Infertility

infertility, the inability of a couple to conceive and reproduce. Infertility is defined as the failure to conceive after one year of regular intercourse without contraception or the inability of a woman to carry a pregnancy to a live birth. Infertility can affect either the male or the female and can result from a number of causes. About 1 in every 10 couples is infertile, or somewhere between 10 and 15 percent of the population.

Normal fertility depends on the production of a sufficient number of healthy, motile sperm by the male, delivery of those cells into the vagina, successful passage of the sperm through the uterus and into the fallopian tubes, and penetration of a normal ovum (egg) by one of the sperm. A successful pregnancy also requires that the fertilized ovum subsequently become implanted in the lining of the female uterus. A problem at any one of these stages can result in a couple’s infertility.

Factors that can have deleterious effects on reproductive capacity in both men and women include previous and current alcohol consumption and drug use, a history of sexually transmitted diseases (STDs), and a number of general medical problems. The impact of smoking on reproduction is considerable. Cigarette smoke is known to contain hundreds of toxic substances, the negative health effects of which have been well documented. By interfering with the production of sperm, smoking can adversely affect male fertility. In women, smoking can affect different stages in the reproductive process, from the pickup of the egg by the fallopian tube to the growth and development of the fetus.

The inability to conceive when desired has been a problem throughout recorded history. The development of modern infertility treatments has enabled many infertile men and women to produce children. However, these treatments have raised many concerns because they significantly increase the chances for multiple births (multiple fetuses carried to term in a single pregnancy). Multiple births are extremely risky; the babies who survive gestation are often born prematurely and at very low birth weights. These babies are further predisposed to physical, mental, and developmental health problems, as well as neurological disorders such as cerebral palsy.