Infertility is the inability of a married couple to reach a pregnancy after 1 year of contact without using contraception or the inability to sustain a pregnancy. Generally, couples need 5-6 months to get pregnant. But in some couples it can be faster than that. For most couples pregnancy occurs naturally within 1 year, however, 20% of couples have a different story, they keep trying and nothing happens or they reach pregnancy but have a miscarriage.

Infertility can be divided into two groups:

· Primary infertility, which is the state of infertility experienced by married couples since they are married.

· Secondary infertility, the condition of infertility experienced by married couples who have experienced conception after marriage

Some possible causes of infertility:

· 30% of infertility is caused by female factors

· 30% of infertility is due to male factors

· 30% of infertility is caused by both female and male factors

Up to 10% of infertility is caused by factors that cannot be explained

In general, infertility is related to physical conditions, processes and time:

1. Physical Conditions

Fertility is largely determined by the physical condition of the husband and wife. This is related to the process of formation and quality of sperm or eggs. Testes can produce 100-200 million cells per day or 1 trillion cells during life. Sperm maturation occurs approximately 70 days. In the female genital tract, sperm cells can live and fertilize eggs between 3-5 days. The ovary can produce 1 egg every month. If not fertilized, the egg will die and go down during menstruation.

The quality of sperm and eggs is influenced by many factors, including:

• · Naturally women experience menopause phase which usually occurs between the ages of 40-50 years. In this phase, the chances of getting offspring are smaller. In contrast to men, the andropause process, which is a decrease in the productive period, usually occurs at a very advanced age.
• · Some genetic disorders can affect fertility, especially those related to genital anatomy and the hormonal system in both husband and wife.
• Certain diseases, such as genital tract infections, varicoceles in men, ovarian cysts, uterine myomas in women, can inhibit pregnancy.
• Smoking and drinking alcohol is proven to reduce the quality of fertility.
• According to research, obesity can affect fertility. In women who are overweight there are abnormalities in the secretion of the gonadotropin hormone by the pituitary gland. This disorder ultimately affects the production of the hormones estrogen and progesterone
• · Work related to chemicals and high pollution can also reduce the quality of fertility.
• · Many studies have shown that stress can interfere with the quality and process of fertility.

2. Process

Occurrence of conception and pregnancy begins with the entry of sperm into the female genital tract and meet with the ovum or egg in the ovary (tubafalopii). The result of fertilization (embryo) is moved towards the uterus to develop in it.

The success of the pregnancy process is strongly influenced by several things:

· The method of contraception: The use of condoms in men or diaphragms in women does not allow the conception process.

· Some anatomic abnormalities, such as abnormalities in the uterus or other genital tract can interfere with the process of pregnancy.

· Diseases such as myoma uteri, not only obstruct the entry of sperm, but also cause the process of adhesions of the embryo in the uterus is disrupted Adhesions or closure of the fallopian tubes can occur due to infection and inflammation, or the growth of connective tissue.

3. Time

The egg is only produced once a month and its life is short. So that knowledge about the fertile period is very important.

To find out the fertile period can be done several ways:

· Calendar method. In using this method, it is necessary to know the menstrual cycle individually. An average woman’s menstruation occurs every 28-35 days. Ovulation occurs 14 days before the next estimated menstruation. In women with a 28-day cycle, ovulation occurs on the 14th day (the first day is counted when menstrual blood first comes out every month). In women with a 35 day cycle, ovulation occurs on the 21st day. This method is sometimes incorrect, because the estimated next menstruation may be missed.

· Body temperature measurement. Measurements were made using a thermometer in the mouth every morning, starting the first day of menstruation before carrying out activities. Ovulation occurs when there is an increase of 0.2-0.4 ° C from the average normal body temperature (36-37 ° C).

· Examination of uterine mucus or cervix. The examination is carried out in the morning after menstruation ends. The fertile period is shown by the presence of clear and elastic mucus in the external genitalia of women. This examination can not be done if the woman has just had sex

· Examination of the hormone LH (Luteinizing Hormone) Hormones that affect the process of ovulation. At the time of ovulation there is an increase in LH levels in the urine. This is one of the most accurate determinations. However, this examination can not be done at any time because it requires no small cost. In principle, an equal role for both husband and wife is needed. Extra patience is needed because the opportunity to get pregnant is only once during a one month period. In an effort to get a pregnancy, counseling is needed, especially for couples who have sexuality problems. For some cases, medical treatment is also needed. Another thing that is no less important is paying attention to the wife’s fertile period because having intercourse during the fertile period provides a greater opportunity to get pregnant. Business that is no less important is to consume balanced, healthy and nutritious food.