What is Primary infertility
Primary infertility is a term used to describe a couple that has never been able to conceive a pregnancy after a minimum of 6 month or maximum 1 year of attempting to do so through unprotected intercourse. Causes of infertility include a wide range of physical as well as emotional factors.
Definitions of infertility differ. Demographers tend to define infertility as childlessness in a population of women of reproductive age, whereas the epidemiological definition refers to “trying for” or “time to” a pregnancy, generally in a population of women exposed to a probability of conception. The time needed to pass (during which the couple tries to conceive) for that couple to be diagnosed with infertility differs between different jurisdictions. Existing definitions of infertility lack uniformity, rendering comparisons in prevalence between countries or over time problematic. Therefore, data estimating the prevalence of infertility cited by various sources differs significantly.A couple that tries unsuccessfully to have a child after a certain period of time (often a short period, but definitions vary) is sometimes said to be subfertile, meaning less fertile than a typical couple. Both infertility and subfertility are defined as the inability to conceive after a certain period of time.
World Health Organization
The World Health Organization defines infertility as follows.
|“||Infertility is the inability to conceive a child. A couple may be considered infertile if, after two years of regular sexual intercourse, without contraception, the woman has not become pregnant (and there is no other reason, such as breastfeeding or postpartum amenorrhoea). Primary infertility is infertility in a couple who have never had a child. Secondary infertility is failure to conceive following a previous pregnancy. Infertility may be caused by infection in the man or woman, but often there is no obvious underlying cause.||”|
One definition of infertility that is frequently used in the United States by reproductive endocrinologists, doctors who specialize in infertility, to consider a couple eligible for treatment is:
- a woman under 35 has not conceived after 12 months of contraceptive-free intercourse. Twelve months is the lower reference limit for Time to Pregnancy (TTP) by the World Health Organization.
- a woman over 35 has not conceived after 6 months of contraceptive-free sexual intercourse.These time intervals would seem to be reversed; this is an area where public policy trumps science.
- The idea is that for women beyond age 35, every month counts and if made to wait another 6 months to prove the necessity of medical intervention, the problem could become worse. The corollary to this is that, by definition, failure to conceive in women under 35 isn’t regarded with the same urgency as it is in those over 35.
In the UK, previous defined infertility as failure to conceive after regular unprotected sexual intercourse for 2 years in the absence of known reproductive pathology. Updated NICE guidelines do not include a specific definition, but recommend that “A woman of reproductive age who has not conceived after 1 year of unprotected vaginal sexual intercourse, in the absence of any known cause of infertility , should be offered further clinical assessment and investigation along with her partner, with earlier referral to a specialist if the woman is over 36 years of age.
Researchers commonly base demographic studies on infertility prevalence on a five-year period. Practical measurement problems, however, exist for any definition, because it is difficult to measure continuous exposure to the risk of pregnancy over a period of years.Primary vs. secondary infertilityCouples with primary infertility have never been able to conceive, while, on the other hand, secondary infertility is difficulty conceiving after already having conceived (and either carried the pregnancy to term or had a miscarriage). Secondary infertility is not present if there has been a change of part.