Failure of conception can be heartbreaking for couples as their lives are put on hold with every passing month reinforcing the fear that they may never be parents. Myriad emotions ranging from anxiety, guilt, fear, shame and anger shroud the lives of couples struggling to conceive. In many communities, the demand to have children is instilled at a very early age, often with a sense of urgency from those who will remind you that the 'clock is ticking'. It is imperative to bear these factors in mind when a patient or a couple consults you for sub-fertility. Eighty percent of couples with no obvious problems and with the woman under the age of 40 years will conceive within 1 year and about 90% will conceive by 2 years. Approximately 50% of fertility problems are related to the female partner, and 25% to the male partner. In the remaining 25% of cases, the cause of sub-fertility remains unexplained.
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