The current fertilization rate of eggs injected is 70 to 80 percent, and pregnancy rates are comparable to those seen with IVF in couples with no male factor infertility. Intra-uterine insemination IUI , also known as artificial insemination, is the process of preparing and delivering sperm so that a highly concentrated amount of active motile sperm is placed directly through the cervix into the uterus. It can be performed with or without fertility drugs for the female patient.
The pregnancy rate is double that from using timed intercourse. IUI is commonly performed as a low-tech, cost-effective approach to enhancing fertility. Please read Intra-Uterine Insemination for more information about this procedure. Historically, oral drugs containing hormones were designed to induce ovulation in women with irregular menstrual cycles who didn't ovulate.
The goal was to stimulate the body to produce and release an egg ready to be fertilized. Later, injected hormones were developed to increase the number of eggs reaching maturity in a single cycle, increasing chances for conception.
These drugs increase the risk of multiple conceptions, are more expensive, require more time and may cause ovarian over stimulation. In the mids, oral drugs were used in women with regular menstrual cycles who ovulate but who have "unexplained infertility. Ovulation induction is always combined with intrauterine insemination, and it should only be considered after a complete and thorough evaluation. All underlying hormonal disorders such as thyroid dysfunction should be treated prior to resorting to using fertility drugs.
Please read Ovulation Induction to learn more about these drugs. Need a doctor? Call us at UCSF or browse our directory. University of California San Francisco. MyChart Find a Doctor. Infertility in Women Treatment. IVF involves stimulating and retrieving multiple mature eggs from a woman, fertilizing them with a man's sperm in a dish in a lab, and implanting the embryos in the uterus three to five days after fertilization. Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.
Coping with infertility can be extremely difficult because there are so many unknowns. The emotional burden on a couple is considerable. Taking these steps can help you cope:. Seek professional help if the emotional impact of the outcome of your fertility treatments becomes too heavy for you or your partner. Depending on your age and personal health history, your doctor may recommend a medical evaluation. A woman's gynecologist or a man's urologist or a family doctor can help determine whether there's a problem that requires a specialist or clinic that treats infertility problems.
In some cases, both you and your partner may require a comprehensive infertility evaluation. Be ready to answer questions to help your doctor quickly determine next steps in making a diagnosis and starting care. Infertility care at Mayo Clinic. Mayo Clinic does not endorse companies or products.
WHO | Infertility definitions and terminology
Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Diagnosis Before infertility testing, your doctor or clinic works to understand your sexual habits and may make recommendations based on these. Blocked fallopian tubes or an abnormal uterine cavity may cause infertility. Hysteroscopy During a hysteroscopy, your doctor uses a thin, lighted instrument hysteroscope to view the inside of your uterus. Sonohysterography During sonohysterography, your doctor uses a thin, flexible tube catheter to inject salt water saline into the hollow part of your uterus.
In vitro fertilization During in vitro fertilization, eggs are removed from mature follicles within an ovary A. Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. References Infertility: An overview — A guide for patients. American Society for Reproductive Medicine. Accessed May 23, Infertility FAQs. Centers for Disease Control and Prevention. Merck Manual Consumer Version.
Frequently asked questions. Gynecologic problems FAQ Treating infertility. American College of Obstetricians and Gynecologists.
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Evaluating infertility. Ask about her rubella status. Family history : for similar problem among the female members, consanguinity, diabetes mellitus, hypertension, twins delivery, breast cancer. Sexual history : Coital frequency, timing, and any associated problems as erectile dysfunction or ejaculatory problems, loss of libido. History of previous marriage or extra-marital sexual relations. Contraceptive history : previous use of any contraceptive method either temporary as condom or permanent as vasectomy.
Past history : medical disease or surgical operations as mumps, tuberculosis, bilharziasis, sexually-transmitted infections, hydrocele, varicocele, undescended testis, appendicectomy, inguinal hernia repair, or bladder-neck suspension operations. Family history : for similar problem among the male members, consanguinity, diabetes mellitus, and hypertension. Abnormal skin depigmentation as vitiligo may suggest an autoimmune systemic disease. Examination should include also the thyroid gland. Breast Examination : to evaluate its development and to exclude any pathology or presence of occult galactorrhoea.
