# Infertility

> Citation bundle for Infertility on The Treatment Registry.
> URL: https://thetreatmentregistry.com/conditions/infertility
> Bundle URL: https://thetreatmentregistry.com/api/citations/conditions/infertility

## Description

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

- **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** — 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 Largely superseded by IVF for most indications but retained for selected cases of tubal disease.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.

## Related procedures

- https://thetreatmentregistry.com/procedures/ivf

## Sources

- [ESHRE — Guidelines for Good Practice in IVF Laboratories](https://www.eshre.eu/Guidelines-and-Legal/Guidelines) — European Society of Human Reproduction and Embryology (accessed 2026-05-09)