Defining Subfertility and Infertility

Normal pregnancy requires a series of successful events before, during, and after sexual intercourse. These processes include average sperm and egg production, the passage of the sperm from the testis through the male reproductive tract, and passage of the egg from the ovary into the fallopian tube (see figure below). After sperms are ejaculated, they swim through the female reproductive tract to penetrate the egg for fertilization. The transport and implantation of the fertilized embryo for embryonic development are also required for pregnancy.13 Any defects in these steps may result in subfertility or infertility.

Subfertility is a delay in conceiving; pregnancy can occur without fertility treatment, but it may take longer to conceive. Infertility is the inability to conceive after a year of unprotected sexual intercourse. In primary infertility, a woman has never been able to get pregnant, while secondary infertility implies that there has been at least one successful pregnancy in the past.

Evaluation for subfertility and infertility may be offered to any individual at high risk for infertility, or by definition, infertile. Women older than 35 years who have failed to become pregnant after six months of unprotected intercourse should receive an expedited evaluation with consideration for fertility treatment if warrented.14

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Note: References are listed at the end of the course.

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