21 November 2018

Am I fertile? How to understand and safeguard your fertility

By the Editorial Comitee IVI Blog


For a significant part of every woman’s life, and for men too, understanding how to know if you’re infertile or fertile, and if so at which times, is a burning question. This applies equally for those who wish to avoid pregnancy, at least for the time being, and to those who would like to start or add to a family. The issues apply equally to women and men, although as we are all aware, the age-related decline in fertility in women is steeper and swifter when it occurs.

In this article we explore the issue of how to know how fertile you are by taking a look at the physical signs of fertility. For women we can offer a broad-brush self-assessment method to answer the question ‘How do I know if I’m fertile?’ and for men some general guidance on when and how to test for low sperm count. We also discuss ways of safeguarding your fertility and look at a range of circumstances in which this may be an advisable course of action in order to hold onto it for the future.


For women: how to know how fertile you are

How do I know if I’m fertile? and its corollary, how to know if you’re infertile are questions which break down into two major issues. The first is that of overall fertility and the ability to conceive in general. The second is about understanding the particular time of your monthly cycle when you are fertile. For women who are actively trying to become pregnant, both sides of the question are equally important.

If you are trying to get pregnant, you can self-assess your overall fertility to some extent by answering a few questions. The answers won’t provide you with a definitive verdict, but will at least help you decide whether you need to seek professional advice.

  • How long have you been trying to become pregnant? If less than six months and you are under 35, wait and keep trying for another six months. If more than 12 months, you should probably seek further advice.
  • Do you have regular periods? This is one of the most obvious physical signs of fertility. If your periods are irregular or altogether absent, it could be an indication of problems with your fertility.
  • Have you been diagnosed with polycystic ovary syndrome or a sexually transmitted disease such as chlamydia, or have you ever had an ectopic pregnancy? While neither one of these conditions completely precludes becoming pregnant, they all reduce the likelihood of conceiving and you should seek advice if you are affected.
  • Are you over 35 years old? For both men and women, fertility is at its peak in the early twenties. For women, fertility starts to decline quite rapidly after the age of 35. Around one third of couples where the woman is over 35 have fertility problems, rising to two thirds where the woman is over 40.

As for the ability to predict the times of the month in which you could, and are most likely to become pregnant if you are fertile, it’s a lot simpler. There is some debate about fertility prediction methods and the general advice is not to rely on this as a reliable contraceptive method. But in general, if you count the first day of your period as day 1, your fertile time is typically between day 10 and day 16. If you have unprotected sex during this time, you will have the best chance of conception.


Understanding fertility for men

For men, how to know how fertile you are is a fairly simple matter. Men’s fertility can be evaluated by a combination of sperm count and sperm quality. Problems with a low sperm count or sperm quality are not uncommon, and are a factor for around one third of couples experiencing infertility. However, a low sperm count does not equate to infertility. It is still possible to conceive naturally. There is also a range of assisted reproduction treatments available to help you achieve your aim of becoming a parent.

  • How to test for a low sperm count is also fairly straightforward. A doctor or specialist clinic can carry out a semen analysis. This is where a sample of your semen is analysed in a laboratory to check the quality and quantity of the sperm.
  • Home kits are available but there is a lack of evidence of reliability and they may only test quantity rather than quality of sperm. They are not really recommended as an answer to the question how to test for a low sperm count.
  • Causes of a low sperm count or poor sperm quality can include hormonal or genetic disorders, sexually transmitted diseases and infections. Certain medications, for example anabolic steroids, cancer medications, some antibiotics and some antidepressants can also be a factor. So can lifestyle factors including recreational drug use and alcohol consumption.

Of course, where a couple is experiencing infertility, often the question ‘How do I know if I’m fertile?’ cannot be asked exclusively in relation to either partner. Often there is no particular male or female ’cause’ but rather a combination of factors. That’s why it’s a good idea where appropriate to seek advice, guidance or treatment as a couple.


Safeguarding your fertility: what are your options?

The simplest advice for safeguarding continued fertility for both women and men has to do with lifestyle choices. Stay in good health through optimum nutrition, avoiding tobacco and excessive alcohol consumption and getting plenty of exercise as well as sleep. This is sound advice which you have almost certainly heard before and no doubt follow as far as practicalities allow.

Another well-known issue is the social phenomenon that due to the demands of career, finances or simply as a matter of personal choice, people are leaving it later to start a family. This is where assisted reproduction treatment can have a major impact, and make it possible to delay parenthood with confidence until the time is right. Let’s briefly cover the options as they relate to women and men.

  • For women, vitrification of oocytes offers the possibility of postponing motherhood if they wish to do so, or if they are going to undergo medical interventions including treatment for cancer. The vitrification of oocytes allows the mature eggs obtained following ovarian stimulation to be cryopreserved so that they can be used at a later date, when the patient decides she is ready, with the same prognosis as at the point when they were vitrified. Due to the fact that ice crystals do not form, oocyte survival rates are high, allowing motherhood to be postponed with reasonable guarantees of success. The procedure and what is involved are explained fully in the video about vitrification of oocytes on IVI’s YouTube channel.
  • For men, sperm freezing is the most effective method of safeguarding fertility. You may wish to consider freezing your sperm in the case of medical treatment which might affect fertility; if you are considering having a vasectomy and want to keep your future options open; or if you have a low sperm count or declining sperm quality.
  • In case of radiation treatment for cancer, vitrification of oocytes, freezing of ovarian tissue, transposition of the ovaries and medical protection of the gonads are further possibilities for the safeguarding of fertility.
  • Some medical treatments for gender dysphoria, including hormone therapy and surgery, can have an impact on your fertility and over time lead to a complete loss of fertility. If you are considering this type of treatment and think that you may want biological children at some point, you may wish to safeguard your fertility before treatment begins. This entails having sperm, eggs or embryos frozen and stored for the possibility of later use in fertility treatment.


How can IVI help with safeguarding fertility?

IVI is a pioneer in the latest assisted reproduction technology in order to pursue the best possible results. We provide personalised care and support during all stages of treatment, and one of the results we are proud of is that 97% of our patients recommend IVI. The statistic that tells the most eloquent story, however, is the fact that 90% of patients who undergo an assisted reproduction treatment at IVI conceive sooner or later. If you would like to check the options as they relate to your particular circumstances, we encourage you to browse our website where you will find detailed descriptions of treatments as well as some interesting true stories from past patients. You can also check our audited clinical results for all the facts and figures relating to our record.

If, having checked our guidance on how to know if you’re infertile, the physical signs of fertility, and the choices at your disposal for safeguarding of fertility, you would like to discuss your circumstances with us, go ahead. We’re always happy to address your concerns and questions, with no obligation. You can use our online contact form for an appointment or give us a call. We’re here to help and, if you go ahead with treatment, we’ll be staying with you through the whole journey.


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