Editing Infertility (section)

=== Medical treatments ===
Clomiphene is a [[selective estrogen receptor modulator]] used to induce ovulation. It works by blocking the negative feedback from estrogen, creating a [[gonadotropin releasing hormone]] (GnRH) increase, which causes release of [[luteinizing hormone]] (LH) and [[follicle-stimulating hormone]] (FSH) from the anterior pituitary. FSH and LH act on the ovaries to increase follicle growth and lead to ovulation.<ref name="Carson 2021" /> [[Letrozole]] is an [[aromatase inhibitor]] which reduces estradiol levels and increases levels of FSH and LH, which can stimulate ovarian follicle maturation and ovulation. Letrozole is the preferred treatment in those with infertility due to PCOS and is associated with a higher pregnancy rate than other treatments.<ref name="Carson 2021" /> Both clomiphene and letrozole have a risk of a multiple gestation pregnancy, with the risk being less than 10%.<ref name="Carson 2021" /> Those with hypogonadotropic hypogonadism require pulsatile GnRH therapy, which is associated with a 93-100% pregnancy rate after 6 months of therapy.<ref name="Carson 2021" /> The risk of a multiple gestation pregnancy with gonadotropins is 36%.<ref name="Carson 2021" /> Ovarian stimulation with clomiphene, aromatase inhibitors, or gonadotropins (especially when combined with intrauterine insemination) have a risk of [[ovarian hyperstimulation syndrome]] which may occur in 1-5% of cycles and presents as [[ascites]], electrolyte abnormalities and blood clots.<ref name="Carson 2021" />

Fertility treatments or medications do not increase the risk of breast, ovarian, or endometrial cancers.<ref name="Carson 2021" />

[[Metformin]] does not increase the rate of live births in those with infertility (including in those with [[Polycystic ovary syndrome|PCOS]]), and its use is not recommended.<ref name="Carson 2021" />

In some cases, in vitro fertilization (IVF) is used, in which induced ovarian follicle stimulation is followed by the extraction of oocytes from the ovaries. The oocytes are then fertilized in vitro by sperm using [[Intracytoplasmic sperm injection]] (ICSI) and the fertilized eggs are re-introduced into the uterus in a procedure called [[embryo transfer]].<ref name="Carson 2021" /> ICSI was first developed in 1978 by [[Robert Edwards (physiologist)|Robert Edwards]] and [[Patrick Steptoe]].<ref>{{cite journal |last1=Steptoe |first1=P. C. |last2=Edwards |first2=R. G. |date=12 August 1978 |title=Birth after the reimplantation of a human embryo |url=https://pubmed.ncbi.nlm.nih.gov/79723/ |journal=[[The Lancet]] |volume=2 |issue=8085 |pages=366 |doi=10.1016/s0140-6736(78)92957-4 |pmid=79723 |access-date=27 June 2024}}</ref>

Ovarian stimulation (such as with clomiphene) combined with in-vitro fertilization or intra-uterine insemination has lower success rates with increasing age.<ref name="Carson 2021" />

Sperm or oocyte donors with in vitro fertilization and gestational carriers are sometimes used for gay couples, those with severe medical conditions that make pregnancy dangerous or preclude pregnancy, those with severe infertility, or females with a non-functioning uterus.<ref name="Carson 2021" />

[[File:IVF.jpg|thumb|263x263px|A depiction of the procedure of in-vitro fertilization]]