The inability of many married couples to have children may be due to the husband or the wife, or both, owing to a variety of conditions, among which many may be described under the term infertility. There may be genetic or pathological sterility, or in the case of the male, impotence and related conditions resulting in the inability to naturally introduce sperm into the female. Male sterility is not uncommon. When it is not responsive to treatment, the couple wishing for the wife to conceive may resort to the use of a surrogate father or artificial insemination. Female infertility may be a feature of age, or a sexually transmitted diseases, such as gonorrhoea or chlamydia, which has lead to a blocked fallopian tube.
When the female is infertile, the problem of inducing conception is addressed by a number of remedial approaches ranging from pharmaceutical treatments and microsurgery, to transferring fertilized embryos from one woman to another or from test-tube or in vitro cultivation. There is also the resort to the use of a surrogate mother. Human breeding problems thus give rise to commercial services such as sperm banks, egg banks, surrogates and their agents, and embryo transfer services. Infertility is particularly hard on women, for whom it attaches as a stigma, and may result in their being ostracized, abandoned, or divorced. Stress on the infertile young married female may lead to mental illness and suicide.
Infertile couples, unable to have one child or unable to have additional children, number in the tens of millions world-wide. In the USA alone, the number is estimated at 3 million. It is estimated that infertility affects 15 percent of couples of childbearing age, and male infertility is responsible in about half of the cases. Infertility remains one of the major unsolved health care problems. The demand for services due to infertility problems has risen markedly in recent years. Couples spend millions of dollars annually on treatments that may work only in a small percentage of cases.