What Is Infertility?
Infertility is “the inability to conceive after 12 month of unprotected intercourse.” This means that a couple is not able to become pregnant after a year of trying. However, for women aged 35 and older, inability to conceive after 6 month is generally considered infertility.
How Common Is It?
Infertility affects 10-15% of couples (1 out of 7 couples has trouble in conceiving). This makes it one of the most common diseases for people between the ages of 20 and 45. Most couples with normal fertility will conceive a year of trying.
What Can Cause Infertility?
Definition of Infertility
Infertility is defined as the inability to conceive after 12 months of unprotected intercourse, or after 6 months for women aged 35 and older.
How Common Infertility Is
Infertility affects about 10–15% of couples, making it one of the most common health challenges for people between ages 20 and 45.
When to Seek Medical Help
Couples are generally encouraged to see a specialist if they haven't conceived after 12 months, or after 6 months if the woman is 35 or older.
Factors That Require Earlier Evaluation
Certain risks—such as irregular menstrual cycles, history of early menopause, prior cancer treatment, or male reproductive issues—may require seeking fertility advice sooner.
What Can Cause Infertility?
A woman’s age can have a big effect on her ability to have a baby, especially as she enters her 30s and 40s. For a healthy woman in her 20s or early 30s, the chances of conceiving each month is 25 – 30 %. But by the time a woman is 40 years old, the chances are 10% or less.
If a woman doesn’t ovulate (release an egg) about once a month, she may have trouble getting pregnant. Problems like polycystic ovary syndrome (POCS), thyroid disease and other hormonal disorders can affect ovulation and lead to infertility. Women who don’t have regular menstrual periods often don’t ovulate. Women who are overweight of underweight are more likely to have problems with ovulation than women of normal body weight.
Fallopian tubes are the tubes attached to the uterus where the sperm and egg usually meet. Blocked or damaged tubes can cause infertility or ectopic pregnancy (pregnancy outside the uterus). The chances of having blocked tubes are higher in women who have or have had endometriosis, surgery in the pelvis or sexually transmitted infections.
Conditions within the cervix, which is the lower part of the uterus, may impact fertility, but they are rarely the sole cause of infertility. It is important for the physician to know the detailed history of the patient. Problems within the uterus may interfere with the implantation of the embryo or may increase the incidence of miscarriage. Possible uterine abnormalities that may be identified include scar tissue, polyps, fibroids or an abnormally-shaped uterine cavity.
Peritoneal Abnormalities refer to abnormalities involving the peritoneum (lining of the surfaces of the internal organs) such as scar tissue (adhesions) or endometriosis. Endometriosis is a condition where tissue that normally line the uterus begins to grow outside the uterus. This tissue may grow on any structure within the pelvis including the ovaries and is found in about 35% of infertile women who have no other diagnosable infertility problem.
A third of all cases of infertility are because of a problem in the male partner. In another third of cases, infertility is due to a combination of male and female problems. In the male partner, infertility can be caused by not being able to make or ejaculate (release) sperm. Sperm quality is also important and is measured by the amount, the movement and the shape of sperm. Sometimes other medical problems can affect a man’s ability to make normal amounts or normal quality sperm. Men with diabetes, for instance, might have trouble ejaculating. Man with cystic fibrosis might have a blockage that prevents the sperm from being ejaculated.
In some (10% or more) cases there may not be an obvious reason why a couple can’t conceive. This is known as unexplained infertility. Fertility treatments can often help these couples.