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Infertility Information

 

Although the number of couples who are unable to have a child is considerable, infertility remains a personal issue. The suffering and despair which infertility may bring to an otherwise perfect relationship is substantial. Couples who are infertile turn to their family doctor for advice and guidance - and sometimes to the specialist for dedicated infertility treatment.

A modern infertility clinic offers a wide range of advanced treatments which are both difficult to comprehend and (sometimes) worrying. And there are other important considerations too - the costs, the time required for infertility treatment, the disappointments, the anxieties. They all raise questions which few of us are able to answer in any simple or immediate way, and they all require the advice of an infertility specialist - particularly about the most suitable form of infertility treatment and the likelihood of success.

The choice of one particular procedure will depend on the type (or cause) of infertility which investigations reveal. But all infertility treatments have one thing in common - the ability to give nature a helping hand, to prepare eggs and sperm so that they have a much better chance of fusing and fertilizing to form an embryo and eventually a healthy pregnancy in the womb. For this reason, these infertility treatment techniques are collectively known as 'assisted conception'.

 

The scale of the infertility problem

A normal fertile couple in their mid-20s having regular sex have a one in four chance of conceiving each month. This means that around nine out of ten couples trying for a baby will conceive within a year. However, one in ten will not - and these couples are either subfertile or infertile. (In these pages, as in everyday life, the term 'infertility' will be used to describe both.)

Infertility is usually defined by doctors as the inability to conceive after at least one year of trying. However, many 'infertile' couples can be helped by assisted-conception treatments.

Before couples embark on assisted conception there are other investigations and treatments which might also help; furthermore, many patients once enrolled in infertility programmes find they do become pregnant naturally, despite many years of trying.

 

Assessing the causes of infertility

Investigations carried out by a family doctor or specialist clinic can provide the likely cause of infertility in most cases. Only around 20 per cent remain unexplained - and even then treatment can be successful. The female partner is responsible for a couple's infertility in around 40 per cent of cases, and the male partner in a further 40 per cent. The tests required to determine a specific cause will assess ovulation, the quality of the fallopian tubes, and hormone levels in women; and sperm production (numbers, movement and shape) in men.

 

Male infertility: the causes

Low sperm count; normally, men produce at least 20 million sperms per millilitre of semen (that's around one sixth of the total ejaculate); fewer is judged to be subfertile Poor sperm motility; sperms will then be unable to swim through the cervix to meet the egg in the fallopian tube Poor shape (known as 'morphology'), so that an individual sperm is unable to penetrate the outer layer of an egg Non-production of sperm (because of testicular failure) or complete absence of sperm (perhaps because of an obstruction) Coital difficulties; perhaps because of ejaculatory failure or impotence

 

Female infertility: the causes

Hormonal disorders; as a result, egg follicles might not grow within the ovary, or an egg might not be released (ovulation) Read more about the polycystic ovary syndrome.
Damaged or blocked fallopian tubes, which will prevent an egg and sperm meeting
Endometriosis, in which womb tissue invades and damages neighbouring reproductive tissue
Excessively thick cervical mucus, which prevents sperm passing through

Assisted conception may help most (though not all) of these conditions, and there is evidence that repeated cycles of infertility treatment can restore fertility to near normal levels.

HOW LIFESTYLE CAN CAUSE INFERTILITY

Personal habits which might affect your fertility or lifestyle factors may impact your health and, thus, affect your ability to conceive. Many of these factors can be regulated to increase overall health and improve your chances of conceiving:

Other Infertility Factors:

Diet and Exercise: Proper diet and exercise are important for optimal reproductive functioning. Women who are significantly overweight or underweight may have difficulty getting pregnant.

Smoking: Cigarette smoking may affect sperm count in men. In women, it may increase the risk of miscarriage, premature birth and low-birth-weight babies.

Alcohol: Alcohol intake can impact sperm counts in men. In women, it may contribute to an increased risk of babies born with birth defects.

Medications: A number of medications, including some of those used to treat ulcers and high blood pressure, can influence a man's sperm count and libido sex drive.

Drugs: Drugs, such as marijuana and anabolic steroids, may affect sperm counts in men. Cocaine use in pregnant women may increase the risk of kidney problems in the baby.

Caffeine: Caffeine may impact a woman's fertility and may increase the risk of miscarriage. However, there is no clear understanding of what amount affects fertility.

Lubricants: A number of products used for lubrication during intercourse, such as petroleum jelly or vaginal creams, have been shown to affect sperm quality and should be avoided if you are trying to conceive.

In some cases, environmental and occupational exposure to chemicals or toxins may impact the ability to conceive. Although there is considerable controversy about the effect of toxins on fertility, four chemicals are now regulated, based in part on their documented effects on human reproduction.

Other Infertility Factors:

Lead: Exposure to lead has been shown to impact fertility in humans. Individuals working with paints/varnishes and auto manufacturing may be at risk.

Medical Treatments and Materials: Repeated exposure to sources of radiation, such as x-rays and cancer treatments (e.g., chemotherapy), have been shown to affect sperm production and contribute to ovarian problems.

Ethylene Oxide: Exposure to ethylene oxide, a chemical used in the sterilization of surgical instruments and in the manufacturing of certain pesticides, may cause birth defects in early pregnancy. It also has the potential to cause early miscarriage.

Dibromochloropropane (DBCP): Handling the toxins found in pesticides, such as DBCP, may lead to ovarian problems in women, possibly leading to early menopause.

Other Environmental Factors: Certain substances found in the chemical and waste material industries and in paper manufacturing, have been associated with a high risk of reproductive problems.

 

 

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