Infertility is a disease of the reproductive system which affects both men and women with almost equal frequency. It is a global phenomenon with some portion of every human population affected. It is estimated that an average of 10% of the global reproductive age population is unable to get pregnant or carry pregnancy to term. While there is no universal definition of infertility, a couple is generally considered clinically infertile when pregnancy has not occurred after at least twelve months of regular sexual activity without the use of contraceptives. Primary infertility is defined as
childlessness and secondary infertility as the inability to have an additional live birth for a parous woman.
Although women’s infertility is of greater research consideration, health care attention and social blame, male conditions cause or contribute to around half of all cases of infertility. It is estimated that approximately one-third of cases of infertility are due to male factors, one-third to female, and the remaining third to a combination of both male and female factors. In approximately 20% of cases, the origin of the condition is never identified and the case is labeled as unexplained.
It is important to remember that the definition of infertility varies between cultures and the Western, clinical definition cited above may not capture variation in cultural perceptions on childlessness. Infertility often does not strictly mean the inability to give birth; in some places the inability to have the number of children that cultural norms dictate maybe considered involuntary childlessness; in other places infertility may be understood as having no sons, or not becoming pregnant soon after initiating sexual activity. Social norms concerning marriage, divorce, and family organization influence perceptions of childlessness to a large degree. In parts of Tanzania and other east and southern African countries, a woman who has had one or more children can be considered childless because children remain with their father in the case of divorce and every marriage is expected to produce children.
