Fertility

The production and the delivery of eggs and sperm are vulnerable processes that anatomical, genetic, hormonal, behavioral, and environmental problems may interrupt and prevent. Infertility is defined in clinical practice as the inability to become pregnant after more than one year of unprotected inter-course. Infertility can be either primary, if the couple has never achieved a pregnancy, or secondary, if it occurs after a couple has already had one or more pregnancy. Worldwide some form of infertility may affect 8 to 12 percent of couples (Day Baird and Strassman 2000; Spira 1986). Infertility is rarely absolute in nature, whereas sterility means the complete, absolute absence of reproductive capacity (the incidence has been estimated to be 3–5% of couples in industrialized countries [Spira 1986]). Female fertility problems may result from disorders in oocyte production, blockage or adhesions of the fallopian tubes, endometriosis (presence of endometrial gland tissue outside the uterus), or uterine and cervical abnormalities. Male infertility may be due to the problems in spermatogenesis (formation of sperm) and sperm transport and maturation (see Goldman, Missmer, and Barbieri 2000).

In Western countries the majority of women are accustomed to controlling their fertility with effective, accessible, and safe birth control methods and abortion. Likewise, Western women with fertility problems are accustomed to seeking medical help in order to become pregnant (Scritchfield 1989). Not every sterile and infertile couple wishes to have children. Thus, a woman and her partner must desire to have children but be physiologically incapable of becoming pregnant to experience herself as infertile and seek medical help.