Abdominal Examination : for any abdominal mass, organomegaly, ascites, abdominal striae, and surgical scars. Genital Examination : type of circumcision, size and shape of clitoris, hymen, vaginal introitus, site, size, shape, surface, consistency, mobility and direction of uterus, any palpable adnexal mass, vaginal discharge, tenderness, uterosacral ligament thickening, and nodules in the cul-de-sac denoting either endometriosis or tuberculosis by per-vaginal PV examination. General Examination : vital signs especially blood pressure , body height and weight BMI , arm-span, secondary sexual characters, and examination of thyroid gland.
Abdominal Examination : for any abdominal mass, undescended testis, inguinal hernia, organomegaly, or ascites. Genital Examination : shape and size of penis, prepuce, position of external urethral meatus, testicular volume by using Prader's Orchidometer.
Management of infertility
Perineal sensation, rectal sphincter's tone, and prostate enlargement by per-rectal PR examination. General : Full blood count, urine analysis, Papanicolaou smear, vaginal wet mount with appropriate culture, Rubella serology, Hepatitis B and C, HIV serology, and Chlamydia trachomatis serology. Hormonal assay : to predict ovulation and ovarian reserve. Mid-luteal serum progesterone level days before the expected menstrual cycle. The use of basal body temperature BBT charting and ovulation predictor home kits are not recommended. Transvaginal ultrasonography : to monitor natural ovulation, to detect any pelvic pathology as uterine or ovarian masses, abnormally-shaped or mal-directed uterus.
No need for ultrasound scanning of endometrium. Hysterosalpingography or Hysterosalpingo-Contrast-Sonography HyCoSy : to evaluate shape of uterine cavity and patency of both fallopian tubes in low-risk women. Thyroid function tests for women with symptoms of thyroid disease.
Semen Analysis: The Universal Standard
Laparoscopy : for possible associated pelvic pathology or adhesions in cases with abnormal HSG findings, previous history of pelvic inflammatory disease or endometriosis. Hysteroscopy : for intrauterine space-occupying lesions detected on HSG as adhesions or polyp no evidence linking it with enhanced fertility. Chromosomal karyotyping : for suspected genetic disorders as Turner's syndrome. Semen analysis after 72 hours of sexual abstinence : interpreted for its volume, sperm count, motility, and morphology according to the WHO reference values Two analyses with 3 months apart at the same lab.
Post-coital test : no predictive value on the pregnancy rate. Anti-sperm antibodies no evidence of effective treatment to improve fertility , and Sperm function tests. Testicular biopsy : A fine-needle aspiration biopsy may required to differentiate between obstructive and non-obstructive azoospermia. Chromosomal karyotyping : for suspected genetic disorders as sex chromosomal aneuploidy, cystic fibrosis, and deletion of Y-chromosome.
Folic acid 0. Rubella vaccination if seronegative avoid pregnancy for one month. Treat any psycho-sexual problem if present. Induction of Ovulation : for women with ovulatory dysfunctions. Provide a controlled ovarian stimulation for assisted reproduction techniques. Could be used for unexplained infertility and female cases with minimal endometriosis. Surrogacy : In women with congenital absence of uterus or after surgical removal. Tubal surgery : as laparoscopic adhesiolysis, tubal cannulation or catheterisation.
Hysteroscopic surgery : as resection of IU adhesions or polyp. For cases who refuse fertilisation in lab. Oocyte donation and Ovarian tissue transplantation : for premature ovarian failure. Adoption : For cases with recurrent unexplained failed IVF cycles. Surgical restoration of duct patency : For cases with previous vasectomy. This work was self-funded.
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Advertisement Hide. Download PDF. Reproductive Biology and Endocrinology December , Cite as. Management of the infertile couple: an evidence-based protocol. Open Access. First Online: 06 March Background Infertility is defined as inability of a couple to conceive naturally after one year of regular unprotected sexual intercourse. Objectives The aim of this study is to provide the healthcare professionals an evidence-based management protocol for infertile couples away from medical information overload.
Results A simple guide for the clinicians to manage the infertile couples. Conclusions The study deploys a new strategy to translate the research findings and evidence-base recommendations into a simplified focused guide to be applied on routine daily practice. This process is experimental and the keywords may be updated as the learning algorithm improves.
Background Infertility is a common clinical problem. Methodology This paper, as a comprehensive review, deploys a new strategy to translate the research findings and evidence-base recommendations into a simplified focused guide to be applied on routine daily practice. History-taking Couples with infertility problem should be interviewed separately as well as together, to bring out important facts that one partner might not wish to disclose to the other.