Female Infertility: Evaluation and Management

Infertility evaluation and treatment in humans have evolved significantly over the past 50 years with increasing successes in achieving pregnancy. Classically, causal conditions such as extreme oligozoospermia or azoospermia, tubal pathology due to sexually transmitted disease or endometriosis, and chronic anovulation are the main targets of a diagnostic workup that will lead to adequate treatments for most individuals and couples with infertility. However, the very moderate fecundability of the human species in general, in combination with delayed attempts to conceive, leads to the high proportion of unexplained infertility cases. In these conditions, tests for gamete quality are lacking, but there is reason to believe that this quality, certainly at the level of the oocyte, may be a dominant problem. For this problem proper treatment options are highly empirical and should continuously be balanced against the remaining prognosis for a spontaneous pregnancy.Keywords: Tubal pathology; male factor; anovulation; unexplained; ovarian stimulation; intra-uterine insemination; in vitro fertilization;