SEXUAL HEALTH CONCERN

Fertility

Also called: infertility, cant conceive, trying to conceive, fertility, fertility treatment abroad

Fertility problems refer to difficulties achieving a pregnancy and can involve one partner, both partners or sometimes have no clearly identifiable cause. Fertility is influenced by age, reproductive health, hormones, genetics, lifestyle and a range of medical factors.

TYPICALLY OCCURS

Age, reproductive conditions, hormones and genetic factors

TREATED BY

Fertility surgery, IVF, IUI and medication

ALSO LINKED TO

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Why it happens?

Achieving a pregnancy depends on several biological processes occurring successfully. Healthy eggs and sperm need to be produced, sperm must be able to reach and fertilise an egg, and the resulting embryo must be able to develop and implant within the uterus. A problem at any stage can reduce the likelihood of conception. Factors affecting ovulation, egg quantity or quality, sperm production or function, the fallopian tubes, uterus or reproductive tract can therefore contribute to fertility difficulties. In some cases, more than one factor is present.

Age is an important influence on fertility, particularly because the number and quality of eggs decline over time, with the decline becoming more significant as reproductive age increases. Fertility involving sperm can also change with age, although usually in a different and more gradual way. Medical conditions can contribute at any age. These include endometriosis, polycystic ovary syndrome (PCOS), problems affecting the fallopian tubes or uterus, hormonal disorders and conditions affecting sperm production or delivery. Previous infections, pelvic or reproductive surgery, cancer treatments and certain genetic conditions may also influence fertility.

Lifestyle and general health can affect reproductive function as well. Smoking, significant changes in body weight, excessive alcohol consumption and certain medications or recreational drugs may reduce fertility in some people. Frequency and timing of sexual intercourse also influence the chance of conception during any individual menstrual cycle. Importantly, fertility problems do not always have an obvious explanation. Some couples have normal results on standard fertility investigations but still experience difficulty conceiving, sometimes described as unexplained infertility. Fertility assessment therefore generally considers both partners together rather than assuming that difficulty conceiving originates from one person.

How far along is it?

Early

Pregnancy has not occurred as quickly as expected, but this does not necessarily indicate a fertility problem. The time normally required to conceive varies considerably between individuals and couples.

Moderate

Attempts to conceive continue without pregnancy over a longer period. Fertility assessment may be appropriate to investigate ovulation, reproductive anatomy, sperm health and other possible contributing factors.

Advanced

Investigations identify one or more significant fertility factors, or pregnancy remains difficult despite initial assessment or management. More specialised fertility support or assisted conception may be considered depending on individual circumstances.

What addresses it?

Treatments that address this

IVF treatment→Female fertility test→

In the UK, fertility assessment is generally worth discussing with a healthcare professional after one year of regular unprotected sex without becoming pregnant. Earlier assessment may be appropriate when the person trying to become pregnant is aged 36 or over, or when there is already a known reason why fertility could be affected.

It can also be worth seeking advice sooner in cases of very irregular or absent periods, previous pelvic infection or reproductive surgery, known endometriosis, previous cancer treatment, known testicular or sperm-related problems, sexual difficulties that prevent regular intercourse, or another condition that could affect fertility.

Fertility concerns can involve either or both partners, so where applicable, assessment is usually most informative when fertility is considered as a shared issue rather than focusing immediately on one person.

Quick Questions:

How long should you try for a baby before seeking fertility advice?

Many couples conceive naturally within a year of regular unprotected sex. If pregnancy has not occurred after one year, fertility assessment is generally worth discussing. Earlier advice may be appropriate depending on age, medical history or known fertility risk factors.

What are the most common causes of fertility problems?

Possible causes include problems with ovulation, egg quantity or quality, sperm production or function, blocked or damaged fallopian tubes, endometriosis, hormonal conditions and abnormalities affecting reproductive anatomy. Sometimes no clear cause is identified.

Can fertility problems involve both partners?

Yes. Fertility difficulties may relate predominantly to one partner, involve factors affecting both partners or remain unexplained after standard investigations. For this reason, fertility assessment often considers both partners.

Does having fertility problems mean IVF is necessary?

No. IVF is one possible fertility treatment, but it is not appropriate or necessary for everyone. Depending on the cause, options may include addressing an underlying medical condition, medication, surgery, intrauterine insemination (IUI), IVF or other assisted reproductive techniques.