Infertility is the failure to conceive (regardless of cause) after 1 year of unprotected intercourse. This condition affects approximately 10-15% of reproductive-aged couples.
Female factors that affect fertility include the following categories:
- Cervical: Stenosis or abnormalities of the mucus-sperm interaction
- Uterine: Congenital or acquired defects; may affect endometrium or myometrium; may be associated with primary infertility or with pregnancy wastage and premature delivery
- Ovarian: Alteration in the frequency and duration of the menstrual cycle—Failure to ovulate is the most common infertility problem
- Tubal: Abnormalities or damage to the fallopian tube; may be congenital or acquired
- Peritoneal: Anatomic defects or physiologic dysfunctions (eg, infection, adhesions, adnexal masses)
Male factors that affect fertility include the following categories:
- Pretesticular: Congenital or acquired diseases of the hypothalamus, pituitary, or peripheral organs that alter the hypothalamic-pituitary axis
- Testicular: Genetic or nongenetic
- Posttesticular: Congenital or acquired factors that disrupt normal transport of sperm through the ductal system
Treatment of infertility
Treatment plans are based on the diagnosis, duration of infertility, and the woman's age. Management of any underlying female and/or male factors affecting fertility may include medical treatment (eg, pharmacotherapy), surgical intervention, or both.