Infertility

Infertility affects 12 to 18% of couples in the United States and may be due to female factors, male factors, or both. A systematic evaluation of the common causes of infertility can identify conditions that may be treated by the obstetrician-gynecologist to help the couple achieve their family-building goals or those that require referral to a subspecialist. This review discusses current recommendations regarding the workup and treatment of the common causes of infertility, including tubal and pelvic factors, ovulatory disorders, and male factors. Advances in assisted reproductive technology are also discussed, including the use of genetic screening in in vitro fertilization and fertility preservation options for individuals facing gonadotoxic therapy. This review contains 6 figures, 8 tables, and 53 references. Key words: anovulation, assisted reproductive technology, clomiphene citrate, infertility, letrozole, oocyte cryopreservation, ovulation induction, semen analysis, tubal factor, uterine factor