Despite common misconceptions surrounding fertility problems, issues in conception arise roughly 30% from females, 30% from males, and the remaining third from a combination of unexplained infertility. That being said, unexplained infertility is becoming less and less labelled as a cause as fertility specialists’ understanding of the subject expands with time. With this knowledge, the options available to those seeking to understand their fertility problems can be mapped out, as expressed later in this post. It is important when doing this to recognise, as the figures show, that one party cannot be presumed to be the root of fertility issues, and instead each person trying to conceive should work through possible fertility issues with professionals for the best hope of conception.
Why Do Fertility Problems Occur?
There are a variety of reasons you may have difficulty conceiving. One key factor is a female’s ovarian age. This is different to their actual age, despite the correlation between young age and increased infertility. A female has a certain number of eggs that cannot be added to but diminishes as she ages, the rate at which they diminish and the quality of those eggs can be dependent on exposure to risk factors. As is often recognised in the fertility profession, women have all of their eggs in two baskets: their ovaries. Thus it is important to limit the risk factors to your eggs that you can control when trying to conceive.
Some of these risk factors other than age include:
- Weight (being both overweight and severely underweight)
- Smoking (including passive smoking)
- Alcohol consumption
- Exposure to Sexually Transmitted Infections (STIs)
- Persistent stress
While these risk factors are mostly expressed in relation to females, many of them also impact male fertility.
What is the Step-by-Step Process to Fertility Problem Diagnosis?
When you are experiencing fertility problems, there are certain steps to be taken to ensure you have the best chance of overcoming them.
1. First, it is worth noting how long before you should consider seeking assistance. It is recommended that if there are no other problems that seem to be causing your infertility, after a year you should get checked by a doctor. This year refers to one which is spent trying to conceive, meaning having sex every two to three days without the use of a form of contraception. However, if you are at an age where your fertility starts to diminish (which can be as early as 35) you should be checked after 6 months of trying to conceive. With same-sex couples, assessments can begin promptly into how fertile each of you are.
2. When visiting the doctors, you can expect to undergo what is called a fertility MOT. This refers to a process through which your doctor monitors your fertility, through measuring the number of antral follicles a female has while performing an ultrasound scan, they will look also at the uterus for any polyps, fibroids or for the presence of any congenital anomaly and analysis of semen for males. Through this process, the doctor aims to discover the cause of the fertility problems. This will be reviewed alongside a medical history and lifestyle assessment in the hope of most accurately understanding what is causing issues with fertility. One key component of the female fertility MOT is AMH testing. AMH refers to the anti-Müllerian hormone, which is secreted by the ovarian follicles. Through testing AMH levels, the egg count can be indirectly quantified. However, as useful as understanding the egg count is, it is not essential for conception. What is more key is the quality of those eggs.
3. Following the fertility MOT your doctor will offer you some options according to the fertility problems you specifically face. This could entail medical treatments for lack of regular ovulation, surgery to repair any accidental finding to the reproductive organs, or assisted conception such as IVF. Over the past 20 years, IVF success rates have tripled in the UK, illustrating the progress of fertility research.
Should I Freeze My Eggs?
The freezing of eggs has become more common for female’s opting to delay childbirth. This is something to consider as early as possible to prevent the diminishing of eggs before you are prepared to fertilise them, but also is worthy of consideration at any point before immediate conception is desired to preserve the current state of eggs. Despite this, as mentioned before, age is not the only factor that contributes to infertility, so do not be disheartened if you had not considered this before. If you have any underlying health issues that could lead to your eggs diminishing at a faster rate your doctor may suggest this as a favourable option for you.
Solving Fertility Problems
Overall, there are many options when facing fertility problems. While there is no blanket solution for everyone trying to conceive, there are plenty of routes to take depending on your personal circumstances. The most important thing is not to give up hope when faced with initial difficulty and instead seek the help of a specialist who, in understanding your individual case, can assist you in overcoming your fertility problems.
Dr Wakim, Thank you for this important information!