Understanding infertility

Infertility is commonly defined as the inability to conceive after at least a year of unprotected sex, or the inability to carry a pregnancy to a live birth. Infertility is not the same thing as sterility. According to the Women's Health Interactive website, two of every three infertile couples who seek treatment are able to have children.

Understanding the facts

According to the American Society of Reproductive Medicine:

• Infertility affects about 6.1 million people in the United States, which is roughly 10 per cent of the reproductive-age population.
• Infertility affects men and women equally.
• About 33 per cent of infertility cases can be attributed to male factors, 33 per cent to female factors, and roughly 27 per cent to a combination of problems in both partners. Causes for the remaining 6 per cent of infertility cases go unexplained.
• Most infertility cases (85 to 90 per cent) are treated with conventional medical therapies such as drugs or surgery.
• In vitro fertilization and similar treatments account for less than 5 per cent of infertility services performed in the United States.

Common reasons

There is no "typical" infertility patient, and the causes of infertility vary widely. According to the American Society of Reproductive Medicine, there are several common reasons why couples may find it difficult to conceive.

For men:

• No sperm cells being produced
• Too few sperm cells being produced
• Adequate quantity of sperm cells produced, but with defects

For women:

• Ovulation disorder
• Blocked fallopian tubes
• Birth defects involving uterine structure

Polycystic ovarian syndrome, or PCOS, is a fairly complex glandular disorder that is becoming widely recognized. According to the International Council on Infertility Information Dissemination, PCOS affects between 5 to 10 per cent of all women and is a leading cause of infertility.

Age also plays a significant role in a woman's ability to conceive. According to the National Women's Health Resource Center, a 15-year-old girl has a roughly 50 per cent chance of becoming pregnant following intercourse. At age 25, chances are 30 to 35 per cent for pregnancy during each menstrual cycle. After age 35, a woman's fertility rapidly declines. Women between ages 40 and 45 have roughly a 3 per cent chance or less per cycle of achieving pregnancy.

Treatment options

The vast majority of infertility cases are treated with drugs or by surgically repairing the reproductive organs. In vitro fertilization (eggs are fertilized outside of the body then placed directly into a woman's uterus) is the method of treatment in a small percentage of cases. Still other couples choose adoption when they are unable to conceive.

Although the causes of and treatments for infertility are primarily physical, infertility is not simply a matter of biology. For many couples, experiencing infertility is a life crisis that evokes emotions similar to those associated with miscarriage or the loss of a child by other means. Often, the pain of not being able to have a child is compounded by a sense of failure and inadequacy.