Physical difficulty in either getting pregnant or carrying a pregnancy to live birth is called impaired fecundity. In other words, it is a measure of infertility mostly described as a physical inability to have a child. It encompasses both infertility (i.e. difficulty with conceiving a pregnancy) and difficulty with carrying a pregnancy to term, as with recurrent pregnancy loss.

According to BabyMed (2017), the US Census Bureau noted a reduction in population growth due to an increase in impaired fecundity and infertility. At the current rate of increase, in just 70 years, nearly 1/3 of the female population will have impaired fecundity or infertility. By 2150, that number could jump to 50% of the female population.

Three main categories of fecundity status are;

  1. Surgical Sterility- Women are classified as surgically sterile if they (or their current husband or cohabiting partner) had an irreversible sterilizing operation, for example, a tubal sterilization, hysterectomy (surgical removal of all of or part of the uterus), or vasectomy (surgical removal of the vas deferens in men). The category is further divided into contraceptive and non-contraceptive subcategories, based on the reasons reported for the sterilizing operation.
  2. Non-surgical Sterility- This is for women who have not reported any sterilization operations for themselves or their current husband or cohabiting partner.
  3. Long interval without conception (or 36-month infertility) – It applies to women not already classified as surgically sterile, non-surgically sterile, or subfecund. It could be defined as having a ‘‘long interval without conception’’ if they had been continuously married or cohabiting, are sexually active in each month, had not used contraception, and had not had a pregnancy for 36 consecutive months or longer

Factors that can increase the risk of impaired fecundity are;

  1. Depression
  2. Smoking
  3. Surgery
  4. Older age
  5. Excessive alcohol use
  6. Being severely over or underweight
  7. History of sexually transmitted infections
  8. Certain health conditions such as polycystic ovarian syndrome (PCOS) which can interfere with ovulation.
  9. Fallopian tube problems.

Ways to prevent impaired fecundity include;

  1. Early detection and medical intervention
  2. Adopting healthy behaviors (such as eating healthy diets and physical exercise) changes that promotes fertility
  3. Decreasing environmental and occupational threats to fertility

Impaired fecundity is diagnosed by a fertility specialist and obstetrician based on the three categories listed above

Impaired fecundity is treated in much the same way as infertility.

If it is associated with carrying the fetus in utero, the reason for miscarriage is sought for. The higher the number of miscarriages, the lower the chance of future birth. In some cases, women are forced to stay in bed for the duration of the gestation in order to keep pressure off of the cervix if a lax cervix is the cause of the miscarriage.

For a female having trouble conceiving, lifestyle changes will be suggested before an official diagnosis of infertility can be made. If after one year, the couple remains unable to conceive, they will no longer be diagnosed with impaired fecundity but infertility.

Compiled by: Victoria Haruna, BSc. (Biochem), MPH (Health Promotion and education)

Reference

  1. Anjani Chandra, Casey E Copen and Elizabeth Hervey Stephen; Infertility and impaired fecundity in the United States, 1982-2010: Data from the National Survey of Family Growth. National Health Statistics Reports. 2013
  2. BabyMed; What is Impaired Fecundity? Retrieved 2017
  3. Crawford S, Smith RA, Kuwabara SA and Grigorescu V; Risks Factors and Treatment Use Related to Infertility and Impaired Fecundity Among Reproductive-Aged Women. J Womens Health (Larchmt). 2017 Feb 10. doi: 10.1089/jwh.2016.6052. [Epub ahead of print]
  4. Duron S, Slama R, Ducot B, Bohet A, Sorensen DN, Keiding N, Moreau C and Bouyer J.Hum Cumulative incidence rate of medical consultation for fecundity problems–analysis of a prevalent cohort using competing risks. 2013 Oct; 28(10):2872-9. Epub 2013 Jul 9.
  5. Meng Q, Ren A, Zhang L, Liu J, Li Z, Yang Y, Li R and Ma L; Incidence of infertility and risk factors of impaired fecundity among newly married couples in a Chinese population. Reprod Biomed Online.2015 Jan;30(1):92-100. doi: 10.1016/j.rbmo.2014.10.002. Epub 2014 Oct 13.