60 percent of these couples will eventually conceive without treatment within three years.

Treatment for unexplained infertility presents a challenge for both the couple and the fertility specialist. Some fertility doctors recommend a treatment of Clomid, gonadotropin, or both to stimulate egg follicle production. This is followed by sexual intercourse at the time of ovulation or artificial insemination with the partner's sperm. If pregnancy still does not occur, then various assisted reproductive technologies, such as in vitro fertilization (IVF), may be performed.


While this chapter has spent a fair amount of time discussing what is possibly wrong with your or your partner's fertility, please do not despair. There is great hope for you to become parents and very soon!

Right now is the best time to be embarking on your journey of fertility and parenthood. That's because medical technology is continuing to advance and has come so far that you have many choices and options. As you read further in this book, you'll learn about basic male and female anatomy and how they work, various tests and procedures, and medications you may be offered. If practical, you may want to try a natural approach to fertility first; we'll discuss natural ways to conceive with nutrition choices, lifestyle changes, and alternative techniques. Of course, the assisted reproductive technologies are discussed in detail. These techniques are explained in plain English so that you'll feel comfortable understanding the ins and outs of IVF and other important technologies. So many new and emerging fertility technologies exist today that anyone who dreams of becoming a mommy or daddy has good reason to feel hopeful and optimistic.

Additionally, fertility issues have come out of the closet and people are talking openly about them. Thank goodness people are finally realizing that fertility dilemmas are nothing to be ashamed of and it helps to share your experiences and thoughts with others. It's perfectly normal for you to feel a wide range of emotions, from crying to jumping with joy. Some days you'll thirst for knowledge and read this book and devour information readily. Other days, frankly, you'll be sick of the whole thing and just need to take a break—go shopping or take a bubble bath or do something else entirely. These are completely normal and natural feelings.

The most important thing is that you are smart and taking the time to learn about your body and your options. That means you'll be able to make the best choices and decisions for you and your unborn baby when those situations present themselves. And they are about to do so—very soon.


Here is a summary of key facts and concepts discussed in this chapter. Overview and Important Facts

• Approximately 15 percent of couples in the United States may be infertile.

• Infertility is defined as not being able to conceive after 12 months of having regular heterosexual intercourse without the use of birth control.

• Facing fertility problems is often difficult to handle and can have devastating emotional and physical effects on you and your partner.

• About one-third of infertility cases may be attributable to the woman and another third to the man, while the last third either has to do with problems involving both partners or remains unexplained.

Causes of Infertility: Health and Lifestyle Concerns for Women

• Advancing age—especially women over the age of 35

Illicit drug use

• Certain prescription medications

• Recent or past use of contraception

• Diet, exercise, and weight

• Certain disease and medical conditions

• Environmental and occupational factors

• Gland and hormone problems

Specific Causes of Infertility for Women

Polycystic ovary syndrome (PCOS)

• Pelvic inflammatory disease (PID)

• Diethylstilbestrol (DES) abnormalities

• Asherman's Syndrome

Causes of Infertility: Health and Lifestyle Concerns for Men

• Illicit drug use

• Certain prescription medications

• Nutrition and weight

• Disease and injury

• Environmental occupational factors

• Gland and hormonal imbalance

Specific Causes of Infertility for Men

• Sexually transmitted disease (STD)

• Obstruction

• Varicocele

• Prior vasectomy

• Diethylstilbestrol (DES)

Unexplained Infertility

• For between 10 and 15 percent of all infertile couples, a definite cause of the infertility cannot be identified.

• As many as 60 percent of these couples will eventually conceive without treatment within three years.

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Defeat Drugs and Live Free

Defeat Drugs and Live Free

Being addicted to drugs is a complicated matter condition that's been specified as a disorder that evidences in the obsessional thinking about and utilization of drugs. It's a matter that might continue to get worse and become disastrous and deadly if left untreated.

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