HemoChat

Evidence-Based AI Medical Search

← Back to guidelines
Obstetrics2790 papers

Female infertility

Last edited: 4/14/2026

Overview

Female infertility refers to the inability to conceive after a year of regular unprotected intercourse, often due to ovulatory disorders, tubal factors, uterine abnormalities, or ovarian issues. 19

Diagnosis

  • Key Diagnostic Criteria:
    • - History of infertility duration and sexual history. - Ovulation assessment (basal body temperature charting, LH surge tests). - Hormonal evaluation (FSH, LH, estradiol, TSH, prolactin). - Imaging studies (pelvic ultrasound, HSG for tubal patency). - Semen analysis for male partner.
  • Recommended Tests:
    • - Hysterosalpingography (HSG) to evaluate uterine and fallopian tube anatomy. - Ovarian reserve testing (AMH, AFC). - Genetic testing in cases of suspected chromosomal abnormalities. 1910

    Management

  • First-Line Treatments:
    • - Ovulation Induction: Clomiphene citrate (50-150 mg/day for 5 days), letrozole (2.5-5 mg/day for 5 days). - Hormonal Therapy: Gonadotropins (FSH) for anovulation or poor ovarian response.
  • Adjunctive Treatments:
    • - Assisted Reproductive Technologies (ART): In vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI). - Lifestyle Modifications: Weight management, dietary supplements (vitamins, minerals), especially thyroid hormones and essential micronutrients. 6916

    Special Populations

  • Pregnancy: Preconception care emphasizing optimal health status and micronutrient sufficiency is crucial 5.
  • Comorbidities: Thyroid dysfunction and micronutrient deficiencies significantly impact fertility outcomes; management should include appropriate supplementation 910.

    • Key Recommendations

  • Implement Preconception Care Programs to optimize maternal health and reduce risk factors for infertility 5 (Evidence: Strong).
  • Evaluate and Address Hormonal Imbalances through appropriate hormonal therapy and monitoring 9 (Evidence: Moderate).
  • Consider ART Options such as IVF for couples with unexplained or severe infertility 1 (Evidence: Moderate).
  • Ensure Adequate Micronutrient Intake, particularly focusing on thyroid hormones and essential vitamins/minerals 910 (Evidence: Moderate).
  • Educate Patients on Supplement Adherence and provide clear, satisfactory information regarding essential micronutrients 2 (Evidence: Moderate).

