Definition of infertility

What it is

Infertility is a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. That is the WHO-ICMART glossary definition, and the MOH gives the same period: infertility after 1 year of being newly married.

Another page states it as the inability to conceive after one year of regular and unprotected intercourse, with the period cut to 6 months in women aged over 35 years.

So the definition rests on three things at once: a set period of time, intercourse that is regular, and intercourse that is unprotected. The period is one year as a rule, and 6 months once the woman is over 35 years.

When to start the work-up

A second line on the same page is about evaluation and not about the definition, and the two are easy to read as one. Evaluate after 6 months of regular unprotected intercourse if the patient is over 40 years, or has an irregular cycle, sexually transmitted diseases, or cancer.

Hold the two 6 month rules apart. One is part of the definition itself and turns on the woman being over 35 years. The other is a reason to evaluate early, and turns on age over 40 years or on one of those three: an irregular cycle, sexually transmitted diseases, or cancer.