Infertility: the facts

The subject of fertility has remained high on the news agenda in recent years and is understandably a topic many people will think about when first deciding to start a family.

While every couple hopes the process of conceiving will be simple for them, unfortunately this is not always the case. More and more people are seeking additional help from fertility experts, with the UK’s NHS recently suggesting this figure to be around one in seven couples, approximately 3.5million people in the UK.

The IVI Group is a European leader in assisted reproduction, and to date has helped over 100,000 children to be born all across the globe. With 40 clinics, in 10 different countries IVI are pioneers within the fertility industry and are at the forefront of medical development and advancement within the field. Many people choose to seek assisted reproductive treatment at IVI due to their high pregnancy success rate, with 9 out of 10 patients who visit an IVI clinic becoming parents.

With the 2015 National Fertility Week upon us, fertility specialist Dr Marcos Ferrando from IVI Fertility has shared his expert insight into some of the key reasons why couples may struggle to conceive, what warning signs to look out for, and how to seek appropriate assisted reproductive treatment if necessary.

Common Causes?

Dr Ferrando Says: “The most common cause of female infertility we see at the IVI clinics is to do with the age of the patient. In today’s society it is common for women to want to delay starting a family until their thirties or forties, however this is when their ovarian reserve and quality of eggs has gone into decline. When females reach the age of thirteen they have roughly 300,000 oocytes, and from this age they start to lose around 1,000 oocytes each month. After twenty-eight years of age the annual loss of oocytes becomes greater, and then when a woman reaches her forties the rate increases yet again.

Other common causes of infertility in women are because of gynaecological problems such as endometriosis and Polycystic Ovarian Syndrome.

In men, infertility is often caused by the quality of the semen and the number of strong sperm in each sample. The quality of the sperm is linked to genetics but also some lifestyle factors may play a role too, for example it is important to keep the testicles cooler than the rest of your body, around 34.5 degrees, so tight underwear should be avoided, and a regular break from sitting down for long periods of time is recommended.”

Is Infertility More Prevalent in Men or Women?

Dr Ferrando Says: “Infertility is equally prevalent in men and women, and there are many fertility treatments for both sexes to help them become pregnant. Based on the cases we see at IVI, infertility is split evenly between the sexes – one third of infertility cases are women, one third men, and one third is a mixture of the couple both experiencing problems with their fertility.”

What Are The Signs of Infertility?

Dr Ferrando Says: “In many cases there are no obvious symptoms which would suggest that a couple could be infertile, and men in particular will not experience any symptoms regarding the quality of their sperm. However, if a couple have been trying for their first baby for one year with no success, we suggest they seek expert help as this length of time usually indicates that there is a problem.

There are also some medical conditions in women such as endometriosis which can be associated with infertility, and these do have symptoms which you can look out for. For example women with endometriosis will experience a lot of pain during menstruation. The condition PCOS is associated with irregular periods. If women experience any of these signs they should speak to their doctor.”

What to Do If You Suspect a Problem…

Dr Ferrando Says “For couples trying to conceive their first baby I recommend they try for a year before they seek help from a fertility specialist. Women are most receptive to conceiving roughly between day 12 and 16 of their menstrual cycle, which is a small window month on month and therefore a year is a very common length of time for couples to try for a baby. If a couple are trying for their second baby after natural conception the first time, then I usually recommend waiting two years before seeking specialist help as we know that it is possible for them to conceive naturally.”

Do Lifestyle Choices Have An Impact?

Dr Ferrando Says “Whether or not eating certain foods can help to boost fertility has been a widely debated topic within the industry for some time now. Unfortunately, there is no scientific link between food or drink and fertility, but undoubtedly leading an overall balanced lifestyle and maintaining a healthy weight is very important.

There are a few factors however that have been proven by credible studies to impact on fertility. The main lifestyle factor is smoking, which has been linked to conception rates, and also the health of unborn babies. I recommend to my patients who are smokers that they should either cut down on the amount they smoke or quit altogether when trying to conceive.

Caffeine and alcohol can also affect fertility, when consumed at a high level. However, if you use these substances in moderation it shouldn’t have an impact on your fertility success.”

What Are The First Steps Towards Treatment?

Dr Ferrando Says “If you have been trying to conceive for a year or two, or you have any pre-existing conditions like PCOS or endometriosis, then I would recommend visiting a fertility specialist for help.

In the first instance, at IVI Clinics we run a series of tests to find out why the couple are struggling to conceive and to help us decide the best course of treatment for each patient.

The first thing we do is ask the female patient whether she is menstruating regularly every month. Once we know this we then check how the semen is performing. We do this by taking a sample of semen from the male patient and analyse it under a microscope to check the quantity, movement and morphology of the sperm, and in some cases we perform tests to see how many chromosomes are in the semen.

Next, we check the female patient’s ovarian reserve through a blood analysis on the third day of menstruation, and as the second stage we would then carry out an ultrasound. During the ultrasound we will count the number of follicles to check whether the patient has a good level of oocytes.

Finally, we perform an exam to test whether the fallopian tube is open or closed, as this can indicate why the patient is struggling to conceive.

After we have completed these tests and received the results we would then review the treatment options – for example IVF, ICSI, egg donation or sperm donation – and discuss with the couple to decide the best course of action.”