Infertility: The diminished ability or the inability to conceive and have offspring. Infertility is also defined in specific terms as the failure to conceive after a year of regular intercourse without contraception.

Infertility can be due to many causes. Studies have shown that a little more than half of cases of infertility are a result of female conditions. The remainder are caused by sperm disorders and by unexplained factors.

Most types of infertility are treatable. In some cases, in vitro fertilization and other lab procedures may be used to ensure fertilization, and special medical care or medication may be required to enable the pregnancy to come to term.

Infertility is on the rise in many countries. The proportion of women in the UK having their first baby at or after age 30 has increased significantly since the mid-70s. This is important because the probability of having a baby decreases by 3 to 5% a year after age 30 and even faster after age 40. The switch from condoms and diaphragms to nonbarrier methods of contraception has also raised the risk that an STD (sexually transmitted disease) will compromise the ability to conceive and bear a child.

To conceive a child, a woman must ovulate -- she must release a mature egg from one of her ovaries --and her male partner must ejaculate tens of millions of mature, motile sperm. While sperm form throughout a man's reproductive life, a woman is born with all the eggs she will ever have. Over the years, her supply is depleted (of about 7 million eggs present at birth, only 400 make it to ovulation) and the remaining eggs age, diminishing their reproductive capacity.

A sperm must reach and penetrate the egg as it travels from the ovary to the uterus. The fertilized egg must then be able to divide many times, implant in the uterus, and form the placenta that is its lifeline until birth. If the Fallopian tubes have been damaged by pelvic infection, or there is endometriosis (misplaced growth of the uterine lining),fertilization or implantation may not be possible.

A normal menstrual cycle involves the release of an egg once a month. That egg can survive up to 24 hours. The easiest way to know the fertile time is to chart the menstrual cycle on a calendar. A woman is most likely to be fertile 10 to 14 days after the start of menstruation depending on her cycle length.

A problem with the semen or sperm affects more than one-third of the couples who are unable to have children. A semen analysis is usually one of the first tests done to help determine whether a man has a problem fathering a child.

It can be stressful for you and your partner to find out the reason for infertility. Knowing where the problem is may create feelings of guilt and blame and may put strain on your relationship. Not being able to find any cause can also create stress. You may want to talk with a counsellor or join an infertility support group before you make your decision. Talking with other people can help you feel less alone.

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