Sixty percent of couples become pregnant within 3 months, but if attempts at impreg­nation are unsuccessful after 6 months, a couple should consult a physician. It has been estimated that about 12% of U. S. couples attempting pregnancy experience fer­tility problems, defined as not conceiving after at least 1 year (Bell et al., 2012; Han­non, 2009). Because approximately 40% of infertility cases involve male factors (20% involve both male and female factors), it is important that both partners be evaluated (Rabin, 2007a). We usually think of infertility as the inability to conceive any children, but secondary infertility—the inability to conceive a second child—occurs in 10% of couples (Diamond et al., 1999).

Infertility is a complex and distressing problem (Greil et al., 2011). It can have a demoralizing effect on the infertile individual’s sense of self and on the couple’s sense of their integrity as a healthy unit (Galhardo et al., 2011; Wischmann et al., 2009). Its causes are sometimes difficult to determine and remain unidentified in many cases. However, between 85% and 90% of infertility cases can be treated with drug therapy or surgical procedures (Hannon, 2009).