Subfertility: Causes, treatment and outcome

G. David Adamson, Valerie L. Baker

Research output: Contribution to journalReview articlepeer-review

Abstract

Common causes of subfertility include ovulatory disorders, tubal disease, peritoneal adhesions, endometriosis, uterine abnormalities, abnormalities of sperm and advancing female age. Infertility is unexplained after thorough evaluation in about 5-10% of cases. Significant caveats must be attached to the interpretation of available data regarding infertility treatments. Successful ovulation induction in anovulatory women is possible for nearly all women except in cases of ovarian failure. Surgery is an option for some patients with tubal damage, adhesions, endometriosis and uterine abnormalities. Male factor infertility may be amenable to treatment of a specific cause, but is often empirical with the use of intra-uterine insemination (IUI) or in vitro fertilization (IVF). Egg donation is currently the most effective treatment available for age-related infertility when other treatments have not been successful. Couples with unexplained infertility may be effectively treated with ovulation induction plus IUI or IVF.

Original languageEnglish (US)
Pages (from-to)169-185
Number of pages17
JournalBest Practice and Research: Clinical Obstetrics and Gynaecology
Volume17
Issue number2
DOIs
StatePublished - 2003
Externally publishedYes

Keywords

  • Adhesions
  • Congenital uterine abnormality
  • Endometriosis
  • Gonadotrophins
  • In vitro fertilization (IVF)
  • Infertility
  • Intra-uterine insemination (IUI)
  • Male factor infertility
  • Myoma
  • Oligo-ovulation
  • Oocyte donation
  • Ovulation
  • Tubal surgery
  • Unexplained infertility

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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