Infertility
By The Treatment Registry editors
Infertility is generally defined as inability to conceive after 12 months of regular unprotected intercourse (6 months over age 35). Causes are female-factor, male-factor, both, or unexplained. Treatment is staged from lifestyle and medical optimisation through assisted reproductive technology, with specific approaches tailored to the underlying cause.
Treatment ladder
Conservative options are first-line where appropriate; surgical options are typically reserved for cases where lower-tier options are unsuitable or have failed. Decisions are individual and depend on clinical assessment.
Conservative
- Lifestyle optimisation and timed intercourse
Weight, smoking, alcohol, and exercise modification; ovulation tracking. Effective in some couples without further intervention.
- Ovulation induction
Clomifene citrate or letrozole for anovulatory women. Frequently combined with intercourse timing or IUI.
- Surgical management of underlying conditions
Laparoscopy for endometriosis, hysteroscopy for uterine adhesions, varicocele repair in male factor — directed at correcting an identified cause before assisted reproduction.
Procedural
- Intrauterine insemination (IUI)
Concentrated sperm placed in the uterus around ovulation. Less invasive and less expensive than IVF; lower per-cycle success rate.
- IVF / ICSI · View procedure page
In-vitro fertilisation, with or without intracytoplasmic sperm injection. The standard ART option for tubal factor, severe male factor, advanced reproductive age, and after failed IUI cycles.
- Donor egg / sperm / embryo cycles
Treatment using donor gametes or embryos. Legal frameworks (anonymity, recognition, parentage) vary materially between jurisdictions and have implications for the resulting child.
- Surrogacy
Pregnancy carried by a surrogate. Legality and enforceability vary widely across countries; cross-border surrogacy carries significant legal complexity.
Surgical
- Tubal microsurgery
Microsurgical repair of fallopian-tube obstruction. Largely superseded by IVF for most indications but retained for selected cases of tubal disease.
- Endometriosis excision
Laparoscopic excision of endometriotic deposits to improve natural conception rates and reduce pain. May be performed before or alongside IVF.