Abstract
Infertility affects approximately 13% of women and 10% of men. The major causes of female infertility are anovulation, fallopian tube disease, pelvic adhesions, endometriosis, and unexplained infertility. Initial treatment for women with anovulatory infertility involves a sequential approach, moving from less to more resource-intensive therapies. Interventions that increase fecundability in anovulatory women include optimization of weight, letrozole or clomiphene ovulation induction for women with the polycystic ovary syndrome, and gonadotropin injections or pulsatile gonadotropin-releasing hormone (GnRH) therapy for women with functional hypothalamic amenorrhea. For women with distal tubal disease, effective treatments include in vitro fertilization (IVF) or laparoscopic tubal surgery. For couples with unexplained infertility, clomiphene plus intrauterine insemination (IUI), gonadotropin plus IUI and IVF are effective treatments. Most women who are infertile will conceive with fertility therapy.
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