What is infertility?
Infertility is defined as the inability to conceive a child despite trying for 1 year. It affects about 9% of the reproductive age population.
To become pregnant, a couple must have intercourse during the woman’s fertile time of the month, which is right before and during ovulation. Because it is difficult to pinpoint the exact day of ovulation, having intercourse every other day during this time maximizes the chances of conception.
After a year of frequent intercourse without contraception that does not result in pregnancy, a couple should be advised to seek help. In some cases, it makes sense to seek help for fertility problems even before a year is up.
A couple may also seek earlier evaluation if:
- The woman is not menstruating regularly, which may indicate an absence of ovulation that would make it impossible for her to conceive without medical help.
- The woman has had three or more miscarriages (or the man had a previous partner who had had three or more miscarriages).
- The woman or man has had certain infections that sometimes affect fertility (for example, pelvic infection in a woman, or mumps or prostate infection in a man).
- The woman or man suspects there may be a fertility problem (if, for example, attempts at pregnancy failed in a previous relationship).
Causes of Infertility
For a woman to become pregnant, there must be healthy sperm, she must ovulate to release an egg, and the sperm and the egg need to mix to allow fertilisation to take place so that the pregnancy can implant in the uterus. The causes of infertility are;
- Male factor – about half of diagnosed causes are thought to be due to factors influencing sperm quality or quantity. This is checked by a sperm test, and repeated 2 months later if the first sample is abnormal. Reversible causes are tight underwear, hot baths, alcohol, nicotine and marijuana.
- Ovulation disorders – characterised by irregular or absent periods. Again, simple lifestyle factors including stress, diet or athletic training can affect a woman’s hormonal balance. Problems with ovulation are assessed by a blood test taken during your period.
- Female anatomy – blockage of the fallopian tubes may result from pelvic inflammatory disease, surgery for an ectopic pregnancy or other problems including endometriosis. A specialised ultrasound test called a HyCoSy can be organised with one of my colleagues to see if the tubes are open.
- Unexplained infertility – occurs in up to 20% of couples.
If you are having difficulty getting pregnant, please contact the secretary on 02 434 8100 to arrange a consultation.