Infertility is an inability to have children. In medical practice, infertility is diagnosed when a couple has been unable to conceive after one year of unprotected intercourse timed to coincide with ovulation. If the woman is over thirty-five years of age or has been unable to carry a pregnancy to term, this time is reduced to six months. Infertility affects 5.3 million Americans. Approximately 40 percent of infertility is due to female factors, 40 percent to male factors, and 20 percent to either combined or unknown factors. STDs and PID are two conditions that can lead to infertility in women. Therefore, educating the public about the risks of these infections is important in preventing infertility and improving women's health.
Conventional treatments for infertility depend on the cause and may include hormonal therapy and surgical procedures. In cases in which conventional methods fail, more advanced assisted reproductive technologies (ARTs) may be used. Current use of ARTs other than artificial insemination by donor is restricted because of limited availability, expense, and relatively low success rates.
PRENATAL DIAGNOSIS AND SCREENING
A variety of prenatal diagnostic techniques are available for couples at increased risk of having a child with certain genetic or developmental abnormalities. These tests include amniocentesis and chorionic villous sampling (CVS). Such invasive techniques are associated with small risks of inducing pregnancy loss or fetal damage and require skilled operators and sophisticated ultrasonography equipment. Ultrasound examination and maternal serum screening tests, which are not associated with any known fetal risks, are used for routine pregnancy screening in some jurisdictions. These techniques can identify many, but not all, fetuses with Down syndrome or serious structural abnormalities such as spina bifida. Because very few fetal abnormalities can be treated effectively before delivery, prenatal screening or diagnosis may raise serious ethical and social issues related to the abortion of fetuses considered to be less than perfect.
Increased availability and public support of reproductive medical care and related educational and prevention initiatives in most developed countries have had an important beneficial effect on the health of women and young children. However, such services are not readily available in all parts of the world, and maternal and infant mortality as well as death and illness from STDs are far too frequent. Providing public health interventions to deal with these problems in an appropriate cultural, social, and religious context remains an urgent and often very challenging priority.