Best Evaluation And Management For Infertility

• September 25, 2022
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After one year of regular unprotected intercourse, infertility is defined as the inability to conceive. For patients who have risk factors for infertility, or if the partner is over 35 years of age, the evaluation may begin earlier. Male factors, ovulatory dysfunction, uterine abnormalities, tubal obstruction, peritoneal factors, and cervical factors are all causes of infertility. A history and physical examination can help in the evaluation process. In men, a sperm analysis should be performed. Gonadotropin therapy, intrauterine insemination or in vitro fertilization can be used to treat sperm abnormalities. On cycle day 21, serum progesterone levels should be measured to confirm ovulation. In women without risk of obstruction, hysterosalpingography can be used to evaluate the uterus and fallopian tubes. Hysteroscopy or laparoscopy is recommended for patients with a history of endometriosis, pelvic infections or ectopic pregnancy. Anovulatory women can be treated with clomiphene in the primary care setting to induce ovulation. Special care is usually required when treating tubal obstruction. Unexplained male or female infertility can be treated with an additional year of unprotected intercourse or assisted reproductive technologies such as intrauterine insemination or in vitro fertilization.

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