Review
Definition and causes of infertility

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Abstract

Infertility is a common problem affecting one couple in six. It can be defined as the incapacity to achieve pregnancy after a reasonable period of sexual intercourse without contraception. The evidence for changes in the prevalence of infertility is difficult to establish. This increase could be due to at least four factors: delayed childbearing, alterations in semen quality due to habits such as cigarette smoking and alcohol, changes in sexual behaviour and elimination of most taboos. Study of the infertile couple has always been focussed on different factors: ovulatory factor (present in about 20% of couples), utero-tubal peritoneal factor (present in ∼30% of couples), semen migration factor (10% of cases) and male factor (30% of couples). Around 40% of all infertile couples exhibit a combination of factors and about 15 % of couples may not display any objective alteration leading to a definite diagnosis. During the past two decades there have been three important changes in infertility practice. First, the introduction of assisted reproduction technologies has provided an opportunity to study basic reproductive processes. Second, societal changes have occurred, such as the increase in the proportion of women over 35 years old seeking pregnancy. This fact is due to a later age for marriage and postponement of pregnancy. Third, the development of molecular biology and genetics has become very important for the study, diagnosis and assessment of couples, many of them considered until now as “unexplained infertile couples”.

Section snippets

Santiago Brugo Olmedo qualified as a medical doctor at the University of Córdoba, Argentina and is currently Medical Director of the Center for Gynecology and Reproduction Studies in Buenos Aires. He specializes in reproductive medicine and andrology. From 1985 to 1986 he studied at the Jones Institute for Reproductive Medicine (USA). In 1990 he was awarded Outstanding Argentinean Fellow in the Innovation Medical Area and became an honorary member of the Brazilian Society of Human Reproduction.

References (33)

  • FH Comhaire et al.

    Towards more objectivity in diagnosis and management of male infertility: results of World Health Organization multicentre study

    International Journal of Andrology

    (1987)
  • P Crosignani et al.

    Unexplained infertility

    Human Reproduction

    (1993)
  • JR Cruz et al.

    Age and reproduction

    Reproductive Medicine Review

    (1999)
  • Guidelines to the prevalence, diagnosis, treatment and management of infertility. The ESHRE Capri Workshop

    Human Reproduction

    (1996)
  • S Franks

    Diagnosis and treatment of anovulation

  • J Hardelin

    Xp22.3 deletions in isolated familial Kallman's syndrome

    Journal of Clinical Endocrinology and Metabolism

    (1993)
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    Santiago Brugo Olmedo qualified as a medical doctor at the University of Córdoba, Argentina and is currently Medical Director of the Center for Gynecology and Reproduction Studies in Buenos Aires. He specializes in reproductive medicine and andrology. From 1985 to 1986 he studied at the Jones Institute for Reproductive Medicine (USA). In 1990 he was awarded Outstanding Argentinean Fellow in the Innovation Medical Area and became an honorary member of the Brazilian Society of Human Reproduction. Currently he is a member of the organizing committee of the 12th World Congress of In Vitro Fertilization to be held in April 2002. Dr Brugo Olmedo holds 15 national and international awards for scientific papers, and has presented more than one hundred scientific papers in National and International Congresses and Societies, as well as having had 27 papers published in medical journals with international referees.

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