Fertility is the natural capability of producing offspring. The human oocytes pass through a long process of folliculogenesis that commences in the intrauterine life and continue throughout puberty and reproductive age until the follicle pool is depleted and menopause ensue. Puberty follows maturation of the hypothalamic-pituitary-ovarian axis, which is the corner stone of female reproduction. In addition, an intact functioning genital tract is essential for natural conception. Female fertility is affected by a variety of factors including chronological age, ovarian reserve, life style and environmental factors. Fertility is a word used to describe the couple’s and not the individual’s reproductive ability. A subfertile couple should therefore be seen and investigated together. Investigations include semen analysis, assessment of ovulation and ovarian reserve, Chlamydia screening and assessment of Fallopian tubes patency. In this chapter we are going to discuss physiology of female reproduction, factors affecting fertility in women, prognosis and investigation of subfertility in women. The detailed management of infertility is outside the scope of this chapter.
Keywords: fertility, fecundity, reproduction, subfertility, ovulation, endometriosis
