Any person who is unable to reproduce is defined as “sterile” and if she is unable to carry a pregnancy to term as “infertile”; scientific categories that at a popular level were synonyms of: dry, machorra, barren, etc. and with the accusing finger always pointing to the same gender, the feminine.
The term sterility, scientifically referenced, appears in various treatises of the 17th century, such as De Sterilitate Utriusque Sexus (Jean Hucher, 1570-1630), Observations diverses sur la stérilité (Louise Bourgeois, 1564-1644), De Sterilitate (Martin Naboth 1675-1721). In recent times, however, the term infertile has come to prevail over sterile to define both situations. Regardless of academic categories and other considerations, the fact is that today these two terms (infertility and sterility) are obsolete, restrictive, poorly perceived by society and embarrassing for those who suffer from them. Moreover, they come from a time when being sterile was really sterile; that is, without any possibility of achieving offspring; quite the opposite of what is happening today. For example, at FIVMadrid more than 80% of infertile couples will be able to have offspring thanks to advances in reproductive medicine. In other words, there is a clear contradiction between the term (sterility/infertility) and the final result (pregnancy).
Therefore, is it not time to look for a new definition to replace them, one that is more in line with the results of reproductive medicine and less pejorative? Reproduction is an essential function through which other beings similar to themselves of the same species are originated. In order to exercise this function correctly, one must be fertile and, therefore, in cases where there is a deviation in the correct function of reproduction, we would be faced with a “reproductive dysfunction” or a being that is “infertile”. Thus, we have two terms to choose from to refer to and categorize our patients. One based on the origin of the problem, dysfunction, and the other on the result of the problem, infertility. In my opinion, the criteria to follow for the use of one (dysfunction) or the other (infertile) in daily clinical practice should be more important the knowledge and results that reproductive medicine offers us today and less the empiricism of the past.
Therefore, the most logical thing to do would be to tell patients that what they suffer from is a reproductive dysfunction (idiopathic, ovarian, tubal, uterine, immunological, etc.) and not infertility, which carries an emotional and pejorative burden and is more related to failure and disability to perform a function.
Impotence due to dysfunction
A very illustrative example of how the mood of patients can change in the face of a term that is verbally and socially shameful is that of erectile dysfunction. In this case, the advent of a revolutionary and effective treatment (sidelfanil) was accompanied by a terminological change (“impotence” for “dysfunction”), which not only raised the self-esteem of the patients who suffered from it, but also placed the pathology before society, family and friends in a natural light.
I hope, with the use of “reproductive dysfunction” instead of “infertility” there will be a substantial change in the attitudes and perceptions of sufferers and some of the society that observes and judges them.