Fertility is a topic that touches many lives, yet it often remains shrouded in misconceptions and uncertainties. Understanding fertility challenges and the available treatments is crucial for individuals and couples navigating this complex journey. In this comprehensive guide, we address frequently asked questions and explore the options available to those facing fertility issues.

What is the current fertility rate in the UK?

The fertility rate in England and Wales has experienced a significant decline in recent years. As of 2023, the average number of children per woman stands at 1.44, marking the lowest rate in at least 85 years. This is a notable decrease from the post-World War II “baby boom” era, where the rate peaked at 2.93 children per woman in 1964.

What is infertility?

Infertility is a common issue that many couples face when trying to conceive. It is defined as the inability to get pregnant after one year of regular, unprotected intercourse. Infertility can stem from various factors, including problems with ovulation, sperm production, or issues with the fallopian tubes. In some cases, infertility remains unexplained, meaning no specific cause can be identified despite thorough medical evaluation. The World Health organization have categorised infertility as a disease of the reproductive organs.

What is female infertility?

Female infertility is a prevalent concern that can arise from several underlying issues:

  • Disruption of Ovarian Function: Conditions like polycystic ovary syndrome (PCOS), premature ovarian failure (POF), and ovarian cysts can interfere with normal ovulation.

  • Fallopian Tube Obstruction: Blockages, scarring, or other damage to the fallopian tubes can prevent the egg and sperm from meeting.

  • Uterine Abnormalities: Issues such as fibroids, polyps, and congenital uterine anomalies can affect implantation and pregnancy.

Women over the age of 35 are at a higher risk of infertility, as fertility declines with age. Other risk factors include smoking, obesity, and a history of pelvic surgery, all of which can negatively impact reproductive health.

What is male infertility and what causes it?

When trying to get pregnant, a female partner usually undergoes fertility tests first, these can be invasive and stressful. However, in a couple, it is equally as likely to be the male experiencing infertility as it is the female. With male fertility problems accounting for around 50% of infertility cases.   

For men, fertility struggles often stem from issues with sperm such as low sperm count, poor sperm motility (sperm movement), and sperm morphology (oddly shaped or not grown fully). But other causes of infertility include Retrograde ejaculation (when the semen goes into the body rather than out of the penis), Varicoceles (when the veins in the scrotum are blocked), age and lifestyle factors.

Watch now: How do you improve sperm quality, motility and count?

How do you test a woman’s fertility?

The type and number of tests vary, depending on the individual and any symptoms that they may be presenting. Tests may include:

  • ‍Ovulation testing (a urine test to determine whether an egg might be being released each month).

  • Ovarian reserve testing (a hormone test to check how many eggs are left).

  • Pelvic ultrasound (to check for any signs of disease).

  • Hysteroscopy (a check of the uterus, to look for any abnormalities).

  • Hysterosalpingography (an x-ray, to check for blockages).

  • Laparoscopy (to examine the fallopian tubes, ovaries and uterus).

How do you test a man’s fertility?

‍As with women, the type and number of tests carried out, will depend on the individual. Tests may include:

  • ‍Semen analysis (to check the number, morphology and motility of the sperm).

  • Genetic testing.

  • Hormone testing.

  • Testicular biopsy.

  • Ultrasound.

 How common are fertility issues in the UK?

Fertility problems are relatively common in the UK. Approximately 1 in 7 couples may experience difficulties conceiving, equating to around 3.5 million people.

When should you seek medical advice?

It’s advisable to consult a healthcare professional if:

  • You’re under 35 and you’ve been trying to conceive for over a year without success.

  • You’re over 35 and you’ve been trying for six months without success.

  • You have known medical conditions: If you have conditions like PCOS or endometriosis, seeking advice earlier may be beneficial.

Additionally, for women over 35, ovarian reserve testing is recommended to assess their egg store and future fertility prospects.

 What fertility treatments are available in the UK?

Several fertility treatments are available, depending on the underlying cause:

  • Medications: Drugs such as clomifene can stimulate ovulation.

  • Surgical Procedures: Operations can correct issues like blocked fallopian tubes or remove endometrial tissue.

  • Assisted Reproductive Technologies (ART): Procedures like in vitro fertilisation (IVF) involve fertilising an egg outside the body and implanting it into the uterus.

