Starting a family is a dream for many people, but it can also be a challenge.
Infertility is defined as the inability to conceive after one year of regular unprotected sex (or six months if you are over 35 years old).
According to the Fertility Society of Australia and New Zealand, one in six couples in Australia and New Zealand suffer from infertility 1
Infertility affects people of all races, ages, and socioeconomic backgrounds.
While it was once thought that infertility was primarily a female issue, the latest research has found that 30% of infertility cases are male-related, 30% are female-related, and 30% are due to a combination of both partners.
The remaining 10% are classified as “unexplained infertility”, which means that no obvious cause can be found after thorough testing 2.
What are the causes of infertility?
Infertility can have many possible causes, depending on the individual or couple. Some of the common causes include:
Age: Fertility declines with age, especially for women.
The quantity and quality of eggs decrease over time, making it harder to conceive and increasing the risk of miscarriage and chromosomal abnormalities.
Men also experience a decline in sperm quality and quantity as they age 3
Ovulation problems: Some women may not ovulate regularly or at all, which means that no eggs are released for fertilisation.
Ovulation problems can be caused by hormonal imbalances, polycystic ovary syndrome (PCOS), thyroid disorders, stress, weight issues, or excessive exercise 4.
Tubal or uterine problems: Some women may have blocked or damaged fallopian tubes, which prevent the sperm from reaching the egg or the fertilised egg from implanting in the uterus.
Tubal problems can be caused by infections, endometriosis, surgery, or pelvic inflammatory disease (PID) 4.
Some women may also have abnormalities in the shape or lining of the uterus, such as fibroids, polyps, or adhesions, which can interfere with implantation or pregnancy 5.
Sperm problems: Some men may have low sperm count (oligospermia) or poor sperm motility (asthenospermia), which means that there are not enough sperm or they are not able to swim well enough to reach and fertilise the egg.
Sperm problems can be caused by genetic factors, infections, varicocele (enlarged veins in the scrotum), smoking, alcohol, drugs, heat exposure, or environmental toxins 6.
Some men may also have abnormal sperm shape (teratospermia) or function (necrospermia), which means that the sperm are not able to penetrate or activate the egg.
Sperm problems can be caused by genetic defects, chromosomal abnormalities, infections, medications, or antibodies against sperm 6.
Unexplained infertility: This is when no obvious cause can be found for infertility after thorough testing.
Some possible reasons for unexplained infertility include undiagnosed underlying conditions, egg and sperm dysfunction, immunological factors, or subtle defects in the reproductive system 7.
What are the treatment options for infertility?
The treatment options for infertility depend on the cause, duration, and severity of the problem, as well as the age and preferences of the couple. Some general treatment options include:
- Lifestyle changes: Improving diet, exercise, sleep, stress management, and quitting smoking, alcohol, and drugs can improve fertility in both men and women 8.
- Medications: Fertility drugs can stimulate ovulation in women or increase sperm production in men. They can also correct hormonal imbalances or treat underlying conditions that affect fertility 8.
- Surgery: Surgical procedures can correct anatomical problems such as endometriosis, fibroids, varicocele, or obstructions in both men and women 8
- Assisted reproductive treatment (ART): This refers to medical and scientific methods that help people conceive without sexual intercourse.
The most common types of ART are intrauterine insemination (IUI) and in vitro fertilisation (IVF).
IUI involves placing washed and concentrated sperm inside the uterus around the time of ovulation.
IVF involves retrieving eggs from the ovaries and fertilising them with sperm in a laboratory.
The resulting embryos are then transferred to the uterus or frozen for future use. 9
Where can I find support for infertility?
Infertility can be a stressful and emotional experience for many people. It can affect your self-esteem, your relationship with your partner, your family and friends, and your mental health.
It is important to seek support from your healthcare provider, your partner, your family and friends, or a support group or a counsellor.
There are also many online resources and forums where you can connect with other people who are going through similar experiences.
Some of the websites that offer information and support for infertility in Australia and New Zealand are:
- Fertility Society of Australia and New Zealand: https://www.fertilitysociety.com.au/
- Your Fertility: https://www.yourfertility.org.au/
- Access Australia: https://www.access.org.au/
- Endometriosis Australia: https://www.endometriosisaustralia.org/
- Jean Hailes for Women’s Health: https://jeanhailes.org.au/
- Andrology Australia: https://www.andrologyaustralia.org/
Remember that you are not alone, and there is hope and help available for you.
If you have any questions or concerns about your fertility, please consult your GP or a fertility specialist.
They can provide you with personalised advice and guidance on your journey to parenthood.
References:
[1] Fertility Society of Australia and New Zealand. (n.d.). Infertility.
[2] Better Health Channel. (2018). Infertility in men and women.
[3] Your Fertility. (n.d.). Age and fertility.
[4] Better Health Channel. (2018). Ovulation problems and infertility.
[5] Better Health Channel. (2018). Infertility in Women.
[6] Healthy Male Organisation. Male infertility.
[7] Your Fertility. (n.d.). Unexplained infertility.
[8] Pregnancy Babys and Birth - Fertility treatments.
[9] Fertility Society of Australia and New Zealand. (n.d.). Assisted reproductive treatment (ART).