Understanding the problem
Understanding the problem
Infertility is the term used when a couple is having difficulty conceiving a baby despite having regular unprotected sex. According to the NHS, around one in seven couples have difficulty conceiving – that’s approximately 3.5 million people in the UK.
For every 100 couples trying to have a baby, 20 will conceive within one month, 70 within six months, 84 within a year and 95 within two years. However, for couples who have been unsuccessfully trying for more than three years, the likelihood of getting pregnant within the next 12 months is 25 per cent or less.
Infertility can be caused by many different factors. In general, about a third of infertility cases can be linked to a problem with the woman and another third to problems with the male partner. In some cases, multiple factors may be to blame, or an exact cause may never be identified.
Infertility in women
In women, infertility is most commonly linked to problems with ovulation. Common hormonal causes preventing ovulating include:
- Polycystic ovary syndrome, where hormonal imbalances interfere with normal ovulation
- Primary ovarian insufficiency (early menopause) when a woman’s ovaries stop working, normally before she is 40 years of age
- Thyroid problems.
Some women suffer from blocked fallopian tubes as a result of pelvic inflammatory disease or a previous ectopic pregnancy, and some sexually transmitted infections (STIs) such as chlamydia can also affect the fallopian tubes. There may also be physical problems with the uterus, the presence of fibroids – non-cancerous clumps of tissue on the walls of the uterus – or endometriosis where tissue similar to the lining of the womb grows in other places such as the ovaries or fallopian tubes.
Infertility in men
Male infertility is usually linked to a low sperm count, reduced sperm mobility and/or a high percentage of abnormal sperm. Any condition that affects or damages the testicles, such as mumps or STIs such as gonorrhoea, can also cause problems such as abnormally low levels of the male sex hormone testosterone.
Lifestyle factors and fertility
Being overweight or obese reduces male and female fertility and, in women, being significantly underweight can affect regular ovulation. Women who undertake rigorous athletic training may experience irregular periods.
Too much alcohol can damage the quality of a man’s sperm, therefore decreasing the chance of fertilisation, and can also decrease a woman’s fertility. Couples should follow the chief medical officers’ guidelines and limit their alcohol intake. The safest approach for women is to not drink alcohol at all, and men should not exceed 14 units per week, ensuring they have at least two alcohol-free days. Research suggests that smoking may also adversely affect fertility in both men and women, and support to quit smoking should be offered to all couples hoping to conceive.
Day-to-day stresses can contribute to the loss of libido (sex drive) and, in severe cases, can even affect ovulation and fertility.
Some prescribed medication, such as those administered during chemotherapy, can affect ovulation and sperm production. In women, antipsychotic medicines can sometimes cause missed periods, while in men, long-term use of anabolic steroids can affect sperm count and mobility. Illegal drugs also have detrimental effects.
Exposure to hazardous chemicals can cause fertility issues.