In a single cycle, the likelihood of conception (achieving pregnancy) for a healthy young couple is approximately 20 percent. During 12 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 35.
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 Polycystic Ovarian Syndrome or 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.
Unexplained (10-15 %) — infertility with no known cause following a complete work up.
A thorough evaluation of the infertile couple begins with investigation for both male and female causes of infertility. The details of each test are covered in more detail in subsequent sections.