In a single cycle, the likelihood of conception (achieving pregnancy) for a healthy young couple is approximately 20 percent. Over twelve months, the combined likelihood of achieving pregnancy is about 85 percent. It is important to know that these numbers will begin to decrease beginning in a woman’s early thirties, declining even further after age thirty-five.
Multiple factors can affect a couple’s ability to conceive. Generally, the causes can be divided into male and female categories.
Male Factor (40%)
Abnormalities in sperm count, motility, appearance, or function; this also includes the inability to have intercourse, either due to injury or other causes.
Female Ovulation Disorder (20-25%)
Abnormalities in the ability to produce or release eggs (includes PCOS).
Female Pelvic Factor (20-25%)
Abnormalities of the pelvic organs including blocked fallopian tubes, adhesions (scar tissue) around the tubes and ovaries, fibroid tumors of the uterus, and moderate to severe endometriosis.
Infertility with no known cause following a complete work-up.
Female Cervical Factor (5%)
abnormalities of the cervical mucus that could decrease the ability of sperm to reach the fallopian tubes.
Therefore, a thorough evaluation of the infertile couple begins with investigation for both male and female causes of infertility. The specifics of each test are covered in more detail in subsequent sections.