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If a couple has failed to conceive spontaneously in 12 months of unprotected intercourse we speak of infertility. About 1 out of 7 couples seek medical guidance for infertility. Due to postponing childbearing this number might increase in the future. Infertility is a disability and should be investigated properly. Factors influencing fertility should be assessed and a work-up for both men and women should be performed. This includes a semen analysis, assessment of the menstrual cycle and evaluation of tubal pathology or other diseases that could influence fertility. If results reveal that a couple cannot conceive spontaneously, they are infertile and appropriate treatment should be offered. Idiopathic infertility means that no cause for infertility was found. In those cases a prognosis should be predicted to evaluate whether a couple should be advised to enter a fertility treatment program or still has sufficient chances of a spontaneous pregnancy within 6–12 months and should therefore be counselled for expectant management.
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The failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. A term that should be used interchangeably with infertility, according to the International Glossary on Infertility and Fertility Care (Fertility and Sterility 2017). Although the difference between ‘infertility’ and ‘sterility’ lies in the fact that no work-up has been done yet to establish the cause and treatment possibilities, for reasons of clarity only the term ‘infertility’ will be used in this chapter
A disease characterized by the failure to establish a clinical pregnancy after 12 months of regular, unprotected sexual intercourse or due to an impairment of a person’s capacity to reproduce either as an individual or with his/her partner
The couple has never conceived a pregnancy before
The couple has conceived before, however is now faced with infertility
Note: within a couple the woman or man can separately have a primary or secondary infertility, meaning that they did achieve a pregnancy in the previous relationship but not with this partner. For example, a woman can have primary infertility while her partner has secondary infertility as he had a child with a previous partner
Quantity and quality of the remaining primordial follicle pool of a woman, reflecting the ability to reproduce
The inability to conceive a pregnancy. A permanent state of infertility
Infection of the fallopian tubes
Pelvic inflammatory disease
Infection of the female genital tract
When fertility investigations did not find a cause for the infertility
The absence of one or both testes from the scrotum. Generally, the testis will not have descended into the scrotum before birth
There is a complete lack of sperm in the ejaculate
Refers to semen with a low concentration of sperm
Refers to reduced sperm motility
If less than 4 % of the sperm show normal morphology
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MD, PhD Jesper M. J. Smeenk
MD, PhD Simone L. Broer
- Bohn Stafleu van Loghum