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According to national data, there has not been a major increase in the proportion of couples who are infertile. However, many more women are seeking medical services for the diagnosis and treatment of infertility – particularly those who have not previously had any children.

In general, women’s fertility begins to decline gradually after age 30, with a steep drop between 35 and 45. This means that, on average, it takes longer for a woman over 35 to conceive, and women are then more likely to be diagnosed with infertility. Pregnancies in women over 35 are also more likely to miscarry.

The most predictable age-related change is a gradual reduction in the number and quality of eggs produced as a woman enters her late thirties. As she nears menopause, eggs are not released in more and more of a woman’s menstrual cycles, making conception impossible.

Physicians and researchers consider a couple to have infertility if, despite regular intercourse without using birth control, they have not conceived for at least a year.

Fifteen to 20 percent of couples will not conceive despite a year of trying. However, this does not mean that they will not conceive later on, even without treatment. Some investigators consider two years without conception to be a better indicator of a couple’s need for assistance.

More than 90 percent of couples will have achieved a pregnancy within two years.

When an individual has no chance to conceive without treatment (for example, a woman does not ovulate or has two blocked fallopian tubes), it is sometimes called sterility.

Infertility is now recognized to be a couple’s issue and is just as likely to stem from problems in the female or the male partner. After couples with infertility undergo testing, about 40 percent of the cases are found to stem from female factors and another 40 percent from male factors.

In 10 percent of couples, infertility factors are found in both the man and woman. In the remaining 10 percent, the infertility remains unexplained after testing.

Because either or both may be involved, it is important to test both the man and woman before starting treatment. No matter what the cause, most treatments require the active participation of both partners.

Yes. Secondary infertility is the name given when the problem arises in a couple who have been able to get pregnant in the past. Sometimes a new factor, such as an infection, has damaged the reproductive organs since the last child was born. Sometimes the aging process makes it more difficult for a couple to conceive, even if they had no problems when they were younger.

Secondary infertility is even more common than infertility in couples who have never achieved a pregnancy.

For a couple to conceive and carry a pregnancy, four parts of the reproductive system must be working adequately:

• A woman’s ovaries must be regularly producing and releasing good-quality eggs.
• Normal sperm must be produced in high enough numbers and delivered during sexual intercourse.
• The reproductive passageways must be clear enough for: a) sperm to enter the uterus (through the cervix) and swim into the tubes to unite with the egg b) the egg or early embryo to travel to the uterus (through the fallopian tubes).
• The lining of the uterus must be capable of having the embryo implant, and of sustaining the pregnancy.
  Many types of problems – including hormone abnormalities or blockages caused by infection or scar tissue – can affect one or more of these functions.

According to national data, there has not been a major increase in the proportion of couples who are infertile. However, many more women are seeking medical services for the diagnosis and treatment of infertility – particularly those who have not previously had any children.

In general, women’s fertility begins to decline gradually after age 30, with a steep drop between 35 and 45. This means that, on average, it takes longer for a woman over 35 to conceive, and women are then more likely to be diagnosed with infertility. Pregnancies in women over 35 are also more likely to miscarry.

The most predictable age-related change is a gradual reduction in the number and quality of eggs produced as a woman enters her late thirties. As she nears menopause, eggs are not released in more and more of a woman’s menstrual cycles, making conception impossible.