Infertility is defined as the failure to achieve a successful pregnancy after twelve or more months of regular, unprotected intercourse. It is further subdivided into primary and secondary categories based on whether the female partner has previously conceived. Women with secondary infertility are those unable to conceive following the birth of a biologic child.
Although the prevalence of secondary infertility exceeds that of primary infertility, affected couples tend to be less likely to seek medical advice. There is a tendency to assume prior childbearing ensures future reproductive success. Regrettably, even physicians have been known to reinforce this belief; at times encouraging couples to simply keep trying. Lost time and compounding stress can be averted by erring on the side of earlier intervention.
A prior live-born delivery can convey a better prognosis for subsequent conception. However, individuals experiencing difficulty conceiving for 10 -12 months should seek fertility-directed evaluation regardless of their reproductive history. Earlier examination may be warranted based on known medical conditions or in women over age 35.