INFERTILITY *Infertility affects 15% of reproductive age couples. *Infertility is defined as a couple’s failure to conceive following 1 year of unprotected sexual intercourse. *reproductive age *endometriosis *environmental and life-style issues. *increased sexual contacts---pelvic inflammatory disease. *deferred childbearing---increasing age.

CAUSES OF INFERTILITY *anovulation 30%. *anatomic defects of the female genital tract 30%. *abnormal spermatogenesis 40%. *male factors and ovulation disorders---commonly observed causes *BBT,biphasic temperature *analysis of a semen specimen *hysterosalpingogram *diagnostic laparoscopy---complemenyary to the hysterosalpingogram

ANOVULATION *BBT *a history of regular menstrual periods strongly suggests regular ovulation. *endometrial biopsy *measurement of serum progesterone *the urinary ovulation-detection kit *symptoms---episodes of amemorihea,irregular,unpredictable MC,hirsutism,galactorrhea,vaginal secretions *abnormal androgen,prolactin,gonadotropin secretion,thyroid dysfunction

ANATOMIC DISORDERS OF THE FEMALE GENITAL TRACT *sperm transport,fertilization,and implantation *acquired and congenital disorders *acute salpingitis---Asherman’s syndrome,curettage *endometrosis,scarring and adhesions,surgery,tumors,trauma *double vagina,double cervix,double uterus TREATMENT OF THE INFERTILE COUPLE

*anovulation *anatomic abnormalities *inadequate spermatogenesis *assisted reproductive technologies---IVF,ZIFT