gynecology and obstetrics
Overview of Infertility
Introduction
Infertility is usually defined as the inability to conceive after 1 year of regular, unprotected sexual intercourse. Infertility is defined as a disease by the World Health Organization (WHO). Frequent, unprotected intercourse results in conception for 50% of couples within 3 months, for 75% within 6 months, and for 90% within 1 year. Infertility can be caused by the following: Sperm Disorders (≥ 35% of couples) Ovulatory Dysfunction or (less frequently) Tubal Dysfunction and Pelvic Abnormalities (about 30%) Abnormal Cervical Mucus ( Unexplained Infertility (about 10%) Inability to conceive often leads to feelings of anxiety, sadness, frustration, anger, guilt, resentment, and inadequacy. Couples wishing to conceive are encouraged to have frequent intercourse when conception is most likely—during the 6 days, and particularly the 3 days, before ovulation. Ovulation is most likely to occur about 14 days before the onset of the next menstrual period. Measuring morning basal body temperature (BBT) daily can help determine when ovulation is occurring in women with regular menstrual cycles. A decrease suggests impending ovulation; an increase of≥0.5°C suggests ovulation has just occurred. However, commercially available luteinizing hormone (LH) prediction test kits, which identify the midcycle LH surge, are probably the best way for women to determine when ovulation occurs and are less time-consuming than measuring BBT. BBT can be useful if women cannot afford or do not have access to LH prediction kits. There is no evidence that any test determining when ovulation occurs improves the likelihood of pregnancy in couples having regular intercourse. Excessive use ofcaffeine, tobacco, or alcohol, which can impair fertility, is discouraged. Evidence that men > 45 are less fertile than younger men, regardless of their female partner's age, is increasing. Although infertility does not encompass recurrent miscarriages ( Spontaneous Abortion ), the consequences are the same. 