While one-third of all infertility cases can explained by female causes and one-third by male, there remains a further third for which no clear explanation can be found. All the tests - for both male and female - show normal results. This is especially so in cases of ‘secondary’ infertility, in which the couple already has one or more children naturally conceived.
With infertility defined as an inability to conceive within one year of trying, younger couples are often advised to keep trying - what doctors call ‘expectant management’. However, this advice will not be appropriate for those well into their thirties when fertility begins to decline. Usual treatment in such cases begins with intrauterine insemination (for several cycles) and is followed by IVF if unsuccessful.
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