Infertility is perhaps one of the most stressful experiences a couple can go through. Infertility is defined by the failure to conceive following twelve months of unprotected intercourse. Global estimates of infertility range between 8 and 12% of couples with women of childbearing age (WHO).
After 12 months of trying for a baby couples can seek assistance. The chance of spontaneously conceiving is about 80-85% at 12 months and 90-95% at 24 months, so most people will fall pregnant with time. When the woman is over 35 years of age or if there have been previous fertility issues or a history suggesting endometriosis, we should start investigating after 6 months.
There can be male factors in 30% of cases, female factors in 35% of cases and in 35% of cases it is “unexplained”. Unexplained infertility is when we are not able to find a specific cause of the infertility. It is not uncommon that there are both male and female factors present. One of the most important factors in infertility is the woman’s age. Unfortunately fertility declines with age, regardless of how fit and well you are. Women are born with a set number of eggs, and both the number and the quality of the eggs decline with age. The chance of a spontaneous pregnancy declines, and unfortunately the risk of a miscarriage or other abnormalities with the baby increases.
When we start investigating for a potential cause for the inability to fall pregnant, we can test the following:
- quality of the sperm (semen analysis)
- whether there is ovulation
- whether the tubes are open, so the egg and the sperm can meet
- whether there is a good reserve of eggs
- whether there is good implantation of the embryo
While being tested for any potential causes of the infertility it is important to look after your general health by eating a healthy diet, having regular exercise, stop smoking, avoid excess of alcohol and take folic acid. Some couples might find they need extra help through counselling to help them with all the challenges they face when dealing with infertility and the infertility investigations and treatment.