If pregnancy does not occur after 12 months of regular unprotected sex, this is a serious reason to consult a reproductive specialist. Modern infertility treatments make it clear that this problem is no longer a death sentence. Reproductive medicine combines advances in genetics, embryology, and endocrinology. The introduction of innovative technologies gives most couples a real chance to overcome physiological barriers and have a healthy child.
How Prevalent Is Infertility in the Modern World?
According to the WHO, approximately 17.5% of the world’s adult population—that is, one in six people—faces the problem of infertility. In large cities, this rate is higher due to chronic stress, an unfavorable environment, and the global trend toward delayed parenthood, where planning for the first child is postponed until after the age of 30–35.
Probability of Conception Based on Duration of Attempts
Conception is a complex biological process with the following statistical indicators:
- One menstrual cycle: The probability of becoming pregnant is 11–15% due to the short fertility window.
- First 6 months: About 60% of couples succeed within six months.
- First year: By the end of 12 months, the rate rises to 84%, which is the standard for assessing reproductive health.
- Second year: Within 24 months, 92% of couples become pregnant.
Impact of age: Women over 35 are advised to consult a doctor after just 6 months of unsuccessful attempts. With age, ovarian reserve declines in both quantity and quality, and the risk of chromosomal abnormalities increases. In this group, IVF with preimplantation genetic testing (PGT-A) is often recommended.
Key Factors Affecting Fertility
Infertility is a diagnosis that affects both partners. Statistics break down the causes as follows:
- Female factor: Accounts for 33% of cases.
- Male factor: Is the cause in 20% of cases and is often asymptomatic.
- Combined factor: Diagnosed in 39% of couples, where both partners have issues.
- Unknown cause: Accounts for about 8% (idiopathic infertility).
Modern diagnostic methods, such as sperm DNA fragmentation analysis and the ERA test, make it possible to identify underlying causes and develop a personalized treatment plan.
Main Causes of Female Infertility
1. Endocrine and Hormonal Disorders
Hormonal imbalances disrupt the menstrual cycle, ovulation, and implantation. These include anovulation, PCOS, hyperprolactinemia, thyroid disorders, and FSH-LH imbalances.
2. Tubal and peritoneal factors
Blockage or damage to the fallopian tubes due to adhesions resulting from infections or surgeries prevents sperm from reaching the egg and increases the risk of an ectopic pregnancy.
3. Decline in ovarian reserve
The egg supply diminishes with age, as well as due to smoking, surgeries, or genetic predisposition, which may require the use of donor material.
4. Endometriosis
The growth of endometrial tissue outside the uterus causes chronic inflammation, reduces egg quality, and prevents implantation.
5. Uterine Abnormalities
Polyps and fibroids distort the uterine cavity, cause inflammation, and interfere with embryo implantation.
6. Immunological Factors
The production of antisperm antibodies or autoimmune attacks on the embryo prevent fertilization and the development of pregnancy.
Major Causes of Male Infertility
- Spermatological disorders: Oligospermia, asthenospermia, and teratospermia.
- Varicocele: Enlargement of the veins in the scrotum, causing the testicles to overheat and sperm to die.
- Infections and inflammation: Lead to obstruction of the seminal ducts.
- Oxidative stress and unhealthy habits: Damage sperm DNA.
Diagnosis and identification of causes
- Hormone profile: Assessment of AMH and thyroid function.
- Pelvic ultrasound: Monitoring of folliculogenesis and the endometrium.
- Semen analysis: Including Kruger morphology and the MAR test.
- Assessment of fallopian tube patency: Using the echo-HSG method.
- Genetic screening: Karyotype analysis and molecular diagnostics.
Modern arsenal of treatment methods
- Ovulation stimulation: Medications to stimulate ovarian function.
- Intrauterine insemination (IUI): Introduction of processed sperm into the uterus at the time of ovulation.
- IVF: In vitro fertilization.
- ICSI: Injection of a single selected sperm directly into the egg in cases of male factor infertility.
- PGT-A: Preimplantation genetic testing of embryos for chromosomal abnormalities.
- Donor programs: Use of IVF with egg donation or IVF with double donation when the patient’s own egg reserve is depleted.
Effectiveness and Chances of Success
- IVF: For women under 35, the success rate on the first attempt reaches 50–54%; after age 40, it is 20–30% (increases with PGT-A).
- ICSI: Ensures success in 60–70% of cases with a significant male factor.
- IUI: Achieves a 20% success rate per cycle.
The success rate of these programs is cumulative and increases with each subsequent attempt or cryoprotocol.
Why It’s Important Not to Delay Seeing a Doctor
Reproductive age is limited. Seeking specialist care early provides more opportunities for effective treatment. The NatuVitro clinic offers a full range of services: from expert diagnostics to ART programs with PGT-A genetic screening. Our goal is the birth of your healthy child.
Frequently Asked Questions About Infertility
1. How long should you try to conceive on your own? Up to age 35, about one year; after age 35, no more than six months. If you have a history of gynecological symptoms or surgeries, you should see a doctor sooner.
2. How risky is IVF for a woman’s health? Modern, gentle stimulation protocols and minimally invasive egg retrieval procedures minimize the risk of complications, including hyperstimulation syndrome.
3. Does stress affect the success of treatment? Yes, elevated cortisol levels can disrupt ovulation and reduce endometrial receptivity, so it’s important to maintain psychological well-being.
4. Is it possible to choose the sex of the child during IVF? The law permits sex selection only for medical reasons to prevent sex-linked disorders.
5. What should you do if an IVF attempt fails? A failed attempt provides the doctor with information to adjust the protocol, which increases the likelihood of success on a subsequent attempt.
