Infertility

Infertility — is the absence of pregnancy in a couple with regular sexual life without contraception for 12 months. For women over 35 years old, the waiting period is usually reduced to 6 months.

The term encompasses various reproductive function disorders and is not a standalone diagnosis without specifying the cause.

Definition

There are two forms:

• primary infertility — pregnancy has not occurred before;
• secondary infertility — there has been a pregnancy in the past, but conception does not occur again.

The assessment is conducted considering the age, health status of both partners, and the duration of attempts to conceive.

Causes

Factors can be female, male, combined, or unexplained:

• female factors — ovulation disorders, polycystic ovary syndrome, endometriosis, pathology of the fallopian tubes, changes in the endometrium;
• male factors — reduced sperm count, motility, or morphology;
• combined causes — contributions from both partners;
• unexplained infertility — the cause is not identified during standard examination.

Diagnosis

The examination includes the assessment of both partners:

• sperm analysis;
• hormonal studies in women;
• ultrasound examination of the pelvic organs;
• assessment of ovulation;
• checking the patency of the fallopian tubes if indicated.

Additionally, body mass, chronic diseases, stress levels, and lifestyle are evaluated.

Treatment

The strategy depends on the cause and may include:

• medication to correct ovulation;
• treatment of inflammatory and hormonal disorders;
• surgical removal of obstacles;
• assisted reproductive technologies.

Nutrition and Fertility

Metabolic health affects reproductive function. Excess body weight, insulin resistance, and significant energy deficiency can disrupt ovulation:

• maintaining a healthy body weight;
• adequate intake of protein and fats;
• ensuring sufficient intake of folates, iron, vitamin D, and omega-3;
• avoiding extreme restrictions before planned pregnancy.

In women with polycystic ovary syndrome, reducing insulin resistance through moderate carbohydrate restriction may help restore ovulation. However, excessive calorie deficiency or strict diets can disrupt the menstrual cycle.

Preparation for conception:

• taking folic acid 400–800 mcg before conception;
• quitting smoking and limiting alcohol;
• moderate physical activity;
• controlling chronic diseases;
• adequate sleep and stress management.

Conclusion

Infertility requires a comprehensive assessment of both partners. Early diagnosis and an individualized approach increase the likelihood of successful conception. Nutrition and lifestyle are supportive factors and should be adjusted according to medical recommendations and reproductive plans.