Most people take their fertility for granted and do not expect to have problems conceiving. However, one in nine couples experience fertility difficulties.
What to do if you suspect a problem
If you have been trying to conceive for a year or more, it is time to seek medical advice. If you are over 35, you should see a doctor if you have been trying to conceive for six months or more.
The first point of contact should be your general practitioner (GP) who will start an infertility investigation. This involves a detailed medical history and a physical examination of both partners and some basic tests to make sure that the woman is ovulating and that the man produces sperm. If everything seems in order, your GP may advise you to keep trying for a little longer before consulting a fertility specialist. However, if your test results indicate a problem, your doctor will refer you to a fertility specialist without delay. The fertility specialist will do more tests to establish the cause of infertility and determine the type of treatment you may need.
Causes of infertility
There are many reasons why pregnancy does not occur. About one third of infertility cases are due to male factors and one third due to female factors. Sometimes both partners have a fertility problem. In about 20 per cent of cases, there is no apparent cause of infertility, so called unexplained or idiopathic infertility. As more couples delay childbearing age-related infertility is becoming more common.
Dealing with infertility
A diagnosis of infertility often comes as a shock. It is unexpected and unwelcome and emotionally challenging. Unlike other adverse life events, which may have a clear resolution, infertility is uniquely distressing because it can last for many years and the outcome is uncertain. Some people find it helpful to discuss their feelings with a psychologist or counsellor. Others feel better if they take action by starting treatment.
What to do next
Once the cause of infertility has been pin-pointed, your doctor will discuss treatment options with you. These will vary depending on the cause of infertility but will most likely involve some form of assisted reproductive treatment. You need a referral from your GP to see a fertility specialist. Your GP may recommend a fertility specialist, unless you have a preference for a particular ART clinic or individual fertility specialist.
The chance of ART treatment working has greatly improved since the late seventies when the first IVF baby was born. Although your chance of having a baby with ART depends largely on factors that are beyond your control, there are some things that you can do to improve the odds. The lifestyle factors that influence the chance of natural conception for both men and women also affect your chance of ART success.