Snapshot A 27-year-old G0P0 female presents with difficulty with becoming pregnant. She and her husband have been trying to conceive for around 6 months, but have been unsuccessful. On physical exam, she has a short stature with a stocky habitus and broad chest. Labs reveal decreased estrogen, increased LH, and increased FSH. Introduction Inability to conceive login to view 2 more bullets Epidemiology login to view 2 more bullets Etiologies login to view 5 more bullets Disorders Category Ovulation Tubal Uterine Pathogenesis Ovaries fail to produce mature oocyte on a regular basis Fallopian tubes fail to capture ovulated ova and/or transport sperm and embryo Uterus fails to allow embryo to implant or support growth/development Risk factors Increasing age Cytotoxic chemotherapy Radiation therapy Diminished ovarian reserve Smoking Endocrine disorders Pelvic inflammatory disease Pelvic tuberculosis Pelvic surgery Complicated abdominal surgery Ectopic pregnancy Uterine leiomyoma Uterine polyps Etiologies Primary ovarian insufficiency Endocrine disorders Polycystic ovarian syndrome Turner syndrome Asherman's syndrome Uterine growths (leiomyoma, polyps) Congenital uterine anomaly Treatment Ovulation induction Oocyte donation Dopamine agonists for hyperprolactinemia Assisted reproductive technology Tubal microsurgery Laparoscopic tubal surgery Assisted reproductive technology Surgery Assisted reproductive technology Presentation Symptoms: etiology dependent and thus patients may report login to view 4 more bullets Physical exam - etiology dependent login to view 13 more bullets Evalution Diagnosis typically based on history and physical login to view 1 more bullet Further testing for female infertility login to view 24 more bullets Differential Use of contraception Insufficient time to conceive Male infertility Treatment Depends on the cause of infertility (see chart above) Ovulation induction login to view 4 more bullets Oocyte donation login to view 1 more bullet Assisted reproductive technology login to view 2 more bullets Surgery to correct anatomic abnormality, obstruction, and endometriosis Prognosis, Prevention, and Complications Prognosis login to view 7 more bullets Complications login to view 4 more bullets