Infertility is a ailment of the reproductive system that impairs one of the body’s most basic functions, the conception of children. Conception is a complicated process that depends upon many factors:

The production of healthy sperm by the man and healthy eggs by the woman unblocked fallopian tubes that allow the sperm to reach the egg. The sperm’s ability to reach the egg, the sperm’s ability to fertilize the egg when they meet, the ability of the fertilized egg (embryo) to become implanted in the woman’s uterus a good quality embryo. For the pregnancy to continue to full term, the embryo must be healthy and the woman’s hormonal environment adequate for its development. When any one of these factors is impaired, infertility can result.

A couple is considered infertile if the woman does not conceive a child after one year of unprotected, well-timed intercourse or she has been unable to carry a pregnancy to a live birth. The diagnosis is sped up for women over 35–treatment is normally recommended after six months of trying to conceive.

Infertility is not a “woman’s” problem. It is a medical problem of the male or female reproductive system. In 40% of cases, the cause is traced to the woman, another 40% of cases are traced to the man. The rest are caused by unknown factors or a physiological incompatibility. Infertility is not only a physical condition–it is an emotional and social condition with accompanying feelings and issues. The infertile couple needs support and consideration from the treatment team, friends, family, and each other.

What is the cause of male infertility and female infertility?
Roughly one-third of infertility cases can be attributed to male factors and another one-third to factors that affect women. For the remaining infertile couples, infertility is caused by a combination of problems in both partners (about 13%) or is unexplained (about 10%).

The most common causes of male infertility include azoospermia (no sperm cells are produced) and oligospermia (few sperm cells are produced). Sometimes, sperm cells are malformed or they die before they can reach the egg. In rare cases, male infertility is caused by a genetic disease such as cystic fibrosis or a chromosomal abnormality.

The most common cause of female infertility is an ovulation disorder. Other causes of female infertility include blocked fallopian tubes, polycystic ovary syndrome (PCOS) and endometriosis. Repeated miscarriages may be caused by congenital anomalies (birth defects) involving the structure of the uterus and uterine fibroids.

How is infertility diagnosed?
Couples are generally advised to seek medical help if they are unable to achieve pregnancy after a year of unprotected intercourse. The doctor conducts a physical examination of both partners to determine their general state of health and to evaluate physical factors that may be causing infertility. Usually both partners are interviewed about their sexual habits in order to determine whether intercourse is taking place for conception.

If the physician cannot find a cause for infertility at this point, more specific tests may be recommended. For women, these include an analysis of body temperature and ovulation (by charting the basal body temperature), an x-ray of the fallopian tubes and uterus, and laparoscopy. For men, initial tests focus on semen analysis.