Infertility

Getting help

Some women get pregnant quickly, but for others it can take longer. It's a good idea to see your GP if you haven't conceived after a year of trying.

You should speak to your GP sooner if:

• you’re a woman aged 36 or over
• you’re already aware that you may have fertility problems

Your GP can check for common causes of fertility problems and suggest treatments that could help. Infertility is only usually diagnosed when a couple haven't managed to conceive after a year of trying.

There are two types of infertility:

• primary infertility – where someone who's never conceived a child in the past has difficulty conceiving
• secondary infertility – where someone has had one or more pregnancies in the past, but is having difficulty conceiving again

Possible causes of infertility

There are many possible causes of infertility, and fertility problems can affect both men and women. In a quarter of cases it isn't possible to identify the cause.

In women, common causes of infertility include:

• lack of regular ovulation (monthly release of an egg)
• blocked or damaged fallopian tubes
• endometriosis – where tissue that behaves like the lining of the womb (the endometrium) is found outside the womb

In men, the most common cause of infertility is too few, abnormally formed or poorly moving sperm (spermatozoa) in the semen.

Risk factors

There are a number of factors that can affect fertility in both men and women, including:

• age – female fertility and, to a lesser extent, male fertility decline with age; in women, the biggest decrease in fertility begins during the mid-30s
• weight – being overweight or obese reduces fertility; in women, being overweight or severely underweight can affect ovulation
• sexually transmitted infections (STIs) – several STIs, including chlamydia, can affect fertility
• smoking – smoking (including passive) affects a woman's chance of conceiving, while in men there's an association between smoking and reduced semen quality
• alcohol – for women planning to get pregnant, the safest approach is not to drink alcohol at all to keep risks to your baby to a minimum; for men, drinking too much alcohol can affect the quality of sperm
• environmental factors – exposure to certain pesticides, solvents and metals has been shown to affect fertility, particularly in men
• stress – can affect your relationship with your partner and cause a loss of sex drive; in severe cases, stress may also affect ovulation and sperm production

There's no evidence to suggest caffeinated drinks, such as tea, coffee and soft drinks, are associated with fertility problems.

To find out more about what you can do to protect your fertility, see:

• Trying to getting pregnant
• How can I improve my chances of becoming a dad

Treating infertility

Fertility treatments include:

• medical treatment – for lack of regular ovulation
• surgical procedures – such as treatment for endometriosis, repair of the fallopian tubes, or removal of scarring (adhesions) within the womb or abdominal cavity
• assisted conception – this may be intrauterine insemination (IUI)or in vitro fertilisation (IVF)

The treatment offered will depend on what's causing your fertility problems and what's available to you on the Health Service.

Private treatment is also available, but it can be expensive and there's no guarantee it will be successful.

It's important to choose a private clinic carefully. You can ask your GP for advice, and should make sure you choose a clinic that's licensed by the Human Fertilisation and Embryology Authority (HFEA).

Some treatments for infertility, such as IVF, can cause complications, such as:

• multiple pregnancy – placing multiple embryos in the womb as part of IVF treatment increases the chance of having twins, which increases the risk of complications for you and your babies
• ectopic pregnancy – the risk of having an ectopic pregnancy is slightly increased if you have IVF

More useful links

• How to use your health services