Harrison's PodClass: Internal Medicine Cases and Board Prep Ep 142: Infertility in a Couple of Reproductive Age
Apr 17, 2025
A clinical case follows a reproductive-age couple struggling to conceive and the timeline for evaluation. They discuss male versus female causes and how common categories like tubal disease, ovulatory disorders, and semen abnormalities contribute. The role of age, BMI, and specific tests such as semen analysis and hysterosalpingogram are highlighted. Counseling and comprehensive couple-based evaluation are emphasized.
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Infertility Definition And Fecundability Pattern
- Infertility is defined as inability to achieve pregnancy after 12 months of unprotected intercourse.
- WHO labels infertility a reproductive system disease affecting over 48 million couples worldwide, with fecundability highest in first three months.
Typical Clinic Couple Case With Recent IUD Removal
- A real couple in their mid-30s tried for six to nine months; the man never had a steady partner and the woman recently removed an IUD seven months prior.
- Their menses were regular and neither reported STIs or family infertility, framing a typical initial clinic scenario.
Male Factors Commonly Match Female Factors
- Infertility causes split fairly evenly: female factors 30–40%, male factors 40–50%, both in 20–30%, unexplained in 10–15%.
- This distribution means male causes are as common or more common than female causes.
