The work of Max Huhner on postcoital examination marked the beginning of that interest in the problem of human infertility which has continued without interruption during the past twenty-three years. From the earliest recorded times the childless marriage has been a major problem both for the individual and for society; but only since the beginning of the present century has genuine progress been made toward the correction of this maladjustment.
All recent advances in the diagnosis and treatment of sterility are based on a better understanding of its etiology. These new ideas may be reduced to three fundamental principles.
First, in the great majority of cases of human infertility the cause of that defect is not some single abnormality but rather the summation or totality of several factors. Complete diagnostic studies show that the average childless couple presents 4.79 factors, each of which diminishes to some extent their capacity for