There can be several reasons why it may take a while for a couple to conceive, which are listed below:
Causes of female infertility:
- Ovarian disorders: there are a number of different ovarian conditions which can reduce fertility; the most common illnesses are PCOS (polycystic ovary syndrome), ovarian cancer and premature ovarian failure (this occurs when the ovaries cease to function a lot earlier than they should, before the age of forty). Less common conditions include Cushing’s syndrome; this is a hormonal condition that stops the ovaries from releasing the eggs.
- Age: women become less fertile as they age, with the chances of conceiving a baby significantly lower after the age of 35.
- Womb conditions: there are several conditions which are associated with the womb and fallopian tubes that can reduce fertility and prevent conception; these include endometriosis (this condition involves tiny portions of the womb tissue breaking off and starting to develop in other parts of the reproductive system; the new growths usually develop into cysts which can cause infertility because the block the passage of the egg), submucosal fibroids (small lumps which develop inside or around the womb; these lumps are not cancerous but they can reduce fertility) and pelvic inflammatory disease (PID); this conditions prevents the egg from travelling into the womb; usually it develops as a sexually transmitted infection. Surgery for previous health conditions, such as cervical cancer or conditions relating to the pelvis may also reduce fertility.
- Medication: medication for other health conditions can affect fertility; some of the drugs that have this effect include prolonged use of non-steroidal anti-inflammatory drugs (such as ibuprofen), medicines used during courses of chemotherapy and illegal drugs, such as cocaine and marijuana.
Causes of male infertility
- Abnormal semen: this is the most common cause of male infertility as it accounts for 75 percent of all cases of infertile males. In many cases, the sperm isn’t shaped normally which means it has trouble moving; this makes it difficult for it to reach the egg. Sometimes the sperm can be less mobile that they should be; there is no real explanation for this but it can make fertilisation much more difficult.
- Low sperm count: some men who have trouble conceiving have a lower sperm count than normal; this reduces the chance of fertilisation.
- Age: men retain fertility much more effectively than women and can usually conceive much later on in life than women; however, fertility does still decrease as men get older.
- Testicular health problems: damage or injury to the testicles can affect the production and storage of sperm, which can have serious implications for fertilisation; conditions such as testicular cancer, undescended testicles, testicular infections and injury to the testicles can all reduce fertility.
- Low levels of testosterone: this condition is also known as hypogonadism; it occurs when the individual does not produce as much testosterone as normal; this can affect sperm production. Usually, this condition is a result of taking drugs or as a by-product of another health condition, such as cancer.
- Drinking: excessive consumption of alcohol has been proved to affect the sperm; drinking regularly, but not excessively will usually have no effect.
- Medication: there are a number of different medications which may affect fertility; these include medication used during chemotherapy to treat cancer and anabolic steroids (these are illegal and are usually used by athletes to increase muscle mass).
Causes of both male and female infertility
- Smoking: smoking affects both female and male fertility. Couples who are seriously considering having a baby should give up smoking as early as possible.
- Stress: stress can have negative effects on mental health, as well as physiological health; many couples find that stress affects the frequency of having intercourse and severe stress can also affect ovulation and sperm production.
- Body weight: being considerably over or under weight can dramatically reduce the chances of conceiving a baby. Obesity affects ovulation and being extremely underweight often causes women to stop having periods. Obesity can also affect male fertility.
- Sexually transmitted infections: many sexual infections cause problems relating to infertility. Chlamydia is particularly dangerous as it has no symptoms; it can cause both female and male infertility.
What happens if I am diagnosed as infertile?
There are a number of different options for those who are diagnosed with infertility, but none of the options are straight forward and patients should be aware that success rates are still relatively low and the process can be physically and emotionally draining. The most common fertility treatments are outlined below:
- Fertility drugs: these are medications which are designed to encourage ovulation; the most common medications include Clomifene and Tamoxifen (these are used to stimulate ovulation), Metformin (this is usually given to women who have not had any success with clomifene and tamoxifen and is often given to women with PCOS) and Gonadotrophins (these can also benefit men).
- Surgery: surgery can be used to treat possible sources of infertility, such as blockages in the fallopian tubes or epididymis (the structure responsible for holding and transporting the sperm in the testicles. Women may have a laparoscopy; this allows doctors to have a closer look at the organs and identify any abnormalities.
- Assisted conception: there are various methods of assisted conception, these are explained in further detail below:
- IVF (In-vitro fertilisation)