Female infertility

Abstract

Infertility is defined as the inability to achieve pregnancy after at least 12 months of regular, unprotected intercourse. Its likelihood rises sharply with age: while women under 30 have a 15‑20 % chance of conceiving each month, this drops to about 10 % after 35. The World Health Organization estimates that 17.5 % of adults—roughly one in six couples—live with infertility.

Key contributing factors include delayed child‑bearing, environmental exposures such as bisphenol A and pesticides, and both male and female reproductive issues. A thorough evaluation starts with assessing ovarian reserve (antral‑follicle count, anti‑Müllerian hormone), hormonal profiles, transvaginal ultrasound, semen analysis, and hysterosalpingography to check uterine cavity and fallopian‑tube patency.

Treatment options fall into two tiers. Low‑complexity methods—ovulation induction, timed intercourse, and intrauterine insemination—can often be performed in an office setting and are best suited to mild male‑factor or unexplained infertility; success rates decline below 10 % per cycle after age 35. High‑complexity techniques—in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), donor‑egg IVF, and pre‑implantation genetic testing—address tubal disease, severe male‑factor infertility, recurrent treatment failure, or genetic concerns.

Because many infertility patients are diagnosed with additional health conditions, a holistic approach is essential. Women over 35 are advised to begin fertility work‑ups after just six months of attempting conception, ensuring timely intervention and personalized care.