What is Infertility?

Infertility affects one in six couple. There are about 60-80 million infertile couples world wide and the rate is increasing. Some patients spontaneously achieve pregnancy but others at some stage experience difficulty in achieving conception and need these patients some kind of assistance in getting pregnant.There is about 3-5% probability of achieving pregnancy in one menstrual cycle.

It is estimated that out of 100 couples with female partner’s age less than 35 years, 80-85% will achieve pregnancy within the first year of unprotected intercourse,90% will conceive within 18 months and about 95% will conceive within two years. The remaining 5% rarely achieve pregnancy without some form of assistance.

Infertility may be defined as an inability to achieve pregnancy within 2 years of having unprotected intercourse, though some clinicians prefer this time limit to be 1 year. Women who are more than 35 years should consult an expert after 6 months of contraceptive free sexual intercourse when it has not resulted in pregnancy. This difference in the time limit is owing to the declining egg quality with increasing age.

In some couples the fertility is impaired to some extent but not completely, these patients may conceive in 3rd year or subsequently without any assistance as there is a delay these patients are called sub fertile   While, infertility is an absolute state of inability to conceive. The cause of infertility could be in either of the partners(Male factor-35%,Female factor-40%) or in 10-15% both partners may beinfertile or subfertile.sometimes each could be individually fertile but as a couple may need assistance to achieve pregnancy the causes could be immunological or genetic, this is called Combined infertility. while in about10%,the fertility  evaluation  show no abnormality,these patients are likely to have problems which are not diagnosed by current availablein vestigations,this is termed unexplained infertility.

Types of infertility
Primary infertility : in this type the couple has never conceived..
Secondary infertility : indicates previous pregnancy but failure to conceive subsequently.

The causes can be categorized as

Male factors Female factors
Defective spermatogenesis Vaginal factor
Obstructive azoospermia Cervical factor
Failure to deposit sperm high in the vagina Endometrial factor
Errors in the seminal fluids Tubal factor
  Ovarian factor
  Endocrine factors
  Immunological factor

When to Consult a Doctor for Surrogacy IVF

Early diagnosis will only ensure the couple has more time available for treatment before advancing age of female partner becomes an additional problem.

It is recommended that both partners are evaluated together, and finding problem in one partner should not stop the basic investigation of other.

Next step is physical examination, followed by routine infertility investigation, and finally by specific investigations and diagnostic procedures.