From the moment we hit adolescence we begin to learn about reproduction, and not just the how, but also the why. We are taught about the worth and sense of fulfillment that can come hand in hand with having a family, so naturally we grow up believing that when the time comes for us to create are own descendants (if of course we wish to), we will be able to do so.
Infertility has been a source of sadness and despair since the earliest times, with stories of the emotional and social struggles of being unable to reproduce even appearing in the Old Testament.
Feeling that your body is suddenly working against you can be a very painful realisation, and on top of this you may then also be expected to make extremely difficult decisions regarding your future. Should you try again? Or is it time to start thinking of other ways to start a family?
So what is infertility? Infertility by definition, is a difficulty in conceiving despite having regular unprotected sex. There is no definitive cut off period after which a medical professional is able to say a couple is ‘infertile’, though statistics do suggest that the probability of a couple who have been trying to fall pregnant naturally for more than three years with no success is 25% or less.
There is no one definitive factor which causes infertility. According to the NHS, approximately one third of fertility problems are due to issues with the female, one third are down to problems with the male, and in up to 23% of circumstances doctors are unable to pinpoint a cause.
Infertility in women :
Ovulation is vital to pregnancy, and without the monthly release of an egg there will be nothing for the male sperm to combine with. Failure to ovulate for whatever reason, is one of the most common causes of infertility and can occur as a result of a number of conditions:
- Problems with the womb or fallopian tubes : The fallopian tubes are essentially the pathway from the ovary to the womb, along which the egg travels whilst being fertilised along the way. When the egg reaches the end of its journey down the fallopian tubes, it is then implanted into the lining of the womb where it then grows and matures into a baby. However, if either the fallopian tubes or the womb are damaged, or indeed if they stop working, it may then become very difficult to conceive.
- Pelvic inflammatory disease (PID): This is an infection which occurs in areas including the fallopian tubes, womb and ovaries and is usually caused by a sexually transmitted infection (STI). The disease can damage and scar the fallopian tubes, thus meaning the egg is unable to travel into the womb.
- Endometriosis : Endometriosis is a condition in which minute pieces of the womb lining begin to grow in other places, such as in the ovaries for example.The growth of this sticky tissue or cysts can lead to blockages and mishaping of the pelvis and can also distort the way in which the follicle releases the egg.
- Treatment to assist fertility
- Surgical procedures
- Assisted conception, which may be intrauterine insemination (IUI) or in-vitro fertilisation (IVF).
- Side effects of medication
- Increased risk of ectopic pregnancy
- Multiple pregnancy
Other possible causes of infertility in women include those listed below:
Male infertility :For men, the most common cause of infertility is abnormal semen, accounting for 75% of all male infertility cases.There are a number of explanations for abnormal male semen, some of which can be found listed below:
Should I tell my partner I am going to the doctor?
Yes, absolutely. If you have concerns about your fertility, talk to your partner – after all this is something which affects you both.The thought that you may not be able to conceive may make it tempting to sneak off to visit your healthcare provider without another soul knowing, and whilst this is an understandable reaction it is always best to be open and honest about your concerns. Tell your other half that you are worried and remember that fertility problems occur equally in men and women so both of you need to be there.The realisation that there could in fact be an issue with conception can be an extremely emotional time, and certainly one in which both parties will need as much support from one another as possible.
When is the right time to seek help?
For most couples ‘How long will it take to fall pregnant’ is one of the first questions they ask when they begin to actively start trying for a baby.Unfortunately there is no set answer to that question, nor is there a definite line after which infertility is declared. Some couples are extremely lucky and find that they conceive after trying for just a short period of time. Others however will find that the process takes far longer, often so long that anxiety, frustration and fear that it may never happen all begin to set in.Having concerns about falling pregnant is entirely natural, but at what point should these concerns be taken to a medical professional?A couple should visit their GP if they have not conceived after one year of trying, although women over the age of 35, and anyone who is aware that they may have fertility problems (for example those seeking treatment for cancer) should seek help sooner. The GP can check for common causes of fertility problems and will also be able to suggest treatments and lifestyle changes that could help.
There are two types of infertility:
Fertility problems are equally divided among men and women with only 5% of cases having no identifiable cause.
Infertility treatments :
There are three main types of fertility treatment available, and the treatment you are offered will really depend on what is believed to be causing the problem and also what is available from your Primary Care Trust (PCT):
Whilst the NHS do fund fertility treatment, eligibility and services tend to vary greatly throughout the UK as it is the responsibility of your local PCT to determine factors such as services and availability. As a patient it is your right to be referred to an NHS clinic for initial investigation, but be aware that waiting lists in some areas can be extremely long and thus the process may be very drawn out. You may wish to consider having private treatment although this can be expensive and there is no guarantee that it will be successful. It is, however, important to choose a private clinic carefully. You can ask your GP for advice, and you should make sure that you choose a clinic that is licensed by the Human Fertilisation and Embryology Authority (HFEA).
Infertility treatments can cause complications including:
All assisted conception clinics in the UK are obligated to offer patients the option of infertility counselling during any stage of their treatment. If you are undergoing treatment or are about to embark upon treatment and you would like to see a counsellor, let your clinic know as soon as possible as there may be a waiting list.
How could infertility counselling help?
Research has shown that infertility often has a stressful impact on relationships and can affect a couple’s sex life. The condition is isolating and can impact on how a couple communicate with each other and with the people around them. There can be a profound sense of loss and grief which can impact on closeness. Infertility can also carry with it a sense of denial with sadness and shock borne individually when pregnancy does not materialise. There can also be feelings of fear, guilt and abandonment from the partner who feels the problem lies with them. Women can feel less feminine and men can feel less masculine in the face of infertility. Infertility can also put stress on your relationship, with studies showing that couples dealing with infertility are more likely to feel unhappy with themselves and their marriages. It is important to express the feelings of sadness, loss and anger and to have good support from people around you who understand your position. As mentioned previously, many clinics offering Infertility Treatments also offer counselling or insist that a couple undertake professional counselling before embarking upon investigations and treatment. This can open up channels of communication and keep a couple in contact with each other as they undergo what can turn out to be challenging course of action.