    • References

    1 Kouklamani-Giannouli AE, Pratsoli E, Sergentanis TN, Tsitsika AK. Long-Term Health Outcomes of Children Born After In Vitro Fertilization (IVF): A Narrative Review. Advances in experimental medicine and biology 2026. link 2 Breuste NJ, Schippert C, von Versen-Höynck F. Adherence to vitamin and dietary supplement intake in fertility and pregnancy care: insights into knowledge, information satisfaction, and formulation variability. Archives of gynecology and obstetrics 2026. link 3 Mitchell RT, Eguizabal C, Goossens E, Grynberg M, Jahnukainen K, Le Clef N et al.. ESHRE good practice recommendations on fertility preservation involving testicular tissue cryopreservation in children receiving gonadotoxic therapies†. Human reproduction (Oxford, England) 2025. link 4 Cakir H, Caglar U, Halis A, Sarilar O, Yazili HB, Ozgor F. Assessing the Knowledge of ChatGPT in Answering Questions Regarding Female Urology. Urology journal 2024. link 5 Ku CW, Tan YB, Tan SI, Ku CO, Godfrey KM, Tan KH et al.. Holistic preconception care: Providing real-time guidance via a mobile app to optimise maternal and child health. Annals of the Academy of Medicine, Singapore 2024. link 6 Gerontakos S, Leach M, Steel A, Wardle J. Feasibility and efficacy of implementing group visits for women's health conditions: a systematic review. BMC health services research 2023. link 7 de Guzman GS, Manalo EM, Banal-Silao MJB. Awareness and perceptions of Filipino obstetrician-gynecologists on fertility preservation: a cross-sectional survey. BMC women's health 2023. link 8 Moore IS, Crossley KM, Bo K, Mountjoy M, Ackerman KE, Antero JDS et al.. Female athlete health domains: a supplement to the International Olympic Committee consensus statement on methods for recording and reporting epidemiological data on injury and illness in sport. British journal of sports medicine 2023. link 9 Aghayeva S, Sonmezer M, Şükür YE, Jafarzade A. The Role of Thyroid Hormones, Vitamins, and Microelements in Female Infertility. Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia 2023. link 10 Smith ES, McKay AKA, Kuikman M, Ackerman KE, Harris R, Elliott-Sale KJ et al.. Managing Female Athlete Health: Auditing the Representation of Female versus Male Participants among Research in Supplements to Manage Diagnosed Micronutrient Issues. Nutrients 2022. link 11 Nose-Ogura S. Advancement in female sports medicine and preventive medicine. The journal of obstetrics and gynaecology research 2021. link 12 Roth C. The Degenerating Sex: Female Sterilisation, Medical Authority and Racial Purity in Catholic Brazil. Medical history 2020. link 13 Esfandiari N, Litzky J, Sayler J, Zagadailov P, George K, DeMars L. Egg freezing for fertility preservation and family planning: a nationwide survey of US Obstetrics and Gynecology residents. Reproductive biology and endocrinology : RB&E 2019. link 14 Huppelschoten AG, Bijleveld K, Braams L, Schoot BC, van Vliet HAAM. Laparoscopic Sterilization Under Local Anesthesia with Conscious Sedation Versus General Anesthesia: Systematic Review of the Literature. Journal of minimally invasive gynecology 2018. link 15 Westberg J, Scott F, Creinin MD. Safety outcomes of female sterilization by salpingectomy and tubal occlusion. Contraception 2017. link 16 Stanford JB, Martin JC, Gibson M, Birdsall E, Brixner DI. Use of clomiphene citrate in the University of Utah Community Clinics. The Journal of reproductive medicine 2013. link 17 Sarikaya HB, Iyilikci L, Gulekli B, Posaci C, Erbil Dogan O, Ok E et al.. Comparison of the effects of 2 different doses of remifentanil infusion for sedation during in-vitro fertilization procedure. Saudi medical journal 2011. link 18 Heesakkers JP, Costantini E, Oelke M. Should we train urologists in female urology? A European view. Current opinion in urology 2009. link 19 Pieczenik G. Are the universes of antibodies and antigens symmetrical?. Reproductive biomedicine online 2003. link61702-6) 20 Mazdisnian F, Palmieri A, Hakakha B, Hakakha M, Cambridge C, Lauria B. Office microlaparoscopy for female sterilization under local anesthesia. A cost and clinical analysis. The Journal of reproductive medicine 2002. link 21 Sehgal N, Goswami SV. Immunological identification of two female-specific proteins from the plasma of Indian freshwater murrel, Channa punctatus (Bloch). Indian journal of experimental biology 2002. link 22 Aisien AO, Olarewaju RS, Ujah IA, Mutihir JT, Sagay AS. Anaesthesia for minilaparotomy female sterilization in JUTH, Nigeria: a fourteen-year review. African journal of medicine and medical sciences 2001. link 23 de la Fuente Fonnest I, Søndergaard F, Fonnest G, Vedsted-Jacobsen A. Attitudes among health care professionals on the ethics of assisted reproductive technologies and legal abortion. Acta obstetricia et gynecologica Scandinavica 2000. link 24 Fletcher JC, Evans MI. Ethical issues in reproductive genetics. Seminars in perinatology 1998. link80034-7) 25 Trout SW, Vallerand AH, Kemmann E. Conscious sedation for in vitro fertilization. Fertility and sterility 1998. link00031-4) 26 Quill TE, Bennett NM. The effects of a hospital policy and state legislation on resuscitation orders for geriatric patients. Archives of internal medicine 1992. link 27 Farjam A, Brugman AE, Lingeman H, Brinkman UA. On-line immunoaffinity sample pre-treatment for column liquid chromatography: evaluation of desorption techniques and operating conditions using an anti-estrogen immuno-precolumn as a model system. The Analyst 1991. link 28 Dearsly AL, Johnson RM, Barrett P, Sommerville J. Identification of a 60-kDa phosphoprotein that binds stored messenger RNA of Xenopus oocytes. European journal of biochemistry 1985. link 29 Hanscombe G. The right to lesbian parenthood. Journal of medical ethics 1983. link

