Female Infertility
Infertility affects about 12 per cent of couples in the United Kingdom. It may be defined as failure to conceive after one year of regular unprotected intercourse, since during this time 75 per cent of normal couples will have achieved pregnancy. Just as it takes two to parent a child, it takes two to be infertile, so both partners need to be investigated - male infertility makes a contribution in 30 per cent of cases. Female causes include failure of ovulation, blockage of transport down the fallopian tube as a result of infection or endometriosis, failure of implantation due to uterine problems, or hostility of the cervical mucous to the partner's sperm. Male causes include failure of sperm production following exposure to drugs or mumps in adult life, persisting low-grade infection, or impotence. The management of infertility depends on the management of any underlying cause - ovulation can be stimulated, blocked tubes maybe opened by surgery, fertilisation may be carried out by direct injection of a sperm into an egg in the laboratory, infection in the male can be treated. About 25 per cent of cases remain unexplained after full investigation of both parties (blood tests and ultrasound show that the woman is ovulating, the tubes have been shown to be patent, the male has got a normal sperm count, a post-coital test has shown live sperm present in ovulatary mucous after intercourse). Of these a number do achieve pregnancy over a period of time, while others remain infertile.
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