INFERTILITY IN WOMEN: CAUSES, EVALUATION, AND ASSISTED REPRODUCTIVE TECHNIQUES

Noyabr, 2025-Yil 265 INFERTILITY IN WOMEN: CAUSES, EVALUATION, AND ASSISTED REPRODUCTIVE TECHNIQUES ¹Namozov Alisher; ² Qarshiyev Samandar ³Norova Odina ⁴Umirova Mohirabonu ¹'²'³'⁴Clinical coordinators of the Department of Obstetrics and Gynecology, DKTF No. 2, Samarkand State Medical University. https://doi.org/10.5281/zenodo.17700184 Introduction: Female infertility is a complex reproductive disorder characterized by the inability to achieve pregnancy after 12 months of regular unprotected intercourse. It remains a major global health concern affecting nearly 10–15% of couples of reproductive age. The condition significantly influences psychological well-being, marital stability, and overall quality of life. The etiology of female infertility is multifactorial, involving ovulatory dysfunction, tubalperitoneal pathology, uterine abnormalities, endocrine disorders, and age-related decline in ovarian reserve. Modern diagnostic methods such as hormonal profiling, pelvic ultrasound, hysterosalpingography, and advanced reproductive imaging have improved the ability to identify underlying causes. Assisted reproductive technologies (ART) including ovulation induction, intrauterine insemination (IUI), and in vitro fertilization (IVF) have expanded treatment opportunities, offering favorable pregnancy outcomes even in severe infertility cases. Objective: To analyze the primary causes of female infertility, evaluate the most effective diagnostic approaches, and assess the role and clinical outcomes of assisted reproductive techniques in achieving successful pregnancy. Materials and Methods: This thesis is based on the review and synthesis of modern scientific literature, clinical guidelines, and evidence-based studies published in peer-reviewed journals. Data were collected from PubMed, Scopus, and Web of Science databases. The analysis included studies on ovulatory disorders, tubal factors, endometriosis-associated infertility, uterine pathology, endocrine dysfunction, ovarian reserve testing, and ART outcomes. Particular focus was given to diagnostic tools such as hormonal assays (FSH, LH, AMH, TSH, prolactin), folliculometry, hysteroscopy, laparoscopy, and imaging techniques assessing tubal patency. Studies evaluating the effectiveness of ovulation induction, IUI, IVF, ICSI, and embryo transfer protocols were also included. Results: The review demonstrated that ovulatory dysfunction, particularly polycystic ovary syndrome (PCOS), accounts for approximately 40% of infertility cases. Tubal blockage and pelvic adhesions, often resulting from pelvic inflammatory disease or endometriosis, contribute to nearly 30% of cases. Uterine abnormalities, including fibroids, polyps, and congenital malformations, were present in up to 15% of infertile women. Ovarian reserve markers, especially AMH and antral follicle count (AFC), were found to be the most reliable predictors of reproductive potential. Noyabr, 2025-Yil 266 ART procedures showed high success rates, with IVF achieving clinical pregnancy rates ranging from 35–45% per cycle depending on age and ovarian reserve, while IUI demonstrated moderate success in mild male factor or unexplained infertility cases. Studies also revealed improved outcomes with individualized stimulation protocols, high-quality embryo transfer, and optimized luteal phase support. Discussion: The findings confirm that female infertility is a heterogeneous condition requiring a systematic and comprehensive diagnostic approach. Early identification of the underlying cause significantly improves treatment outcomes. Ovulatory dysfunction responds well to pharmacological induction methods, while surgical correction of tubal or uterine pathology enhances natural conception chances. In cases where natural conception remains unlikely, ART provides a highly effective alternative. The success of ART is strongly influenced by age, ovarian reserve, endometrial receptivity, and embryo quality. Advances in reproductive medicine— including cryopreservation, preimplantation genetic testing, and refined stimulation protocols— have further increased pregnancy success rates. Multidisciplinary management involving gynecologists, endocrinologists, and reproductive specialists ensures individualized and patientcentered care. Conclusion: Female infertility remains a significant reproductive health issue with diverse etiologies requiring accurate diagnosis and targeted intervention. Modern diagnostic methods allow for early detection of hormonal, tubal, uterine, and ovarian reserve abnormalities. Assisted reproductive technologies represent a major breakthrough in infertility treatment, offering effective solutions for women with persistent or severe infertility. 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