A normal fertile couple in their mid-20s having regular sex has a one in four chance of conceiving each month. This means that around nine out of ten couples trying for a baby will conceive within a year. However, one in ten will not - and these couples are either subfertile or infertile. Infertility is usually defined by fertility specialists as the inability to conceive after at least one year of trying. However, many 'infertile' couples can be helped by assisted-conception treatments.
Causes of Male Infertility

Low sperm count; normally, men produce at least 20 million sperms per milliliter of semen (that's around one sixth of the total ejaculate); fewer is judged to be subfertile.
Poor sperm motility; sperms will then be unable to swim through the cervix to meet the egg in the fallopian tube.
Poor shape (known as 'morphology'), so that an individual sperm is unable to penetrate the outer layer of an egg.
Non-production of sperm. (because of testicular failure) or complete absence of sperm (perhaps because of an obstruction)

Causes of Female Infertility

Hormonal disorders; as a result, egg follicles might not grow within the ovary, or an egg might not be released (ovulation).
Damaged or blocked fallopian tubes, which will prevent an egg and sperm meeting.
Endometriosis, in which womb tissue invades and damages neighbouring reproductive tissue.
Excessively thick cervical mucus, which prevents sperm passing through.
Assisted conception may help most (though not all) of these conditions, and there is evidence that repeated cycles of treatment can restore fertility to near normal levels.

Assisted Conception

Assisted conception is not usually a first resort in the treatment of infertility. Other options such as advice on the timing of intercourse may have been tried first. In fact, the treatment route, which a doctor chooses will mainly depend on the result of investigations. For example, fertility drugs with timed intercourse will be no help to a couple whose infertility is a result of the female's blocked fallopian tubes; only surgical repair or assisted conception will help in this case.

In Vitro Fertilization (IVF)

IVF is the original 'test-tube baby' technique, and probably the most widely practiced assisted-conception procedure in the world. In simple terms, IVF removes several eggs from the ovary, fertilizes them in the laboratory with sperm from the male partner and transfers a small selection of the resulting embryos to the womb for implantation and pregnancy. Although IVF was developed to treat couples whose principal cause of infertility is tubal damage, the technique has also been found useful in those with endometriosis, sperm disorders (poor sperm counts or morphology) and even unexplained infertility.

Steps in IVF

Drug treatment, to stimulate several eggs to mature.
Monitoring of treatment, to measure the growth of follicles, individualize drug doses and prevent serious side effects.
Egg collection, usually under local anaesthetic, lasts between 10 and 20 minutes.
Sperm sample, provided on the same day as egg collection.
Fertilization.
Embryo transfer (usually two or three days after fertilization).
Pregnancy testing/monitoring.

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