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Fifty years ago, infertility was a nonissue, as the topic was not discussed socially and little was known about it scientifically. Now, however, there are countless media reports, more infertile women in the population, and a larger proportion of infertile couples seeking treatment in a fertility industry that is estimated at $3 billion annually. Although infertility is now an issue, it does not come without controversy. The first segment explains how infertility is differently defined, some major causes of infertility, women's personal responses to infertility, and the available medical treatments and their success rates. The next section discusses bioevolutionary and social/cultural theories of motherhood as they pertain to infertility, and ends with some larger societal implications of fertility treatments for motherhood.

In the United States, rates of involuntary childlessness are reported to be increasing, with 2002 reports from the Centers for Disease Control and Prevention (CDC) showing that 7.4 percent of married women experienced infertility. By 2007, it was reported that one in seven men and women experience infertility. Infertility is also a problem of global proportions, and the industry reflects the unequal distribution of wealth around the world. Infertility affects on average 8–12 percent of couples worldwide, yet the numbers may not represent the entire world because infertility problems are underreported in developing countries due to the focus on perceived overpopulation problems. Fertility treatment services are available in developed countries and services cross borders, as sperm can be ordered from several developed countries. Further, one can hire the services of surrogate mothers in India. Recent reports show that today's failing global economy is increasing the sales of surrogacy.

Definition

Defining the existence and legitimacy of any medical condition can become contested terrain. There are some competing medical definitions for infertility, which highlight the tensions between the desire to produce a more accurate diagnosis and the current capabilities of diagnostic tests and treatments. Most definitions assume heterosexuality, with one classification having wide acceptance by the medical industry: a couple is considered infertile if neither spouse is surgically sterile, they have correctly timed sexual intercourse, have not used contraception, and have not conceived during the past 12 months or longer. This definition is contested by those who believe that the availability of for-profit fertility treatments has created the one-year time frame, which sometimes even cuts the time to six months.

The World Health Organization defines infertility if a child is not conceived after two years of unprotected sexual intercourse with the same partner. This definition is backed by a 2004 finding by the National Collaborating Centre for Women's and Children's Health that states that under normal conditions, about 84 percent of couples in the general population will conceive within one year if they do not use contraception. Of those who do not conceive in the first year, half will do so in the second year. Moreover, 94 percent of women over 35, and 77 percent of those over 38, will conceive after three years of trying. Some believe that if a waiting period of two years of unprotected sex was required before turning to assisted reproductive technologies, many people would be spared the heavy emotional, physical, and financial stresses of a process that often poses health risks and a low success rate.

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