Primary Infertility

Definition - What does Primary Infertility mean?

Primary infertility is a condition where an individual or couple is unable to give birth to a child after having regular intercourse without the use of any birth control methods for at least one year. It could be due to the couple not being able to conceive a child or the inability of the woman to maintain the pregnancy until she is ready to deliver a live child.

The management of primary infertility involves not only female or male related problems affecting fertilization and implantation but also addressing the underlying causes of miscarriages and stillbirths.

FertilitySmarts explains Primary Infertility

Infertility can be discussed in two forms.

  • Primary infertility - When a woman has never been able to give birth to a live child having had more than 12 months of regular unprotected intercourse.
  • Secondary infertility - A woman has had a successful pregnancy and childbirth in the past but is unable to give birth to another child after regular unprotected intercourse for 12 months since the last live birth.

Primary infertility can be a result of a physical condition or an emotional disturbance in either the male or female or sometimes both partners.

Common factors

  • Advanced age
  • Obesity / underweight
  • Psychological distress (eg: depression, stress, anxiety)
  • Sexually transmitted diseases
  • Hormonal abnormalities of the hypothalamic-pituitary-gonadal axis
  • Medical conditions (eg: diabetes, celiac disease, thyroid disease, adrenal disease)
  • Genetic disorders / damaged DNA
  • Smoking
  • Environmental exposure (eg: toxins, radiation)
  • Cancer / cancer treatment

Female related factors

  • Structural abnormalities of the vagina, uterus and fallopian tubes
  • Autoimmune disease eg: antiphospholipid syndrome, anti-sperm antibodies
  • Gynecological disorders eg: endometriosis, polycystic ovary syndrome (PCOS), pelvic inflammatory disease (PID)
  • Abnormality of egg maturation and release (ovulation)

Male-related factors

  • Structural abnormalities of the testis, vas deferens, and glands in the reproductive system
  • Autoimmune disease (eg; antisperm antibodies)
  • Poor quality and quantity of sperm


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