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Overview of infertility

Wendy Kuohung, MD
Mark D Hornstein, MD
Section Editor
Robert L Barbieri, MD
Deputy Editor
Kristen Eckler, MD, FACOG


Infertility is a common condition with important psychologic, economic, demographic, and medical implications. Demand for infertility services has grown substantially even though the prevalence of infertility has been stable. This phenomenon may be due to entry of the "baby boom" generation into the reproductive age group during a period of highly publicized technologic advances, and unparalleled publicity given to fertility issues in the lay press.

This topic review will provide an overview of infertility issues. More detailed discussions of both male and female infertility are found elsewhere.

(See "Causes of female infertility".)

(See "Evaluation of female infertility".)

(See "Overview of treatment of female infertility".)


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Literature review current through: Sep 2016. | This topic last updated: Apr 7, 2016.
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  1. Practice Committee of tAmerican Society for Reproductive Medicine. Definitions of infertility and recurrent pregnancy loss. Fertil Steril 2008; 90:S60.
  2. GUTTMACHER AF. Factors affecting normal expectancy of conception. J Am Med Assoc 1956; 161:855.
  3. Zinaman MJ, Clegg ED, Brown CC, et al. Estimates of human fertility and pregnancy loss. Fertil Steril 1996; 65:503.
  4. Wang X, Chen C, Wang L, et al. Conception, early pregnancy loss, and time to clinical pregnancy: a population-based prospective study. Fertil Steril 2003; 79:577.
  5. Gnoth C, Godehardt D, Godehardt E, et al. Time to pregnancy: results of the German prospective study and impact on the management of infertility. Hum Reprod 2003; 18:1959.
  6. Slama R, Hansen OK, Ducot B, et al. Estimation of the frequency of involuntary infertility on a nation-wide basis. Hum Reprod 2012; 27:1489.
  7. Habbema JD, Collins J, Leridon H, et al. Towards less confusing terminology in reproductive medicine: a proposal. Fertil Steril 2004; 82:36.
  8. Van Voorhis BJ. Outcomes from assisted reproductive technology. Obstet Gynecol 2006; 107:183.
  9. Chandra A, Copen CE, Stephen EH. Infertility and impaired fecundity in the United States, 1982-2010: data from the National Survey of Family Growth. Natl Health Stat Report 2013; :1.
  10. Thoma ME, McLain AC, Louis JF, et al. Prevalence of infertility in the United States as estimated by the current duration approach and a traditional constructed approach. Fertil Steril 2013; 99:1324.
  11. www.cdc.gov/nchs/products/pubs/pubd/series/sr23/pre-1/pre-1.htm (Accessed on October 05, 2006).
  12. Mascarenhas MN, Flaxman SR, Boerma T, et al. National, regional, and global trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys. PLoS Med 2012; 9:e1001356.
  13. WHO Technical Report Series. Recent Advances in Medically Assisted Conception Number 820, 1992, pp 1-111.
  14. Hull MG, Glazener CM, Kelly NJ, et al. Population study of causes, treatment, and outcome of infertility. Br Med J (Clin Res Ed) 1985; 291:1693.
  15. Bhattacharya S, Porter M, Amalraj E, et al. The epidemiology of infertility in the North East of Scotland. Hum Reprod 2009; 24:3096.
  16. Kerr J, Brown C, Balen AH. The experiences of couples who have had infertility treatment in the United Kingdom: results of a survey performed in 1997. Hum Reprod 1999; 14:934.
  17. VanderLaan B, Karande V, Krohm C, et al. Cost considerations with infertility therapy: outcome and cost comparison between health maintenance organization and preferred provider organization care based on physician and facility cost. Hum Reprod 1998; 13:1200.
  18. Halman LJ, Abbey A, Andrews FM. Why are couples satisfied with infertility treatment? Fertil Steril 1993; 59:1046.
  19. Ceballo R, Abbey A, Schooler D. Perceptions of women's infertility: what do physicians see? Fertil Steril 2010; 93:1066.
  20. Wilkes S, Hall N, Crosland A, et al. General practitioners' perceptions and attitudes to infertility management in primary care: focus group study. J Eval Clin Pract 2007; 13:358.
  21. Wilkes S, Hall N, Crosland A, et al. Patient experience of infertility management in primary care: an in-depth interview study. Fam Pract 2009; 26:309.
  22. Practice Committee of the American Society for Reproductive Medicine, Practice Committee of the Society for Assisted Reproductive Technology, Practice Committee of the Society of Reproductive Biology and Technology. Revised minimum standards for practices offering assisted reproductive technologies: a committee opinion. Fertil Steril 2014; 102:682.
  23. American College of Obstetricians and Gynecologists Committee on Gynecologic Practice and Practice Committee. Female age-related fertility decline. Committee Opinion No. 589. Fertil Steril 2014; 101:633.
  24. Brosens I, Gordts S, Valkenburg M, et al. Investigation of the infertile couple: when is the appropriate time to explore female infertility? Hum Reprod 2004; 19:1689.
  25. Schwartz D, Mayaux MJ. Female fecundity as a function of age: results of artificial insemination in 2193 nulliparous women with azoospermic husbands. Federation CECOS. N Engl J Med 1982; 306:404.
  26. Practice Committee of American Society for Reproductive Medicine. Diagnostic evaluation of the infertile female: a committee opinion. Fertil Steril 2012; 98:302.
  27. ESHRE Task Force on Ethics and Law, including, Dondorp W, de Wert G, et al. Lifestyle-related factors and access to medically assisted reproduction. Hum Reprod 2010; 25:578.
  28. Ethics Committee of American Society for Reproductive Medicine. Child-rearing ability and the provision of fertility services: a committee opinion. Fertil Steril 2013; 100:50.
  29. Pandey S, Maheshwari A, Bhattacharya S. Should access to fertility treatment be determined by female body mass index? Hum Reprod 2010; 25:815.
  30. Ethics Committee of the American Society for Reproductive Medicine. Human immunodeficiency virus and infertility treatment. Fertil Steril 2004; 82 Suppl 1:S228.
  31. Ethics Committee of American Society for Reproductive Medicine. Access to fertility treatment by gays, lesbians, and unmarried persons: a committee opinion. Fertil Steril 2013; 100:1524.
  32. Welmerink DB, Voigt LF, Daling JR, Mueller BA. Infertility treatment use in relation to selected adverse birth outcomes. Fertil Steril 2010; 94:2580.
  33. Jaques AM, Amor DJ, Baker HW, et al. Adverse obstetric and perinatal outcomes in subfertile women conceiving without assisted reproductive technologies. Fertil Steril 2010; 94:2674.
  34. Messerlian C, Platt RW, Tan SL, et al. Low-technology assisted reproduction and the risk of preterm birth in a hospital-based cohort. Fertil Steril 2015; 103:81.
  35. Declercq E, Luke B, Belanoff C, et al. Perinatal outcomes associated with assisted reproductive technology: the Massachusetts Outcomes Study of Assisted Reproductive Technologies (MOSART). Fertil Steril 2015; 103:888.
  36. Wise LA, Mikkelsen EM, Sørensen HT, et al. Prospective study of time to pregnancy and adverse birth outcomes. Fertil Steril 2015; 103:1065.