There is considerable heterogeneity in human fecundity as evidence by varying time-to-pregnancies and a high incidence of pregnancy loss, particularly during the post-conception and implantation sensitive windows. Behavior is an important aspect of human fecundity as conception requires sexual intercourse timed to ovulation, and loss requires recognition of pregnancy. This chapter reviews the epidemiology of fecundity impairments such as conception delay, pregnancy loss and infertility while discussing methodologic nuances that underlie epidemiologic study and approaches for developing strong analytic approaches for study. The implications of fecundity impairments for gynecologic and urologic health and later onset diseases are also discussed in support of the ovarian and testicular dysgenesis hypotheses, which purport an early origin for fecundity impairments.
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