Infertility is the inability to conceive and become pregnant after 12 months of regular, unprotected sex. Infertility is a common medical condition, affecting approximately six million Americans every year. It is estimated that about 10% to 15 percent of heterosexual, married couples that try to conceive are unable to do so after one year.

12 months may seem like an arbitrary length of time, but it makes sense given that most fertile couples become pregnant within a year. So if a couple does not conceive after a year of effort, it is likely that the man, the woman, or both partners are infertile.

Infertility affects men and women equally. 80 percent of infertility cases have a known cause, and half of these are wholly or partially due to male infertility factors, most commonly azoospermia (the absence of any sperm) or oligospermia (the presence of too few sperm). Infertility in women is usually due to anovulation (absence of ovulation), blocked fallopian tubes, or uterine abnormalities, gynecologic problems that physicians often refer to as female infertility factors.

In men, hormone disorders, illness, reproductive anatomy trauma and obstruction, and sexual dysfunction can temporarily or permanently affect sperm and prevent conception. Some disorders become more difficult to treat the longer they persist without treatment.

Because sperm development takes over two months, illness that was present during the first cycle may affect mature sperm, regardless of a man's health at the time of examination.

Incidence and Prevalence of Infertility

According to the National Institutes of Health, male infertility is involved in approximately 40 percent of the 2.6 million infertile married couples in the United States. One-half of these men experience irreversible infertility and cannot father children, and a small number of these cases are caused by a treatable medical condition.

Conception and pregnancy are complicated processes involving many biologic factors and phases: the man needs to produce healthy sperm and the woman healthy eggs; the cervical mucus needs to be healthy and abundant so that the sperm can travel up through the cervical canal to the uterus and fallopian tubes; the fallopian tubes need to be open and accessible so that the sperm can reach the egg; the sperm has to be able to fertilize the egg when they make contact; the fertilized egg (the embryo) has to be able to implant in the woman's uterus; and, finally, both the embryo and the woman's uterine environment need to be healthy and strong for the baby to come to term. If any one of the biologic factors is impaired or damaged in any way, infertility can result. Infertility in women has been linked to aging, a history of pelvic inflammatory disease, and certain lifestyle behaviors.

Infertility is diagnosed after an infertility workup. Treatment may include medication, surgery, or in vitro fertilization (IVF). About half of all couples that receive treatment are able to conceive.

At Klein & Birns Urology, our aim is to be the leader in providing the highest quality and most comprehensive urologic care in New York. Find out how Klein & Birns Urology can serve you and your family by calling (212) 744-8700 or by making an appointment.