Couples who want a baby and have not conceived despite a year of unprotected intercourse have an infertility problem. Infertility means a reduced capacity to reproduce; it certainly does not mean that reproductive function has been lost completely.
Infertility is a common problem, affecting roughly 15% of couples who want to have a child. It can appear even when all the conditions needed for pregnancy seem to be met. Conditions such as a chocolate cyst (endometriosis) can also cause infertility.
Assessing Infertility
Once a couple decides to have a baby, they usually want results quickly. Yet when the fertile window is taken into account, a quick result is hard to achieve. For this reason couples who want a baby should wait about a year before suspecting infertility. In couples under the age of 25 this period extends to two years.
Even when a couple suspects infertility, it is important to discuss the process with a doctor and make a plan. In some cases a simple medical review is enough to overcome the problem. Erectile difficulties, insufficient intercourse, showering immediately afterwards and the use of cosmetic products such as lubricants can all stand in the way of pregnancy.
Considering that ovulation occurs once a month and that fertilisation is possible within a window of roughly 18 hours, only a correct assessment can help a woman to conceive.
Assessment of the Male Partner
If environmental factors have been ruled out, the individuals themselves must be assessed. In men this is done through semen analysis. Tests evaluate factors such as sperm count, antisperm antibodies and the fertilising capacity of the sperm.
Assessment of the Female Partner
In women, the assessment of infertility begins with ovulation. Whether ovulation takes place is examined at this stage. Obesity, stress, hormonal disorders and thyroid disease can all affect ovulation. Beyond that, the ability of the fallopian tubes to carry the sperm is of great importance for fertilisation.
The tubes must therefore also be assessed. After ovulation and the tubes, the uterus is examined. Formations such as fibroids in the uterus, congenital anomalies of the uterus or adhesions may be among the causes of infertility.