Background: Infertility is the failure to establish a clinical pregnancy after 12 months of regular, unprotected sexual intercourse or due to an impairment of a person’s capacity to reproduce either as an individual or with his or her partner. The World Health Organisation (WHO) has characterised infertility as a disease affecting 48 million couples and 186 million individuals globally. Over 80% of couples in the general population will conceive within one year if the woman is aged under 40 years. Of those who do not conceive in the first year, about half will do so in the second year (cumulative pregnancy rate over 90%). The Health Service Executive (HSE) has estimated that one in six heterosexual couples will experience infertility in Ireland.
The causes of infertility can be due to problems with the female and/ or male reproductive systems. Female causes can relate to abnormal ovulation (polycystic ovarian syndrome, premature ovarian failure, hypothalamic or pituitary disease), fallopian tube damage (pelvic surgery or infection) and uterine disorders (endometriosis, polyps or fibroids, congenital disease). Male causes can relate to reproductive tract obstruction (trauma, infection), testicular failure (chemotherapy), genetic disorders (cystic fibrosis), hormonal disorders (hypothalamic, pituitary) and medications (steroid use). In approximately one quarter of all cases, the cause is unknown or ‘unexplained’.
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