Infertility, and the treatments designed to overcome it, are more visible today than ever before. From Celine Dion openly discussing her struggle and ultimate success with fertility treatments, to Robert Edwards winning the 2010 Nobel Prize in Physiology for the development of IVF, we see evidence of fertility treatments every day. This increased visibility has done much to diminish the embarrassment that many couples previously associated with infertility. It has also prompted people to ask the question: is infertility on the rise?
To determine if infertility is on the rise, we must first define infertility and know a little bit about normal fertility. If a couple has engaged in one year of properly timed, unprotected intercourse and has not conceived, they are considered infertile. This one year time frame comes from studies of young healthy couples who belong to traditional societies in which pre-marital sex as well as post marital contraception are forbidden. We find that 85-90% of these couples become pregnant within one year of marriage. Consequently, the 10-15% of couples who do not become pregnant is considered infertile.
The problem with this definition is that it is based on the reproductive experience of young couples. Unfortunately, as a couple ages (specifically the female partner), their ability to become pregnant decreases. This decrease begins slowly in the mid 20s and becomes dramatic in the mid to late 30s. By the time a women reaches 40 years of age, her ability to become pregnant is roughly 10% of what it was when she was 20.
When you consider that the average age of marriage and the age of first pregnancy have steadily increased over the last 50 years, it is no wonder why more people require fertility treatments these days. Combine this with a significant increase in the number of fertility centers and dramatic improvements in success rates of IVF and you have an explanation to why it seems like everyone is doing IVF.
To return to our original question, however, is infertility on the rise? The answer is yes, slightly. The rise is mostly due to the older age at which people are attempting to have children. Therefore the increase is not so much a biological phenomena as it is a social one.
Of course, whether infertility is more common or not is relatively unimportant to the couple struggling to build a family. They are more interested in finding out whether they can have a baby or not. Fortunately, the answer is almost always yes. Modern fertility treatments are designed to treat every type of infertility and although couples may have to take some unorthodox steps, ultimately, almost all patients can be successful.