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Fertility – Everything You Need to Know

Statistics show that the average global fertility rate has dropped by half over the last 50 years, and everyone planning to have a baby should learn how to improve their conception chances.

What Is Fertility?

Fertility describes one’s ability to bear children. A fertile couple should be able to conceive within 12 months of regular unprotected sex. If they don’t, they could have problems with their level of fertility and should consider an evaluation with a reproductive health specialist to establish the cause.

To determine the female fertility status, the doctor may perform a screening to establish ovarian reserve and hormonal levels. A pelvic examination may also be necessary to check for structural features inhibiting fertility. In males, a semen analysis can help assess sperm health.

Female Fertility

Female fertility is a woman’s capability to get pregnant and give birth to her biological baby. A woman is most fertile during ovulation – when the ovaries release a mature ovum. However, the menstrual cycle is irregular in many cases, and it is difficult to predict the fertile days. Therefore, if you plan to have a baby, you should practice unprotected sex frequently to increase your chances of getting pregnant.

Male Fertility

Male fertility is a man’s ability to start a pregnancy with a female partner. Sperm health is the most significant determinant of a man’s fertility, which relies on aspects of the sperm such as shape, quantity, and movement.

Common Reasons for Infertility

There are several factors that may impact the fertility level of individuals. Below, you can find some of the most common causes of infertility for both women and males. 

Reasons for female Infertility

• Age: as women get older, their ovarian reserve reduces. Moreover, your chances of having unusual chromosomes and less viable eggs increase, making it difficult to become pregnant.

• Lifestyle: if you are underweight, you could experience ovarian dysfunction. Also, strenuous exercise can negatively impact ovulation.
  
  
• Uterine fibroids may hinder embryo implantation, impacting your fertility.
  
  
• Cervical mucus complications: your cervical mucus becomes thinner during ovulation to allow sperm to swim, a failure which you may have difficulty conceiving.
  
  
• Ovulation disorders such as hypothalamic amenorrhea, polycystic ovary syndrome (PCOS), and primary ovarian insufficiency (POI) can cause irregular or missed menstrual periods, lowering your chances of getting pregnant.
  
  
• Pelvic inflammatory disease (PID): this upper female genital tract infection may damage the fallopian tubes, blocking the egg from passing through to the uterus
  
  
• Endometriosis: this comes about when endometrial tissue develops outside the uterus. This condition can damage the fallopian tubes, leading to infertility.
  
  

Reasons for Male Infertility

• Age: sperm health declines with age. The quantity of viable sperm diminishes above 40 years, leading to infertility.
  
  
• Lifestyle: excessive smoking and alcohol abuse can negatively affect sperm quality and lead to impotence. Also, being overweight is associated with reduced testosterone levels.
  
  
• Stress: studies reveal that men who are undergoing a stressful life exhibit suboptimal sperm parameters
  
  
• Drugs and medication: some drugs such as anabolic steroids, sulfasalazine, herbal remedies, chemotherapy medication, and illegal drugs like cocaine can affect the production and quality of semen.
  
  
• Ejaculation disorders: having difficulty releasing semen during intercourse can limit your ability to make your partner pregnant
  
  
• An infection, congenital disorder, or injury to the testicles can hinder spermatogenesis, affecting fertility.
  
  
• Poor semen quality: if your ejaculate has a low sperm count, immotile or no sperm, your chances of conception will be minimal

Lifestyle Choices to Increase Fertility and Chances of Conception

Here are some of the natural ways to boost your reproductive health.

Protect Yourself Against STIs: Some infections like gonorrhoea and chlamydia are among the highest risk factors for fertility. Stick to one uninfected partner or use protection during sex.

Ensure You Are in Good Shape: Maintaining a healthy body weight helps promote regular ovulation and healthy sperm production.

Try to Minimise Stress Levels: Increased stress can impede human reproduction hormones (oestrogen, testosterone, and progesterone) and reduce your sexual function. Practise healthy and safe coping techniques, especially when trying to get pregnant.

Avoid or Quit Smoking: If you are smoking already, quit to prevent the effect of tobacco on your fertility.

