18. Infertility

Infertility is defined as failure to conceive spontaneously in 12 months of unprotected intercourse. Approximately one out of seven couples seek medical guidance for infertility. Due to postponing childbearing, this number may increase in the future. Infertility is a disability and should be investigated properly. Factors that influence fertility should be assessed and a work-up for both men and women should be performed. This includes a semen analysis, assessment of ovulations 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 these cases, a prognosis should be predicted to evaluate whether a couple should be advised to enter a fertility treatment programme or still has sufficient chances of a spontaneous pregnancy within 6–12 months and should therefore be counselled for expectant management.