What is fertility?
Fertility is the ability to conceive. The crucial step of this process is known as fertilisation — an egg is released from the ovary and is picked by the Fallopian tube. The egg then travels along the Fallopian tube where, at some point, it is penetrated by the sperm to form a single cell. The fertilised egg takes three days to travel to the uterus (womb), and during this time the cells continue dividing. The fertilised egg, now known as an embryo, implants itself in the endometrium (lining of the womb). About one in seven couples living in the western world have problems conceiving.
How long should the couple try naturally before seeking advice?
94% of couples who have regular unprotected sexual intercourse (2 to 3 times a week) conceive within two years of trying. The chance of getting pregnant in any one month is 20%, but this declines with the female age. In every 100 couples:
- 20 will conceive within one month
- 70 will conceive within six months
- 85 will conceive within a year
- 90 will conceive within eighteen months
- 94 will conceive within two years.
Normal couples who are not aware of any medical problems that can affect their chance to conceive naturally and where the female partner is younger than 35 years old are advised to try for a minimum of one year before seeking medical advice. If unsuccessful, couples should seek advice from their GP or fertility specialist, who normally starts simple tests for fertility.
Five important things you can do to protect your fertility
1. Eat a healthy, well balanced and varied diet
2. Keep fit and watch your weight. Check with your practice nurse if your weight is average or if you are under or over weight
3. Avoid excessive alcohol (>3-4 units/week for women or > 12 units/week for men)
4. Quit smoking
5. Prevent sexually transmitted infections
What is infertility?
Infertility means being unable to conceive after hvaing regular unprotected sexual intercourse for more than two years, in the absence of known reproductive disease. There are two types of couple infertility: Primary infertility — couples who are unable to conceive and have never achieved a pregnancy. Secondary infertility — couples who after having had one or more pregnancies are unable to conceive.
What are the causes of infertility?
- The ovaries are not releasing eggs (anovulation) or the eggs are immature
- Uterine abnormalities
- The fallopian tubes are damaged or blocked or absent (for example after surgery for an ectopic pregnancy)
- The lining of the womb does not develop properly
- Hormone problems
- Sex-related problems (difficulty getting an erection or ejaculating)
- Retrograde ejaculation (sperm travels backwards to the bladder)
- The tubes that carry the sperm are damaged or blocked or absent
- Testicular failure
- Drug treatment
Who and when to investigate
Couples who have not conceived after 1 year of regular unprotected sexual intercourse should be investigated. Also, couples who have a known cause of infertility, have predisposing factors, or where a woman is aged 35 years or over should be offered early investigations and if necessary referred to an assisted conception centre.