Infertility

A failure to achieve a clinical pregnancy after 12 months or more of regular unprotected intercourse, reflecting impaired fecundity due to female, male, or combined factors. Possible female factors are age, ovulation disorders (PCOS), tubal damage (chlamydia or pelvic inflammatory disease), and uterine conditions (structural abnormality, fibroids, endometriosis). Possible male factors are semen quality, structural blockage of vas deferens, and retrograde ejaculation. General lifestyle factors are tobacco smoking, alcohol consumption, severely underweight or overweight, untreated STIs, autoimmune diseases, and chemotherapy.