    Original source

    1. [1]
      Long-Term Health Outcomes of Children Born After In Vitro Fertilization (IVF): A Narrative Review. — Kouklamani-Giannouli AE, Pratsoli E, Sergentanis TN, Tsitsika AK Advances in experimental medicine and biology (2026)
    2. [2]
      Adherence to vitamin and dietary supplement intake in fertility and pregnancy care: insights into knowledge, information satisfaction, and formulation variability. — Breuste NJ, Schippert C, von Versen-Höynck F Archives of gynecology and obstetrics (2026)
    3. [3]
      ESHRE good practice recommendations on fertility preservation involving testicular tissue cryopreservation in children receiving gonadotoxic therapies†. — Mitchell RT, Eguizabal C, Goossens E, Grynberg M, Jahnukainen K, Le Clef N et al. Human reproduction (Oxford, England) (2025)
    4. [4]
      Assessing the Knowledge of ChatGPT in Answering Questions Regarding Female Urology. — Cakir H, Caglar U, Halis A, Sarilar O, Yazili HB, Ozgor F Urology journal (2024)
    5. [5]
      Holistic preconception care: Providing real-time guidance via a mobile app to optimise maternal and child health. — Ku CW, Tan YB, Tan SI, Ku CO, Godfrey KM, Tan KH et al. Annals of the Academy of Medicine, Singapore (2024)
    6. [6]
      Feasibility and efficacy of implementing group visits for women's health conditions: a systematic review. — Gerontakos S, Leach M, Steel A, Wardle J BMC health services research (2023)
    7. [7]
      Awareness and perceptions of Filipino obstetrician-gynecologists on fertility preservation: a cross-sectional survey. — de Guzman GS, Manalo EM, Banal-Silao MJB BMC women's health (2023)
    8. [8]
      Female athlete health domains: a supplement to the International Olympic Committee consensus statement on methods for recording and reporting epidemiological data on injury and illness in sport. — Moore IS, Crossley KM, Bo K, Mountjoy M, Ackerman KE, Antero JDS et al. British journal of sports medicine (2023)
    9. [9]
      The Role of Thyroid Hormones, Vitamins, and Microelements in Female Infertility. — Aghayeva S, Sonmezer M, Şükür YE, Jafarzade A Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia (2023)
    10. [10]
      Managing Female Athlete Health: Auditing the Representation of Female versus Male Participants among Research in Supplements to Manage Diagnosed Micronutrient Issues. — Smith ES, McKay AKA, Kuikman M, Ackerman KE, Harris R, Elliott-Sale KJ et al. Nutrients (2022)
    11. [11]
      Advancement in female sports medicine and preventive medicine. — Nose-Ogura S The journal of obstetrics and gynaecology research (2021)
    12. [12]
      The Degenerating Sex: Female Sterilisation, Medical Authority and Racial Purity in Catholic Brazil. — Roth C Medical history (2020)
    13. [13]
      Egg freezing for fertility preservation and family planning: a nationwide survey of US Obstetrics and Gynecology residents. — Esfandiari N, Litzky J, Sayler J, Zagadailov P, George K, DeMars L Reproductive biology and endocrinology : RB&E (2019)
    14. [14]
      Laparoscopic Sterilization Under Local Anesthesia with Conscious Sedation Versus General Anesthesia: Systematic Review of the Literature. — Huppelschoten AG, Bijleveld K, Braams L, Schoot BC, van Vliet HAAM Journal of minimally invasive gynecology (2018)
    15. [15]
      Safety outcomes of female sterilization by salpingectomy and tubal occlusion. — Westberg J, Scott F, Creinin MD Contraception (2017)
    16. [16]
      Use of clomiphene citrate in the University of Utah Community Clinics. — Stanford JB, Martin JC, Gibson M, Birdsall E, Brixner DI The Journal of reproductive medicine (2013)
    17. [17]
      Comparison of the effects of 2 different doses of remifentanil infusion for sedation during in-vitro fertilization procedure. — Sarikaya HB, Iyilikci L, Gulekli B, Posaci C, Erbil Dogan O, Ok E et al. Saudi medical journal (2011)
    18. [18]
      Should we train urologists in female urology? A European view. — Heesakkers JP, Costantini E, Oelke M Current opinion in urology (2009)
    19. [19]
      Are the universes of antibodies and antigens symmetrical? — Pieczenik G Reproductive biomedicine online (2003)
    20. [20]
      Office microlaparoscopy for female sterilization under local anesthesia. A cost and clinical analysis. — Mazdisnian F, Palmieri A, Hakakha B, Hakakha M, Cambridge C, Lauria B The Journal of reproductive medicine (2002)
    21. [21]
      Immunological identification of two female-specific proteins from the plasma of Indian freshwater murrel, Channa punctatus (Bloch). — Sehgal N, Goswami SV Indian journal of experimental biology (2002)
    22. [22]
      Anaesthesia for minilaparotomy female sterilization in JUTH, Nigeria: a fourteen-year review. — Aisien AO, Olarewaju RS, Ujah IA, Mutihir JT, Sagay AS African journal of medicine and medical sciences (2001)
    23. [23]
      Attitudes among health care professionals on the ethics of assisted reproductive technologies and legal abortion. — de la Fuente Fonnest I, Søndergaard F, Fonnest G, Vedsted-Jacobsen A Acta obstetricia et gynecologica Scandinavica (2000)
    24. [24]
      Ethical issues in reproductive genetics. — Fletcher JC, Evans MI Seminars in perinatology (1998)
    25. [25]
      Conscious sedation for in vitro fertilization. — Trout SW, Vallerand AH, Kemmann E Fertility and sterility (1998)
    26. [26]
      The effects of a hospital policy and state legislation on resuscitation orders for geriatric patients. — Quill TE, Bennett NM Archives of internal medicine (1992)
    27. [27]
      On-line immunoaffinity sample pre-treatment for column liquid chromatography: evaluation of desorption techniques and operating conditions using an anti-estrogen immuno-precolumn as a model system. — Farjam A, Brugman AE, Lingeman H, Brinkman UA The Analyst (1991)
    28. [28]
      Identification of a 60-kDa phosphoprotein that binds stored messenger RNA of Xenopus oocytes. — Dearsly AL, Johnson RM, Barrett P, Sommerville J European journal of biochemistry (1985)
    29. [29]
      The right to lesbian parenthood. — Hanscombe G Journal of medical ethics (1983)
    Share:TwitterRedditLinkedIn

    HemoChat

    by SPINAI

    Evidence-based clinical decision support powered by SNOMED-CT, Neo4j GraphRAG, and NASS/AO/NICE guidelines.

    ⚕ For clinical reference only. Not a substitute for professional judgment.

    © 2026 HemoChat. All rights reserved.
    Research·Pricing·Privacy & Terms·Refund·SNOMED-CT · NASS · AO Spine · NICE · GraphRAG