    • Artificial Insemination: Intrauterine insemination (IUI) involves inserting sperm directly into a woman’s uterus, playing a crucial role in infertility treatments, especially for couples with specific sperm and fertility qualifications.

    • Donor Eggs: Used in IVF for women who cannot produce their own eggs or for same sex male couples, donor eggs are part of third-party reproduction and involve legal considerations regarding donor anonymity and implications for children born from donor eggs.

Preserving Fertility Options (Frozen Embryos and Eggs)

Preserving fertility through options like freezing embryos or eggs can be a valuable choice for individuals or couples not ready to conceive immediately. This is particularly beneficial for women approaching the age of 35, as fertility declines with age.

Frozen embryos can be used in future IVF treatments, while frozen eggs can be utilized for IVF or intrauterine insemination (IUI). It’s essential to discuss these options with a fertility specialist to understand the costs, success rates, and potential risks involved. Considering your medical history and the advice of a fertility expert can help you make an informed decision about preserving your fertility for the future.

What are the success rates of fertility treatments?

Success rates vary based on factors like age, the cause of infertility, and the type of treatment:

  • IVF: According to the Human Fertilisation and Embryology Authority (HFEA), the average birth rate per embryo transferred for women under 35 is approximately 32%. This rate decreases with age.

    • Multiple pregnancy is a common complication of ART, particularly with IVF. Limiting the number of embryos transferred can help prevent this outcome and reduce associated risks like preterm birth.

  • Other Treatments: Success rates for treatments like intrauterine insemination (IUI) or fertility medications vary and should be discussed with a healthcare provider.

How do I choose a fertility clinic?

Selecting the right fertility clinic is a crucial step in your fertility journey. Consider the following factors:

  • Success Rates: Look for clinics with high success rates for your specific type of infertility.

  • Experience: Choose a clinic with experienced doctors and staff who understand your unique needs.

  • Facilities: Evaluate the quality of the clinic’s facilities and equipment.

  • Cost: Compare the costs of different clinics and understand what is included in the price.

Additionally, research the clinic’s reputation by reading reviews from other patients and seeking referrals from your GP or other healthcare professionals. A well-regarded clinic with a proven track record can make a significant difference in your treatment experience.

Is NHS funded IVF treatment accessible?

NHS-funded IVF access varies across the UK and depends on specific commissioning policies set by Integrated Care Boards (ICBs). These policies include specific eligibility criteria such as age, body mass index (BMI), and whether one partner has a child from a previous relationship. It’s essential to check local guidelines to understand eligibility and availability.

What lifestyle changes can improve fertility?

Adopting a healthy lifestyle can positively impact fertility:

  • Balanced Diet: Consuming a nutritious diet supports overall reproductive health.

  • Regular Exercise: Engaging in moderate physical activity helps maintain a healthy weight and reduces stress.

  • Avoiding Harmful Substances: Limiting alcohol intake, quitting smoking, and reducing caffeine consumption can enhance fertility prospects.

How does age affect fertility?

Age is a significant factor in fertility:

  • Women: Fertility declines gradually from age 30, with a more rapid decrease after 35. By age 40, the chance of natural conception within a year drops to around 5%.

  • Men: While men can remain fertile into older age, sperm quality declines over time, potentially affecting the ability to conceive.

Early recognition and proactive measures can improve the chances of getting pregnant naturally.

Can stress affect Fertility?

While stress alone is unlikely to cause infertility, it can impact overall health and well-being, potentially influencing reproductive health. Managing stress through relaxation techniques, counselling, or support groups can be beneficial during the fertility journey.

For more tips watch our video on The cost of hidden stress and how to mitigate it.

Are there support services available?

Yes, numerous support services are available:

  • Counselling: Professional counselling can help address the emotional aspects of fertility challenges.

  • Support Groups: Organisations like Fertility Network UK and the Fertility Alliance offer support groups and resources for individuals and couples.

  • Online Communities: Engaging with online forums, like the IVFN, can provide a sense of community and shared experience.

How can IVFN help?

Navigating fertility challenges can be emotionally and physically demanding. However, understanding the factors involved and the treatments available can empower individuals and couples to make informed decisions. Seeking professional advice early, adopting a healthy lifestyle, and accessing support services are crucial steps toward achieving fertility goals.

Here at IVFN our leading fertility experts from around the globe provide advice and support on a number of fertility questions and our community of thousands of people on their own fertility journey are can provide additional support so you know you’re not alone. Join today.