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INFERTILITY AND RELATED ISSUES

Infertility is defined as the failure to conceive after one year of attempting pregnancy. Primary infertility denotes those patients who have never conceived. Secondary infertility applies to patients who have conceived previously. Approximately 15% of couples experience infertility, which may result from subfertility or sterility (the innate inability to conceive) in either partner or both. The female is responsible in 40%–50% of cases. The male is responsible in 30% and is contributory in another 20%–30% of couples. However, it is crucial to recall that multiple etiologies are found in 40% of infertile couples | INFERTILITY AND RELATED ISSUES SPECIAL FERTILITY PROCEDURES HYPERANDROGENISM INFERTILITY Infertility is defined as the failure to conceive after one year of attempting pregnancy. Primary infertility denotes those patients who have never conceived. Secondary infertility applies to patients who have conceived previously. Approximately 15 of couples experience infertility which may result from subfertility or sterility the innate inability to conceive in either partner or both. The female is responsible in 40 -50 of cases. The male is responsible in 30 and is contributory in another 20 -30 of couples. However it is crucial to recall that multiple etiologies are found in 40 of infertile couples. The incidence of infertility has increased perhaps 100 over the past 20 years in developed countries because of increasing sexually transmitted disease especially gonorrhea and Chlamydia causing subsequent tubal damage an increased number of sexual partners increasing the potential for acquiring STDs intentionally delaying pregnancy the contraceptive s used and smoking 1 pack day decreases the chance of pregnancy by 20 . Infertility accounts for 10 -20 of all gynecologic office visits. Fertility rates are established using fecundibility the chance of pregnancy per month of exposure . Only 25 of young healthy couples having frequent intercourse will conceive per month 60 by 6 months 75 by 9 months and 90 by 18 months . Fecundibil-ity declines with age and the effect is more pronounced in women than in men. By 36-37 years of age the chance of pregnancy is less than half that at 25-27 years of age. 769 Copyright 2001 The McGraw-Hill Companies. Click Here for Terms ofUse. 770 BENSON PERNOLL S HANDBOOK OF OBSTETRICS AND GYNECOLOGY Careful evaluation should detect probable cause s for infertility in 85 -90 . Happily even without therapy 15 -20 of infertile couples may be expected to achieve pregnancy over time. Therapy excluding in vitro fertilization will result in pregnancy in 50 .