About fertility

Infertility can be due to a number of causes. These include problems with eggs (a reduced store or failure to release), blocked fallopian tubes or low numbers of sperm. At our Women's Hospital, we will investigate all possible causes to allow us to develop a treatment plan that best suits your needs.

In one in four couples, there is no identifiable cause for infertility despite thorough investigations, but even in this situation, we will still be able to help you with various treatment options.

Fertility in men

The quality and quantity of sperm both have a major impact on fertility. Some men produce low numbers of sperm (oligozoospermia), which reduces the chances of a sperm reaching the egg.

Fertility problems may also be caused by sperm not being able to swim properly or by the sperm being abnormally shaped.

All men seeking fertility treatment will be asked to attend the clinic for a semen analysis, which will check for all these factors.

Sperm problems may be the cause of infertility in as many as 50% of couples suffering from infertility. If any problems with sperm are identified, we may be able to provide assisted conception treatment using ICSI (intracytoplasmic sperm injection).

Some men produce semen that does not contain any sperm. This is called azoospermia. Half of azoospermic men have normal sperm production from the testes, but there is a blockage which prevents sperm from entering the semen.

This may be due to:

  • Failure of the sperm transport tubes to develop
  • A blockage of the sperm transport tubes
  • A previous vasectomy operation

All of these can potentially be treated using IVF with ICSI after retrieving sperm using a minor operation that we can carry out in the Fertility Centre.

Fertility in women

Every month a fertile woman releases an egg and her body prepares for a fertilised egg to implant. Each egg is encased within a special set of cells called the follicle which helps the egg develop and grow. In a normal cycle, only one egg will develop to maturity and be released from its follicle. This is why most naturally occurring pregnancies result in a single baby.

During the time the egg is growing, the lining of the womb starts to thicken. This is a highly specialised environment where the early embryo will attach and implant.

Approximately 14 days after the start of the last menstrual period, the ripe egg is released (ovulation). This is the best time to have intercourse and try for a baby.

The egg enters the fallopian tubes where, for about 24 hours, it may be fertilised. If the egg is fertilised it will begin to develop into an embryo as it passes down the tube into the womb where it may implant. If the egg is not fertilised, or the embryo does not implant, all the extra lining of the womb prepared for the embryo breaks down and results in a menstrual period.

Problems may occur because of a failure to ovulate, as a result of blocked fallopian tubes, or problems with the womb lining.

How you can improve your own chances

Whether you are trying to get pregnant without our help, or just want to improve your chances of conception, there are a number of things you can do:

  • Have a healthy, balanced diet and take reasonable exercise– being overweight has been shown to have a negative impact on fertility. You can seek more advice on this from us or your GP.
  • Do not smoke– not only might this reduce your chances of conception, but either parent smoking can have effects on your unborn child.
  • Avoid excess alcohol.
  • Be aware of what date you might ovulate, though in general we would recommend trying to have intercourse at least twice per week, which should mean that you will always have intercourse during the fertile period.
  • Avoid the use of vaginal lubricants such as KY jelly, Durex Play or Astroglide, which are toxic to sperm and will reduce your chances of conception.
  • Women should take folic acid tablets in preparation for pregnancy to reduce the risk of their child having developmental problems. Some women require a higher dose of folic acid (5mg). Women with a body mass index of 30 or above, epilepsy, diabetes or malabsorption conditions such as inflammatory bowel disease require this dose.

Obviously, many people will fulfil all of the above and still have difficulty getting pregnant. If you have been trying for a pregnancy and not succeeding, then this is the stage when you should seek further help and advice