Overcoming Infertility

Infertility is hard to pin down. A couple with no known reproductive problems might try for years to have a baby but fail simply because their timing was off. Are they infertile? Not physically, but they would be classified as such because infertility is usually defined as the inability to conceive after 1 year of unprotected sex.

Types of Infertility
Hypofertile couples have trouble conceiving quickly. Their fertility may be less than ideal or they may be having problems with timing, but they can eventually conceive without special treatment. For example, the man might have a low sperm count, or the woman might have endometriosis—roadblocks, but not brick walls. Sterile couples won't be able to conceive without medical or surgical treatment. For example, the man might not create enough sperm to fertilize an egg, or the woman might have blocked fallopian tubes.

Infertility's Many Causes
A poorly functioning male reproductive system is the problem for 30 to 40 percent of couples seeking help for infertility. The man may have a low sperm count, sperm that move too slowly through the female reproductive system (low motility), semen that is too thick, or not enough of it.
Another 30 to 40 percent of fertility problems are caused by a malfunction in the female system. The most common, accounting for between 10 and 15 percent of all infertility, is the inability to release a healthy egg into the fallopian tube. Other problems include endometriosis, infection, or blocked tubes. In a significant percentage of couples (10 to 15 percent), sperm are unable to penetrate the mucus that lines the cervical canal leading to the uterus. About 10 percent of couples who seek help for infertility never learn the cause of their problem. Most turn out to be hypofertile and eventually do have children.
One important factor responsible for infertility in women is simply aging. Women tend to be most fertile in their early 20s. From then on, fertility declines rather slowly until about age 35, after which it becomes harder and harder to become pregnant. One in 7 couples is infertile if the woman is 30 to 34 years old; 1 in 5 is infertile if she is 35 to 40; and 1 in 4 can't conceive if she's 40 to 44.

Methods of Overcoming Infertility
Since the possible causes of female infertility are so varied and numerous, treatment may sometimes be difficult, and it may involve a great number of different measures from hormone replacement to surgery. In any case, in recent decades an increasing number of formerly hopeless fertility problems have been overcome thanks to remarkable medical advances. They are known under the collective terms "artificial insemination" and "assisted reproductive technology".