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What is infertility

Infertility is usually defined as not becoming pregnant after a year of trying, but some couples know or suspect they are infertile well before a year is up.

For instance, the woman might have irregular periods or not ovulate at all. Studies from various European countries show 15 -20% of couples experience infertility some time in their reproductive life, so it is a very common problem. For many people infertility is not absolute. The chance of conception may be lower than normal, say only 1-5% a month, so it takes longer to get pregnant.

For some people infertility is absolute - there may be no sperm, or the woman's fallopian tubes may be blocked.  This used to be called sterility, but this is a misleading term because modern treatment gives most couples with absolute infertility a good chance of having a child.

Very broadly about half of infertility is male based and about half female based.  Whatever the cause of the infertility is it is a couple's problem and requires the couple to work together towards a solution.

Common causes of infertility

Women
  • Tubal problems
  • Endometriosis
  • Ovulation disorders
  • Polycystic ovaries
  • Recurrent miscarriage
  • Hormonal problems
  • Autoimmune (antibody) disorders

Men
The cause of most male infertility remains unknown. Known causes can include the following:

  • Failed vasectomy removal
  • Retrograde ejaculation
  • Blocked ducts
  • Absence of vans deferens
  • Undescended testes in childhood
  • Autoimmune (antibody) disorders
When should I do something?The right time to seek help is when you are concerned. Often simple tests to check ovulation and sperm quality will give you the assurance you need to happily try a little longer before more intensive investigation.

There are some simple tests that check ovulation and sperm quality that can provide reassurance to couples so that to either try a little longer before more intensive investigation or to quickly identify a problem.

A woman's chance of conceiving each month falls with age, especially in the late 30s and early 40s, so age is an important factor to consider. In some cases you may be encouraged to wait a while before any invasive tests are performed, for example, if you have been trying for only a few months, the woman is under 35, and there is nothing to suggest an anatomical problem.

On the other hand, couples that may need longer to conceive because the woman is older, require earlier investigations because there is less time left for conception. 

There are circumstances when earlier advice should be sought, such as:

  • lack of regular periods
  • known low sperm count
  • a previous operation to bring down a testis into the scrotum as a child
  • previous treatments for cancer in either partner.

Get to know your chance of having a baby

A typical fertile couple in their mid-to-late 20s having regular sex have about a 20-25% chance of conceiving each month. After 6 months at least three-quarters of such couples will be pregnant, and after a year at least 90%. Click here to work out your chances of having a child given the length of time you and your partner have been trying for and your age.