More than 15% of couples anywhere in the world have difficulty conceiving a child. It is important to understand the concept that this difficulty in conceiving a child is a condition that affects a couple and not just the woman or just the man. The common causes for a delay in becoming pregnant may arise from conditions in the male partner (40%), female partner (40%) or a combination of both (10%). In 10% of couples, there is no specific cause for infertility that can be identified.

The male partner may be affected by conditions where the production of sperms is hampered. This may be in terms of number of sperms or their quality. There may be other causes of male infertility such as abnormal hormone production, abnormal development or sexual dysfunction. The diagnosis in most cases of male infertility is based on a sperm test or semen analysis. Treatments are usually in the form of semen washing with intrauterine insemination, donor semen insemination or ICSI.

The female partner may be affected by conditions in which there are abnormalities of the ovaries, tubes, uterus or a combination of these.

When the ovaries are affected, ovulation (i.e. the regular release of an egg at the correct time every month) is affected. The most common causes are advanced age and polycystic ovaries. Ovulation disorders can be diagnosed by doing ultrasound from the tenth day of the period. These conditions can be treated by ovulation induction or in certain cases by egg donation.

Affected tubes abstains the sperms from approaching the egg and further blocks the fertilized embryo to travel to the uterus for implantation. The common reasons for blocked tubes are pelvic infections (tuberculosis, chlamydia, gonorrhoea), endometriosis and woman who have undergone tubal ligation (sterilization operation). These may be corrected surgically in selected cases. Other women will need IVF.

Abnormalities of the uterus can result in infertility as well as repeated pregnancy losses particularly in the first three months. These abnormalities may be present right from a woman's birth or they may appear later (adhesions, polyps). These abnormalities can usually be corrected by hysteroscopic surgery.

In general, treatments for infertility can range simply from waiting for a few months to advanced procedures. Each couple has their own set of unique characteristics which will determine the course of management. It should be pursued at a much faster pace for older couples (>35 years).