Infertility due to problems with male reproductive health,
leading to difficulty in fertilizing the egg.

• Low sperm count or low-quality sperm
• Hormonal imbalances
• Erectile dysfunction
• Blockage in sperm ducts or varicocele

Infertility due to problems with female reproductive health, preventing conception or successful pregnancy.

• Ovulation disorders (e.g., polycystic ovary syndrome, PCOS)
• Blocked fallopian tubes
• Endometriosis
• Uterine abnormalities
• Age (diminished ovarian reserve)

1. Medical History : A detailed medical history of both partners is taken, including any past reproductive, sexual, and overall health issues.
2. Physical Exam : For men, a physical exam may include examining the genitals for abnormalities, while for women, it can include a pelvic exam to assess the reproductive organs.

1. Ovulation Testing : Blood tests are done to check hormone levels (like progesterone) to determine whether ovulation is occurring
2. Ovarian Reserve Testing : The test helps ascertain the type and quantity of eggs that are ready for ovulation. It often involves blood tests for follicle-stimulating hormone (FSH), estradiol, and Anti-Müllerian hormone (AMH).

1. Pelvic Ultrasound : Used to check for uterine or ovarian abnormalities such as fibroids, polyps, or ovarian cysts.
2. Hysterosalpingography (HSG) : An X-ray procedure where dye is injected into the uterus and fallopian tubes to check for blockages or abnormalities.
3. Transvaginal Ultrasound : Helps assess the uterus and ovaries more closely.

1. Anti-sperm Antibody Test: Checks for immune reactions against sperm in either partner, which can impair sperm function.
2. DNA Fragmentation Test: Assesses the integrity of sperm DNA, which can affect fertility and miscarriage rates.

1. Semen Analysis: A primary test where the semen is evaluated for sperm count, motility (movement), and morphology (shape). This is often repeated to confirm results.
2. Blood Tests: To check hormone levels, including testosterone and follicle-stimulating hormone (FSH), which can influence sperm production
3. Scrotal Ultrasound: Used to detect problems in the testicles, such as varicoceles or blockages in the ducts that carry sperm.
4. Genetic Testing:Conducted if there is very low or no sperm in the semen, to identify any chromosomal abnormalities.

1. Genetic Testing for Both Partners : Sometimes, genetic abnormalities can be the cause of infertility, so genetic testing may be done if indicated.
2. Postcoital Test : This test checks the interaction between the sperm and cervical mucus to see if the sperm can survive and move through it.
3. Endometrial Biopsy (for Women) : A small tissue sample is taken from the lining of the uterus to check for normal ovulation and proper development of the uterine lining.

Blood tests to evaluate hormone levels, such as:

1. FSH (Follicle-Stimulating Hormone)
2. LH (Luteinizing Hormone)
3. Estrogen
4. Testosterone
5. Thyroid Hormones (T3, T4, TSH)

Infertility diagnosis involves a thorough evaluation of both partners and can be completed over several weeks to months. Once the cause is identified, treatment plans can be created accordingly.

Treatments for infertility in female-assigned individuals and women include:

1. Lifestyle and Natural Interventions : Both underweight and overweight individuals may experience improved fertility through weight normalization. Eating a balanced diet and regular physical activity can help optimize reproductive health. Reducing stress through relaxation techniques or therapy may help improve fertility in some individuals.
2. Medications : Fertility medications enhance the amount of eggs your ovaries release, increasing your likelihood of becoming pregnant.
3. Surgery : Surgery can remove fibroids, polyps, and scar tissue in addition to opening obstructed fallopian tubes. The providers could offer advice on how to increase your chances of getting pregnant. These may include things like
   • Laparoscopy or hysteroscopy : To correct anatomical problems such as blocked fallopian tubes, uterine polyps, or endometriosis.
   • Using a home ovulation kit, a kit you can purchase at the drug store or online to help predict ovulation.

Treatments for infertility for men include :

1. Medications: Medication has the ability to increase hormone levels, including testosterone. To assist you keep an erection during sex, there are medications for erectile dysfunction as well.
2. Surgery: Some men require surgery to fix structural issues or to clear obstructions in the tubes that deliver sperm. Surgery for varicocele can improve sperm health and increase the likelihood of pregnancy.

With assisted reproductive technology (ART), some couples require further assistance to conceive. ART is any fertility treatment that involves a healthcare provider handling the sperm or egg. You can use ovulation-stimulating drugs to improve your chances of getting pregnant before using any of these methods:

1. Intrauterine Insemination (IUI): Involves injecting sperm into the uterus at the exact moment of ovulation. It is often used when there are mild sperm abnormalities, unexplained infertility, or cervical mucus issues.
2. In Vitro Fertilization (IVF) : IVF is one of the most effective and widely used treatments. It entails taking the eggs out of the ovaries, fertilizing them in a lab with sperm, and then putting the resultant embryos inside the uterus.
3. Intracytoplasmic sperm injection (ICSI) : This operation might be carried out while doing IVF. Every egg is directly injected with one sperm by an embryologist. Subsequently, an embryologist inserts one to three embryos into your uterus.
4. Fertility Preservation (Egg or Sperm Freezing) : Useful for individuals undergoing treatments (e.g., cancer therapy) that may affect fertility or those who wish to delay childbearing.
5. Donor Eggs, Sperm, or Embryos : For individuals with poor egg or sperm quality or for same-sex couples, donor eggs, sperm, or embryos can be used.
6. Surrogacy : In cases where the woman cannot carry a pregnancy, surrogacy (using another woman to carry the pregnancy) may be an option.
7. Assisted Hatching : This technique may improve the chances of implantation during IVF by thinning the outer shell of the embryo.