Question

The National Institute of Health and Care Excellence definition of Infertility is:
A. Failure to conceive at a time of one’s choosing
B. Failure to conceive for a period of two years
C. Failure to conceive after frequent unprotected sexual intercourse for one to two years in couples in the reproductive age group
D. Failure to conceive after frequent unprotected sexual intercourse for ten years in couples in the reproductive age group

Answer 1

Hint: Infertility is established when a couple has tried to conceive via sexual intercourse without using any reproductive contraceptives. Conception refers to the process of conceiving a foetus and becoming pregnant after fertilization and implantation.

Complete answer: According to the National Institute of Health and Care Excellence (NICE), the definition of infertility is “Failure to conceive after frequent unprotected sexual intercourse for one to two years in couples in the reproductive age group”
Now, fertilization is the process of fusion of male and female gametes, which in the case of humans are ovum and male sperm nuclei. Fertilization involves the fusion of male sperm nuclei to female egg nuclei. Fertilization occurs in the female genital tract and to be more specific, it occurs in fallopian tubes in the female uterus. Implantation is the process of attachment of the embryo to proliferated endothelium in the mother’s uterus. After these two processes are complete, then only we can call a female pregnant or that she has conceived her child.
The second term in the statement is “unprotected sexual intercourse” which we will now understand, unprotected sexual intercourse refers to having sexual intercourse without the use of any reproductive contraceptives. A reproductive contraceptive is a substance that is used to hinder fertilization and examples are condoms, diaphragms, oral contraceptive pills, etc. Without the use of reproductive contraceptives, there is no artificial barrier to prevent fertilization. A couple is advised to have frequent unprotected intercourse for a year or two in case of difficulty in conception as this time period gives a chance for a natural method of pregnancy. The couple should however be in the reproductive age group as then the chances of conception are greater due to active and functioning reproductive organs.
Now, considering the options:
Option A: A time of one’s choosing is not a definitive and confirmatory way to conceive as the ovulation cycle needs to be taken into consideration when trying to conceive. A female can effectively conceive during her fertility period which is when a female is most likely to ovulate and hence conceive.
Option B: Failure to conceive for a period of two years does not specify the age, manner, and frequency of the intercourse of a couple.
Option C: Here, frequent sexual intercourse which has unprotected meaning without use of contraception is specified, and moreover, the couple is of reproductive age and has been trying for one or two years which is all the information we need to consider a couple fit for the definition of infertility.
Option D: Ten years is a very long period of time in which the reproductive ages of the couple may pass too.
Hence, the correct answer is C.

Note: The requirements for a successful pregnancy:
1. No contraceptives should be used
2. Frequent sexual intercourse in sync in the fertility period of the female
3. One to two years of the time period
4. The couple should be in the reproductive age group