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Mira Aubuchon Richard O. Burney Danny J. Schust Mylene W.M. Yao
The physician’s initial encounter with the infertile couple is extremely important because it sets the tone for subsequent evaluation and treatment. Factors from either or both partners may contribute to difficulties in conceiving; therefore, it is important to consider all possible diagnoses before pursuing invasive treatment.
The main causes of infertility include male factor, decreased ovarian reserve, ovulatory disorders (ovulatory factor), tubal injury, blockage, or paratubal adhesions (including endometriosis with evidence of tubal or peritoneal adhesions), uterine factors, systemic conditions (including infections or chronic diseases such as autoimmune conditions or chronic renal failure), cervical and immunologic factors, and unexplained factors (including endometriosis with no evidence of tubal or peritoneal adhesions).
Basic investigations that should be performed before starting any infertility treatment are semen analysis, confirmation of ovulation, and the documentation of tubal patency.