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In normal infertile couples, the actual cause for infertility cannot be detected; perhaps there is dysfunctional interaction between the sperm and the oocyte, poor quality of the embryo, or a disruption at the implantation site.In the future, identifying a mutation or the absence of a specific gene as the cause of infertility may be possible in this patient population.Management of any underlying female and/or male factors affecting fertility may include medical treatment (eg, pharmacotherapy), surgical intervention, or both.

Male and female factors each account for approximately 35% of cases.

Often, there is more than one factor, with male and female factors combined causing 20% of infertility.

Reproduction requires the interaction and integrity of the female and male reproductive tracts, which involves (1) the release of a normal preovulatory oocyte, (2) the production of adequate spermatozoa, (3) the normal transport of the gametes to the ampullary portion of the fallopian tube (where fertilization occurs), and (4) the subsequent transport of the cleaving embryo into the endometrial cavity for implantation and development.

Infertility is caused by male and/or female factors.

The mucus forms a netlike structure that does not allow the passage of sperm.

Mucus secretion increases during the mid follicular phase and reaches its maximum approximately 24-48 hours before ovulation.In societies where family planning and professional career development are prioritized, some women postpone childbearing until their 30s and beyond.As a result, these women may have more difficulty conceiving and have an increased risk of miscarriage.A complete infertility evaluation is performed according to the woman's menstrual cycle and may take up to 2 menstrual cycles before the etiology is determined.Obtain the following medical history and information from the couple: Treatment plans are based on the diagnosis, duration of infertility, and the woman's age.Although stress and distress (anxiety or depression) have been considered factors in reducing pregnancy chances with ART, the number of studies has been limited and considerable between-study heterogeneity is noted.