Infertility Evaluation and Treatment

( N Engl J Med . 2025 Mar 13; 392(11):1111–1119. doi: 10.1056/NEJMcp2311150) Infertility affects many couples for a variety of reasons and can apply to heterosexual couples who struggle to conceive, homosexual couples, single parents by choice, anyone who wants or needs to freeze oocytes, and transgender individuals. Primary infertility is diagnosed when there is no previous history of conception, and secondary infertility is diagnosed where there has been at least one documented pregnancy. Assisted reproductive technology such as in vitro fertilization (IVF) can be used in any of these situations, and nearly 5% of births in the United States can be attributed to it. Though IVF is applicable to almost all forms of infertility, access to treatment is spotty and varies greatly based on location and insurance coverage. This article is a clinical practice vignette, addressing infertility, strategies and evidence for diagnosis, treatment, guidelines, and future research potential.