Infertility is the inability to conceive. Infertility is also known ordinarily as childlessness

Definition of Infertility:

It is defined as the inability of a couple to conceive after 1 year of normal sexual activity , without contraceptives.

What is the difference between infertility and sterility?

Sterility is an absolute or finite state of inability to conceive. For example, a woman who has congenital absence of the uterus or vagina can be said to be sterile.

What is fecundability and fecundity?

Fecundability is the probability of having a pregnancy with one menstrual cycle.

Fecundity is the ability to achieve a live birth from one cycle’s exposure to pregnancy.

Incidence of Infertility:

The incidence (the frequency of new cases in a previously screened population) is about 3%.

In developed countries, infertility affects about 10% to 15% of married couples.(Prevalence of infertility)

In developing countries, despite the concern about overpopulation and undernutrition, infertility affects a much higher percentage of the married couples. Eg It is estimated that 30 to 40% of women in sub-Saharan Africa ,would complete their reproductive years without having a child.

Infertility is a worldwide problem .Recent advancements  in investigation and treatment of infertility has gone a long way in alleviating the problem.

Approximately 25% of couples experience infertility at some point in their lives.

60% of married couples having regular, unprotected intercourse, would achieve pregnancy after 6 months of cohabitation. At the end of 12 months, up to 90% would have achieved pregnancy. At the end of 18 to 24 months, 95% would have achieved pregnancy.

What is primary infertility?

This refers to infertility, when no pregnancies ever resulted from the marriage (Not even abortions or ectopic pregnancy).

What is secondary infertility?

This refers to infertility, when previous pregnancies have resulted (irrespective of the outcome-eg abortions or ectopic pregnancies).

What are the two most powerful predictors of the outcome of the management of infertility?

i) The age of the female partner (Female Age) is the most powerful predictor of outcome. In women fertility is maximal between the ages of 18 to 24 years. It declines after the age of 35. Therefore it may be necessary to investigate a 36 year old woman after a short duration of marriage (exposure) while a 19 year old married lady may be investigated after two or more years.

ii) The next most powerful predictor of the outcome of infertility is the duration. The longer the duration of infertility the less likely are the chances of conceiving.

I do not want to overwhelm my readers, who are mostly  non medical staff/students. Therefore it will be covered in numerous posts. Subsequent posts will cover causes, types,investigation and management of infertility.

References:

Page 748-750, Chapter 18 Obstetrics. CMDT 2006 -Current Medical Diagnosis and Treatment. Edited by Lawrence M. Tierney, Jr. ,Stephen J. McPhee, Maxine A. Papadakis 45th edition Lange Publications.Mc Graw Hill

Chapter 15, infertility and subfertility, Ist edition ,Textboot of Obstetrics and Gynaecology for Medical Students by Akin Agboola et al.

Pages 432 to 435, Chapter 36 Infertility by I.D. Cooke .Dewhurst’s Textbook of Obstetrics and Gynaecology for Postgraduates.Sixth edition. Edited by D. Keith Edmonds.

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