Fifteen per cent of couples who want a baby experience an unwanted delay in conception. Although there has been no change in the prevalence of fertility problems, more cojples seek help than did previously. The causes of fertility problems include disorders oi ovjlation. sperm and the Fallopian tube, although no identifiable cause is found in a third of couples trying for a baby. | h a p t e r 7 I Subfertility conception include mo ceive low coital frequ of intercourse to ovul smoking and a body i range 20-30 weight k Factors affecting fertiL couples trying to conce conception advice on v conception and to redi plications for the rnothi Definition Epidemiology Causes of female subfertility Causes of male siibfertility 76 History and examination 80 76 Investigations 81 77 Treatment of male and female siibfertility 82 79 Assisted conception 84 Table Factors adve Female factors MaJe OVERVIEW Fifteen per cent of couples who want a baby experience an unwanted delay in conception. Although there has been no change in the prevalence of fertility problems more cojples seek help than did previously. The causes of fertility problems include disorders oi ovjlation. sperm and the Fallopian tube although no identifiable cause is found in a third of couples trying for a baby. In 39 per rent of couples a problem will be found in both partners. Fertility treatment may be medical surgical or involve assisted conception whereby the egg and sperm are brought into close proximity to facilitate fertilization. Age 37 years Low Of H heal - fenstrual FSH Drug level 10u L 5H follicle-stimulatin Definition Subfertility is defined as the failure to conceive within 1 year of unprotected regular sexual intercourse. For couples who have had no previous conception the subfertility is defined as primary while couples who have had a previous conception and have then not conceived again are defined as having secondary subferlility. intercourse is approximately 60 per cent. At the end of 1 year 85 per cent of couples will have conceived. The single most important factor in determining fertility is the age of the female partner with fertility reducing rapidly in women over 35 years of age Fig. . Factors that reduce the chance of a spontaneous Epidemiology Approximately 50 per cent of couples will conceive after receiving advice and simple treatment but the remainder .
