Natural fertility in the context of assisted reproduction

Every 5th-7th couple experiences times of involuntary childlessness. After 6 months without conception subfertility has to be assumed. In the case of unexplained subfertility the chance of spontaneous conception is relatively high over longer time periods of expectant management. But this is inappropriate for women aged over 35 years. An early shift to assisted reproduction technology (ART) provides significantly higher cumulative life birth rates; for this reason expectant management should no longer be offered to women aged over 32 years. Even after repeated, failed ART cycles every second couple can hope for a live birth, 70% of which will result from continuing ART and 20% from natural conception. Couples trying to conceive should be informed that disorders such as minor diseases, stress or sexual intercourse during the implantation period do not interfere with conception