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Infertility (Glossary)

Infertility: Infertility is defined as the inability to become pregnant after at least one year of frequent unprotected sex. Primary infertility indicates never having conceived or carried a pregnancy to term, while secondary infertility means the inability to conceive or maintain a pregnancy after having done so in the past. Secondary infertility is thought to be more common than primary infertility. Impaired fertility indicates that you have the anatomical/biochemical ability to bear children, but for some reason, the chances of conceiving are reduced. The current estimate is that about 10 percent of all couples face fertility issues.

It is interesting to note that while infertility has received more and more attention in the media, the actual rates of infertility have remained fairly stable. There are exceptions, though: infertility rates are rising among women of color and in all young women between the ages of 20 and 24. This rise is thought to be due to an increase in sexually transmitted diseases which can damage the reproductive organs, either by themselves or through causing pelvic inflammatory disease.

Infertility seems to be fairly gender-blind. Male causes (low sperm count or poor motility) account for about 40 percent of cases, while female causes (hormones, eggs, reproductive organs) account for another 40%. In the remaining 20 percent, the problem may either be unexplained or due to problems in both partners. Many couples will face more than one cause for their fertility problems.

When infertility has been diagnosed, there are a number of possible treatments which can be undertaken, depending on the cause of the problem. In some cases, all it takes is more frequent sex or having the man switch from briefs to boxers to achieve pregnancy. Other cases require a bit more assistance. Fertility drugs can regulate the reproductive hormones and trigger the release of one or more eggs per cycle. Surgery may fix blocked fallopian tubes or remove endometriosis, fibroids, or ovarian cysts. In artificial insemination, a concentrated dose of sperm (from your own partner or a donor) is placed in the uterus through a catheter. Fertility drugs and artificial insemination are often used together.

More high-tech solutions include in vitro fertilization, donor eggs and embryos, and gestational carriers (surrogate mothers). The cost of infertility treatments can be staggering, reaching in excess of $20,000. And while not a "cure," adoption is another highly rewarding approach to having the children you desire.