Introduction to Infertility

Couples facing fertility challenges often remark that it seems to them as if no one else has such issues. Everywhere they turn, they encounter families with children, and wonder why they have been singled out for this "rare" condition. Due to changing attitudes and the advent of technologies to treat such issues, discussing the topic of fertility has become more acceptable in today's society. Yet, the stigma associated by some parts of the community to fertility issues combined with a feeling of inadequacy can, and often does, lead to a sense of isolation and/or exclusion for the couples.

While it may seem that fertility challenges are quite rare, statistics show that 15 - 20% of all couples will face some form of fertility issue in their marriage.

What is Infertility?

The generally accepted definition of infertility is the inability of a couple attempting to conceive a pregnancy for a period of 12 months or more, to become pregnant. This standard is derived by statistical analysis.  A couple attempting to conceive have a 20% chance (with optimal conditions) of becoming pregnant in any given month. Accordingly, until at least 6 months have passed, they remain within the statistical average. Since optimal conditions can be interfered with (unbeknownst to the couple) by many factors, we require a 12 month period in order to assume that there is a fertility problem.

Are there any exceptions to the 12 month rule?

Yes, of course. In cases where there is a medical condition that is known to influence fertility, a couple should seek professional advice immediately. If there is a concern in this area, please consult with a Puah counsellor or your medical advisor.

Additionally, recognized factors such as advanced maternal age or a prior diagnosis of fertility issues for one or both of the partners would also warrant a diagnosis of infertility without requiring the 12 month waiting period.

The Talmud says that a couple who have been married for 10 years should divorce. Why is the waiting period 12 months instead of 10 years?

The Talmud is referring to a waiting period before divorce is required, not to a waiting period to be classified as having a fertility problem. In the past, there were Poskim who required a 10 year waiting period before allowing certain typed of tests to be performed. However, almost all current Poskim agree that today's advanced understanding of fertility and ability to test for problems allow for the reduction of this period to considerably less time. This increased expertise in dealing with fertility issues has also led the vast majority of Poskim to rule that there is no longer a requirement to divorce at all.

Is fertility always a women's issue?

Absolutely not. In fact, female factors are the contributing factor 40% of the time and male factors are the contributing factor an equal 40% of the time; the remaining 20% of the cases can not be attributed to one of the partners and are categorized as either a "couples" or unexplained issue.

Is fertility always a medical issue?

Also no. As we will discuss in further detail on this website, there are many external factors, such as stress, that can lead to fertility problems.

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