Treatment of infertility
Abstract
Primary evaluation of infertility consists of confirmation of regular ovulation and capacity to produce functional spermatozoa, and exclusion of any anatomical barrier for infertility. If the sperm analysis is normal, clomiphene is the first-line treatment in anovulatory women. Obese women suffering from polycystic ovary syndrome may be first offered metformin for 3-4 months before the addition of clomiphene. If ovulation cannot be induced with clomiphene, aromatase inhibitors, ovarian drilling gonadotrophin stimulation are the subsequent steps. If no response is obtained after 4-6 ovulatory cycles, intrauterine insemination and in vitro fertilisation should be offered.
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