Overview of treatment of female infertility
- Wendy Kuohung, MD
Wendy Kuohung, MD
- Associate Professor of Obstetrics and Gynecology
- Boston University School of Medicine
- Mark D Hornstein, MD
Mark D Hornstein, MD
- Professor of Obstetrics, Gynecology & Reproductive Biology
- Harvard Medical School
Infertility is a complex disorder with significant medical, psychosocial, and economic aspects. Great strides have been achieved in infertility therapy, particularly the development of assisted reproductive technology (ART).
Once the cause of infertility is identified, therapy aimed at correcting reversible etiologies and overcoming irreversible factors can be implemented. The couple is also counseled on lifestyle modifications to improve fertility, such as smoking cessation, reducing excessive caffeine and alcohol consumption, and appropriate frequency of coitus (every one to two days around the expected time of ovulation) (table 1). (See "Optimizing natural fertility in couples planning pregnancy".)
The patient should be involved in fertility treatment choices. These choices involve four major factors: effectiveness (eg, live birth rate), burden of treatment (eg, frequency of injections and office visits), safety (eg, risk of ovarian hyperstimulation and multiple gestation), and financial costs .
This topic will provide an overview of the treatment of female. The evaluation of female infertility, as well as the causes and treatment of male infertility, are discussed separately:
●(See "Causes of female infertility".)
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- OVULATORY DISORDERS
- Weight modulation
- - High body weight
- - Low body weight
- Ovulation induction agents
- - Clomiphene
- - Aromatase inhibitors
- - Gonadotropin therapy
- Other agents
- - Metformin
- - Tamoxifen
- - Laparoscopic surgery
- - Dopamine agonists
- Assisted reproductive technologies
- TUBAL FACTOR INFERTILITY AND ADHESIONS
- Procedures for improving tubal patency
- - Distal obstruction
- - Proximal obstruction
- In vitro fertilization
- - Salpingectomy for hydrosalpinx
- UTERINE FACTOR INFERTILITY
- Synechiae, septa, congenital anomalies
- Endometrial polyps
- Luteal phase defect
- CERVICAL FACTOR INFERTILITY
- UNEXPLAINED INFERTILITY
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS