Infertility must be approached in a systematic,
case-specific way. This ensures
clear communication between the couple
and their fertility specialist, and allows
both partners to receive accurate information
about the causes of infertility, available
treatment options, and success rates. The
key is full individualization based on diagnostic
findings, age, infertility duration, previous
attempts, and psychological readiness.

Male Factor Infertility

– Severe sperm disorders (severe oligospermia
or asthenospermia): In vitro
fertilization (IVF) with intracytoplasmic
sperm injection (ICSI) is recommended.

– Azoospermia (absence of sperm in the
semen): If sperm retrieval is possible from
the testicles or epididymis, microsurgical
retrieval is followed by IVF with ICSI. If retrieval
is not possible, donor sperm is suggested
for intrauterine insemination (IUI).

– Mild or moderate sperm disorders:
Homologous IUI using prepared sperm is
indicated. After 3–4 failed IUIs, IVF is advised.
If the cause is linked to varicocele,
surgical treatment may be considered, although
outcomes are debated.

Tubal Factor Infertility

– Bilateral tubal obstruction: IVF is recommended.

– Hydrosalpinx (blocked, fluid-filled
tubes): Laparoscopic removal or ligation
of the tubes is recommended before IVF,
as hydrosalpinx negatively affects success
rates.

Ovulatory Dysfunction

– Ovulation disorders: Ovulation induction
using fertility medications is advised,
followed by timed intercourse or IUI under
monitoring.

Endometriosis

– Clinically suspected or confirmed: Diagnostic
or operative laparoscopy is recommended.
Depending on severity, options
may include natural conception, IUI, or IVF.

Uterine Factor Infertility

– Endometrial polyps, submucous fibroids,
uterine septa: Hysteroscopic
treatment is recommended. After treatment,
depending on clinical context,
couples may try natural conception or proceed
with assisted reproduction.