الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 187 |  |  |
| | | from | 187 | | |
Abstract
Infertility is generally defined as one year unprotected intercourse without conception (1). It is usual therefore to wait for at least one year of appropriate unprotected intercourse beginning investigations for infertility (2). Approximately 85-90% of healthy young couples conceive within 1 year. Infertility therefore affects approximately 10-15% of couples and is an important part of clinical practice for many clinicians (1).
The approach to the infertile couple should begin with detailed medical, sexual and social histories followed by physical examination of both partners. The sequence of investigations should be ordered such that, the simplest least invasive and most productive tests are completed first (3).
Before any formal investigation begins, the major causes of infertility and the basic components of the infertility evaluation designed to identify them should be outlines for the couple. The major causes of infertility include ovulatory dysfunction (15%), tubal and peritoneal pathology (30-40%), male factors (30-40%), uterine pathology is generally uncommon and the rest is largely unexplained (4). The three main disorders of female infertility are anovulation, tubal diseases and endometriosis (3).
Normal ovulation requires co-ordination of the menstrual system at all levels; the central hypothalamic pituitary axis, the feedback signals and local responses within the ovary. The loss of ovulation can be due to any one of an assortment of factors operating at each of these levels. The end result is a dysfunctional state (5).