It is defined as the difficulty that a couple has to achieve pregnancy after a year of trying to maintain regular sexual relations. The limit established in one year of attempt is modified in cases of women over 35 years of age, or with a medical pathology that may lead to a worse reproductive prognosis (previous oncological processes, previous gynecological surgeries...), in which case it would be necessary to assess before.
It is a term that refers to those couples who achieve pregnancy, but in which it does not reach term, presenting recurrent pregnancy losses.
Both criteria are sufficient to be referred to a consultation for evaluation and reproductive advice, as well as indications for fertility preservation.
The basic fertility study consists of the evaluation of both members of the couple in cases of sterility, performing a gynecological and ultrasound examination of the woman, as well as a blood test for hormonal determinations and serology of sexually transmitted diseases, mandatory before carry out any reproductive process.
For the male, a seminogram will be requested, along with a blood test for serology as in the case of women. With this, it is intended to know the state of the ovarian reserve of the woman and the existence of a seminal sample suitable or not for one type of reproductive technique or another.
If the couple's prognosis is good after the basic study, a tubal permeability test will be performed to verify the integrity and permeability of the internal genital tract, and if so, the start of reproductive treatment will be chosen, if the couple so wishes. through artificial insemination.
In cases of infertility with women over 38 years of age, in cases of infertility with a diagnosis of severe male factor, tubal factor or after failure of artificial inseminations, reproductive treatment through In Vitro Fertilization will be considered.
In cases of women without a partner, or with a same-sex partner, wishing to become pregnant (with or without previous sterility), the same basic study described above will be carried out on the woman who is going to be the one to carry out the treatment and future pregnant woman. for women with infertility prior to the start of treatments.