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infertility The inability to conceive or maintain a
PREGNANCY. Infertility may be transitory (relate to a
specific set of circumstances), treatable, or perma-
nent. Infertility affects about 10 percent of Ameri-
cans who attempt pregnancy.
There are numerous possible causes of infertil-
ity that can affect any of the various stages in the
process of CONCEPTION. Causes may affect the
woman, the man, or the couple in equal distribu-
tion. One of the most significant is the woman’s
age. An increasing number of women in the
United States delay starting their families until
completing their education and establishing their
careers, the average age of first pregnancy is age

30. Though a woman can remain fertile into her
    late 40s, the likelihood of conception appreciably
    diminishes each year after age 35.
    Infertility is highly emotional for most people.
    Infertility often comes as a shock, particularly for
    younger people who had no reason to suspect
    they were not fertile. Some people feel guilt or
    regret about choices made earlier in life in regard
    to CONTRACEPTIONand FAMILY PLANNING. Diagnostic
    procedures and treatment approaches can be inva-
    sive and expensive and are without assurances.
    Though ASSISTED REPRODUCTIVE TECHNOLOGY(ART)is
    highly advanced and makes pregnancy possible for
    thousands of couples every year, it nonetheless is
    unable to help two thirds of couples who cannot
    conceive.
    Female factor infertility In female factor infer-
    tility the reason for infertility rests with the
    woman. A third of infertility circumstances arise
    from female factors. Ovulatory dysfunction is the
    most common of them and may result from age,
    genetics, health conditions, or medical treatments.
    Blocked FALLOPIAN TUBESare also common. Previ-
    ous ECTOPIC PREGNANCY, abdominal or pelvic sur-

gery, and complications from untreated SEXUALLY

TRANSMITTED DISEASES (STDS) may SCARand other-

wise damage the fallopian tubes. Congenital

anomalies of the reproductive organs, such as

malformations of the UTERUS, may prevent implan-

tation. EATING DISORDERSsuch as anorexia nervosa

and OBESITYinfluence the body’s endocrine func-

tions and OVULATION. Cigarette smoking, excessive

ALCOHOLconsumption, and substance abuse also

affect FERTILITY.

FEMALE INFERTILITY FACTORS

age over 35 excessiveALCOHOLuse

anorexia nervosa CHEMOTHERAPY

cigarette smoking CUSHING’S SYNDROME

DIABETES ENDOMETRIOSIS

OBESITY OVARIAN CYST

PELVIC INFLAMMATORY DISEASE PITUITARY GLANDdysfunction

(PID) POLYCYSTIC OVARY SYNDROME

PREMATURE OVARIAN FAILURE (PCOS)

(POF) previousECTOPIC PREGNANCY

RADIATION THERAPY SICKLE CELL DISEASE

substance abuse TURNER’S SYNDROME

untreated HYPOTHYROIDISM UTERINE FIBROIDS

uterine malformations

Male factor infertility In male factor infertility

the reason for infertility rests with the man. A

third of infertility circumstances arise from male

factors. Male infertility factors may result from

problems with spermatogenesis (production of

SPERM), SEMENproduction, ERECTIONand EJACULA-

TION, sperm count, sperm morphology (structure),

and sperm motility (movement). Body tempera-

ture and scrotal temperature are crucial for sper-

matogenesis and sperm survival. Circumstances

that prevent the SCROTUMfrom dropping, such as

tight clothing, or sustained exposure to heat, such

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