Threshold values for sperm concentration, motility, and morphology can be used to classify men as subfertile, of indeterminate fertility, or fertile. None of the measures, however, are diagnostic of infertility.

Clomiphene is superior to metformin in achieving live birth in infertile women with the polycystic ovary syndrome, although multiple birth is a complication. (ClinicalTrials.gov number, NCT00068861 [ClinicalTrials.gov].).

PTGS2, HAS2 and GREM1 gene expression correlates to morphological and physiological characteristics and provides a novel approach to predict human embryo development. Ultimately, with better predictors of follicular and embryonic health, higher quality embryos can be selected and transferred, reducing higher order pregnancy rates.

Infertility, defined as the failure to achieve pregnancy after 12 months of regular unprotected sexual intercourse, affects 8.8% of US women aged 15 to 49 years 1 and is often associated with significant physical and emotional stress. This review summarizes current evidence regarding the pathophysiology, diagnosis, and management of infertility for heterosexual couples. 2 MethodsWe searched the PubMed and Cochrane databases for Englishlanguage studies of the epidemiology, diagnosis, and management of infertility published from January 2015 to November 2020, including randomized clinical trials (RCTs), meta-analyses, systematic reviews, and observational studies. Based on these criteria, 71 articles were identified, including 5 clinical trials, 31 systematic reviews, 29 meta-analyses, and 6 practice guidelines. We manually searched references for additional relevant publications. RCTs, metaanalyses, and systematic reviews applicable to a general medical readership were prioritized for inclusion.

Among infertile couples, treatment with induction of superovulation and intrauterine insemination is three times as likely to result in pregnancy as is intracervical insemination and twice as likely to result in pregnancy as is treatment with either superovulation and intracervical insemination or intrauterine insemination alone.