Approach to the infertile couple

The approach to the infertile couple is a complex process that requires sensitivity, medical precision and a comprehensive vision. Infertility is an increasingly present reality in the population: according to the World Health Organization, 1 in 6 people of reproductive age face difficulties conceiving. Given this scenario, the objective is not only to achieve a pregnancy, but to accompany the couple until they achieve the most important thing: the birth of a healthy baby. Understanding the causes, risk factors and the diagnostic process is essential to initiate adequate treatment and improve reproductive prognosis. Therefore, the approach must be carried out simultaneously on both members of the couple, always with humane and specialized attention.

Infertility has become a growing condition.

Infertility is defined as the inability to achieve a clinical pregnancy. after 12 months of regular unprotected sexual relations. In women over 35 years of age, the study should be started after 6 months due to the natural decrease in ovarian reserve.

In Mexico, the Global Fertility Rate has decreased to 1.9 children per woman (INEGI 2021), reflecting demographic changes and an increase in cases of infertility, both female and male.

What are the most frequent causes in the treatment of infertile couples?

Infertility can be due to female, male or mixed factors:

Female factors (40–50%)

Ovulatory disorders, including Polycystic Ovary Syndrome (PCOS).
Tubal problems secondary to infections or endometriosis.
Alterations in the uterus or cervix, such as fibroids or malformations.
Endocrine disorders: insulin resistance, thyroid dysfunction, hyperprolactinemia.
Low reservation ovarian, evaluated by AMH, FSH and antral follicle count.

Male factors (30–40%)

Alterations in the concentration, mobility or morphology of sperm.
Surgical history, exposure to heat, toxins or infections.
Spermatobioscopy is the initial test to identify alterations in semen.

Idiopathic infertility (10–20%)

It occurs when a clear cause cannot be identified after a complete study.

What is the importance of time in fertility?

Time is a critical factor in the approach to the infertile couple, since the chances of pregnancy decrease as the months of unsuccessful search pass.

In healthy couples under 35 years of age:

20% achieve the pregnancy in one month
70% in 6 months
90% in one year

When there is some factor of infertility, the probabilities drop to approximately 48% in one year, which is why a timely evaluation is recommended.

When to start the infertility study?

It is recommended to start the approach when:

before the age of 35: after 12 months without achieving pregnancy.
after the age of 35: after 6 months.
Immediately if exists:
- Endometriosis
- Menstrual disorders
- Uterine or tubal disease
- Thyroid disorders
- Suspicion of male factor

An early diagnosis reduces the emotional burden and allows the most appropriate treatment to begin.

A complete clinical evaluation is the essential first step.

The clinical history is a fundamental tool in the approach to the infertile couple. Must include:

Weight, height, BMI and visible hormonal changes (acne, hirsutism, galactorrhea).
Menstrual rhythm, surgical history and previous illnesses.
Exposure to toxic substances or medications that affect fertility.
A good initial assessment avoids unnecessary studies and guides the medical team towards the most probable cause.

The approach to the infertile couple is a process that requires experience, empathy and a deep analysis of the factors that affect fertility. With an adequate assessment, a timely diagnosis and a specialized team, it is possible to increase the chances of achieving a healthy pregnancy and fulfilling the dream of starting a family. At Advanced Fertility Center Cancún we have a team of specialists who will provide you with the professional and human service that you deserve. Now that we have shared a little information about approaching the infertile couple. We would like to know what other questions or concerns you may have about Advanced Fertility Center Cancún that you would like our medical team to resolve. You can share them in the comments. What other topics would you like us to talk about on our blog? Please write them in the comments below! If you want to know our clinic, you can contact us here: