Basic Infertility Evaluation

Abstract

Infertility for women younger than 35 years old is defined as 1 year of unprotected intercourse without conception. However, for women who are older than 35, this time frame decreases to 6 months. As women pursue careers and put family planning on hold, childbearing and infertility have become rising issues. The ASRM has published a committee opinion reviewing the decline of fecundity in women starting at the age of 32, and according to the National Survey of Family Growth in 2013, approximately 11% (6.9 million) of reproductive age women have utilized fertility services in their lifetime. While most couples who present to your office may not meet the strict definition of infertility, the likelihood of success without treatment declines by approximately 5% for each additional year of the female partner’s age and by 15–25% for each added year of infertility. Therefore, all patients who present with concern of family planning or infertility should be counseled regarding the reproductive process and the relationship of age and fertility. Additionally, a history and physical exam tailored to addressing infertility are warranted to ensure further evaluation is not indicated. This chapter on infertility will help guide you through this process.