History and epidemiology of human fertility

The history of human fertility spans the history of mankind. It started with the discovery of the fact that sexual intercourse leads to pregnancy and childbirth and continued to evolve along the centuries. In antiquity, fertility was thought to be the act of gods, but slowly with the advance and emancipation of the human mind, the mysteries of fertility started to evolve one after the other. The invention of observation tools and the start of experimentation were an integral part of the Renaissance and led to the discovery of spermatozoa, oocytes, and fertilization. Further developments were achieved during the following two centuries, but it was the beginning of the 20th century that marked a rapid evolution of our understanding of human fertility with the discovery of the phases of the menstrual cycle, ovulation, and the hormonal interaction controlling these events. Progress continued and culminated in the IVF and ICSI revolutions toward the end of the 20th century, making the dream of a healthy child achievable for almost all infertile couples who can have access to fertility services. Epidemiological studies have shown that 9% of couples are infertile both in the developed and developing worlds and that there are at least 72 million infertile couples in the world; only 50% of them seek medical advice, and only 25% receive the services.