The Approach to the Infertile Couple. Addressing infertility in a couple is a complex process that requires sensitivity, medical precision, and a comprehensive perspective. Infertility is increasingly common in the population: according to the World Health Organization, 1 in 6 people of reproductive age face difficulties conceiving. In this context, the goal is not only to achieve a pregnancy, but to accompany the couple until reaching what truly matters: the birth of a healthy baby.
Understanding the causes, risk factors, and diagnostic process is essential for beginning the appropriate treatment and improving reproductive outcomes. For this reason, evaluation must be performed simultaneously in both partners, always with specialized and compassionate care.
Infertility Has Become an Increasing Condition
Infertility is defined as the inability to achieve a clinical pregnancy after 12 months of regular, unprotected sexual intercourse. In women over 35, evaluation should begin after 6 months due to the natural decline in ovarian reserve.
In Mexico, the Global Fertility Rate has decreased to 1.9 children per woman (INEGI 2021), reflecting demographic changes and a rise in infertility cases, both female and male.
What Are the Most Common Causes of Infertility?
Infertility may arise from female factors, male factors, or mixed causes.
Female Factors (40–50%)
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Ovulatory disorders, including Polycystic Ovary Syndrome (PCOS)
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Tubal problems secondary to infections or endometriosis
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Uterine or cervical abnormalities, such as fibroids or malformations
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Endocrine disorders: insulin resistance, thyroid dysfunction, hyperprolactinemia
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Low ovarian reserve, evaluated through AMH, FSH, and antral follicle count
Male Factors (30–40%)
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Alterations in sperm concentration, motility, or morphology
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Surgical history, exposure to heat, toxins, or infections
A semen analysis is the initial test used to identify abnormalities in sperm.
Idiopathic Infertility (10–20%)
This occurs when no clear cause is identified after a complete evaluation.
Why Is Timing So Important in Fertility?
Time is a critical factor in the evaluation of an infertile couple, as pregnancy rates decrease the longer conception attempts remain unsuccessful.
In healthy couples under 35 years old:
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20% conceive within one month
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70% within six months
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90% within one year
When any infertility factor is present, the chances drop to approximately 48% in one year, which is why timely evaluation is recommended.
When Should Infertility Evaluation Begin?
Evaluation is recommended when:
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Before age 35: after 12 months without achieving pregnancy
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After age 35: after 6 months
Immediate evaluation is recommended in cases of:
- Endometriosis
- Menstrual irregularities
- Uterine or tubal disease
- Thyroid disorders
- Suspected male factor
Early diagnosis reduces emotional burden and allows treatment to begin promptly.
A Complete Clinical Evaluation Is the Essential First Step
Medical history is a key tool when assessing an infertile couple. It should include:
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Weight, height, BMI, and visible hormonal changes (acne, hirsutism, galactorrhea)
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Menstrual pattern, surgical history, and past illnesses
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Exposure to toxic substances or medications that may affect fertility
A thorough initial evaluation avoids unnecessary tests and guides the medical team toward the most likely cause.
The approach to the infertile couple requires experience, empathy, and a deep analysis of the factors that affect fertility.
With proper evaluation, timely diagnosis, and the support of a specialized team, it is possible to increase the chances of a healthy pregnancy and achieve the dream of building a family.
We Are the Best Fertility Clinic in the Mexican Caribbean!
At Advanced Fertility Center Cancun, we have a team of specialists ready to provide you with the professional and compassionate care you deserve.
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