Infertility is a common condition that affects many couples, with important psychological and medical implications.
The presentation will be as per the definition. There may be physical sign such as physical habitus that is suggestive of a genetic cause such as Turner syndrom or Klinefelter syndrome. Or vague abdominal symptoms in endometriosis. Most other causes are asymptomatic. There may be obvious complaints such as amenorrhea (primary or secondary) so a detailed sexual development history is required for both partners .
A comprehensive history and examination is key to the initial assessment for women:
The treatment is dependent on the identified cause of the infertility by various procedures and medications. In vitro fertilization may be of use or more advance techniques such as oocyte donation or surrogacy .
The prognosis depends on the cause of infertility. With the advent of in vitro fertilization may be aided. Other procedures such as oocyte donation of surrogacy may be required depending on the problem. There also has been uterine transplantation to aid infertility.
With the increase in family planning and increased women career development, many women postpone child bearing to beyond 30 years of age, as a result their chances of conceiving are decreased because the fecundability rates are lower at these ages.
Reproduction requires that the male and female reproductive tracts be intact with normal oocyte and normal spermatozoa. The transport of the egg has to be adequate into the fallopian tube where fertilization occurs and then proper implantation into the endometrium  .
With infertility there are:
Up to 10% of couples of reproductive age are infertile. The prevalence increases with age with women between 15 and 34 having a prevalence of 8% and 35 to 39 being 25%. Male factors listed above account for 26% of the causes of infertility, cervical factors account for 3%, coital problems 6% and endometriosis 6% and tubal damage 14%  .
For the genetic causes, there is little to prevent, but for the acquired causes such as infections causing infertility (usually sexually transmitted), protected sex is mandatory unless both partners have been cleared for possible infections.
Infertility is the failure to conceive after 1 year of frequent unprotected intercourse in women less than 35 years of age and for woman who are 35 years or older the time cut off is 6 months. The infertility may be due to a single cause or multiple factors. There have been many new developments that can improve chances of conceiving.
Other term that need to be defined include fecundability which the chance of getting pregnant each month and fecundity, which is the ability to achieve a live birth from one menstrual cycle. The general fecundability rate is about 0.22 to 0.25 and the fecundity rate is 0.15 to 0.18 per month.