Infertility:
It is the inability to conceive despite having unprotected intercourse.

Causes of female infertility:
1- Problems with ovulation: caused by:

• Ovarian cysts.
• Thyroid problems either overactive or underactive.
• When the ovaries stop working before the age of 40.

2- Scarring caused by cervical or pelvic surgeries.
3- Fabriods: by blocking the falliopian tubes or preventing the egg from attaching itself in the uterus.
4- Inflammation of the fallopian tube resulting in blockage or damage due to sexually transmitted diseases or tissues bind.
5- Endometriosis: when endometrial tissues grow outside of the uterus.
6- Some side effects of some medications.

Causes of Male infertility:
– Low number of sperms or no sperms at all.
– Problems with sperm delivery.
– Quality of your semen is effected by testicles infections, congenital defects, undescended testicles, diabetes, or Varicocele .
– Hypogonadism.
– Ejaculation disorders: difficulty to release sperms during intercourse.
– Some side effects of some medications.

Other risk factors that can effect:
– Age: due to the number and quality of eggs, or health problems.
– Obesity.
– Smoking
– Being underweight

Evaluation and diagnosis:
Women:
– Pelvic examination to check for infection, fabroids, or endometriosis.
– Ovulation check by blood test to check on hormones.
– Ultrasound scan to check the ovaries, and uterus to check for fibroids or blockage.
– X-ray of your uterus and fallopian tubes to check for any blockage.

– Laparoscopy:

To examine the ovaries, uterus, fallopian tubes, and abdominal cavity.
A cut in lower abdomen will be done.
Then the laparoscope will be used through the cut to check for any abnormalities.

– Hysteroscopy: through the cervix by a hysteroscope attached to a camera. To diagnose any abnormalities like fibroids or polyps within the uterine cavity.
– Hysterosalpingo-contrast sonography: small amount of fluid is injected into the uterus, then ultrasound is used to check if the fluid passes through the fallopian tubes to check for any blockage.

Men:
– Sperm analysis to check sperm movement and structure.
– Urine sample or transrectal ultrasound to check for any obstruction.

Treatment options:
For women:
– Hormonal and fertility medication: to help in ovulation and regulating hormones levels.
– Surgery: by removing the tissues causing the blockage, removing uterine fibroids, endometriosis, or treating damaged fallopian tube.

For men:
– Surgery can be used to correct any blockage to make the sperm ejaculate normally.
– Varicocele repair.
– Surgical extraction of sperm.

For both:
– Intrauterine insemination (IUI): collecting sperms outside then placing them directly inside the uterus during ovulation.
– IVF (in vitro fertilization): Egg is fertilized with a sperm in a laboratory, then after fertilization, it is placed back inside the uterus.