Infertility is the failure to conceive after 12 months of regular intercourse without the use of a contraceptive method. A couple with a known cause of infertility, such as irregular or infrequent or painful menstruation or a known hormonal disorder or older female age >35 years, should not wait for more than 6 months before seeking help.
There are many lifestyle choices that may reduce the chances of conceiving. Some of these reduce the frequency of intercourse hence the chance for egg and sperm to meet. Some reduce the quality of eggs or sperm; or affect the ability of the uterus to receive an embryo.
The diagnosis can be made after the loss of two or more pregnancies. It is uncommon and occurs in about 1% to 2% of women. Although there are several known causes, the cause may not be obvious in up to 50% of women.
Cervical cerclage is a procedure in which a stitch is placed around the mouth of the womb (cervix) to help keep it closed and enable a pregnancy to go to term in women with a history suggestive of cervical insufficiency.
POI is the loss of ovarian activity before age 40y resulting in the disappearance of menstruation for more than 4 months and symptoms of low estrogen levels. It occurs in 1-3% of women.