Maintain a Healthy Meal Program: Eating plenty of vegetables and fruits full of antioxidants promotes improved sperm health.

Limit Vigorous Physical Exercise: Strenuous exercise can negatively impact hormone production and ovulation. However, moderate exercise is beneficial in increasing antioxidant enzyme levels that help protect sperm in men.

Cut Down on Alcohol Intake: Excessive alcohol consumption increases the risk of ovulation disorders. Also, it can hamper sperm and testosterone production and lead to impotence in men. Moreover, alcohol can be harmful to your unborn baby.

Avoid Exposure to Toxins and Pollutants: Toxins and pollutants like lead and dry-cleaning solvents can affect your fertility. Wear protective gear when handling chemicals like pesticides to prevent skin contact.

Freeze Sperm/Eggs: Consult your doctor about collecting and freezing sperm or eggs to preserve your fertility before commencing cancer treatment (radiotherapy or chemotherapy).

Avoid Using Lubricants During Intercourse: Even if they don’t kill sperm, they might prevent them from swimming through the cervix.



Fertility Treatment – Egg Donation, IVF, and More

For couples or individuals who are trying to conceive, but are unable to do so due to fertility problems, there is a wide variety of fertility treatment options. Some of the most common ones include: 

Hormones and Fertility Medication 

Hormones and fertility drugs can help you regain regular ovulation and restore hormone levels. Moreover, counselling and medication can help treat ejaculation or erection disorders.

Surgery

If your fertility problem is due to fibroids, endometriosis, or sperm duct blockage, the doctor may recommend a surgical procedure.

Intrauterine Insemination (IUI)

IUI is an assisted reproductive technology (ART) procedure that involves directly placing sperm into the uterus with the help of a catheter. This placement maximizes the chances of fertilisation and is ideal if your sperm has low motility.

In Vitro Fertilisation (IVF)

With In Vitro-Fertilisation, the doctor collects sperm and a mature egg and then puts them close for fertilisation in the lab. After three to five days, they transfer the embryo to your womb.

Intracytoplasmic Sperm Injection (ICSI)

ICSI is comparable to IVF, except that in this case, the doctor injects one healthy sperm into an ovum. Your fertility doctor may recommend this procedure if the man displays poor sperm mobility.

Donor Sperm and/or Egg

If you have difficulty conceiving because either or both of you have a fertility issue, you can benefit from a donor egg or sperm with IVF treatment. Your fertility healthcare provider can help you identify a suitable sperm/egg donor through their sperm and egg bank facility.

Donor Embryos

You may opt to use donor embryos if you haven’t succeeded in using the usual IVF. The treatment involves identifying a suitable frozen donor embryo, thawing, and transfer. However, the baby will be biologically related to you or your partner.

Why Is Knowledge Around Fertility So Important?

The global fertility rate is drastically declining. The leading causes of fertility problems are lifestyle and age-related. Avoiding harmful habits like smoking, drugs, and alcohol abuse and adopting a healthy lifestyle can help boost your fertility. Moreover, if you and your partner have tried conceiving unsuccessfully for one year, consult a reproductive endocrinologist for an evaluation. The specialist can help establish the cause and recommend a suitable fertility treatment to help with your journey to parenthood.

References

• ESHRE Capri Workshop Group. (2005). Fertility and ageing. Human reproduction update, 11(3), 261-276. Retrieved from https://academic.oup.com/humupd/article/11/3/261/759255

• Pincus, G. (2013). The control of fertility. Elsevier. Retrieved from https://books.google.no/books?hl=en&lr=&id=ehQlBQAAQBAJ&oi=fnd&pg=PP1&dq=fertility+&ots=HD3Vwi4B8H&sig=v_6i6D3z87E0Sn6hs6dFAr9oul4&redir_esc=y#v=onepage&q=fertility&f=false

• Hirschman, C. (1994). Why fertility changes. Annual review of sociology, 20(1), 203-233. Retrieved from https://www.annualreviews.org/doi/abs/10.1146/annurev.so.20.080194.001223

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