What are the causes?
Infertility is defined as the inability to conceive after 12 months or more of unprotected sex. If you have been trying to have a baby for a year or more, it is time to speak to your GP. If you are over 35, you should see a doctor if you have been trying to conceive for six months or more.
About one in six Australian couples experience fertility difficulties. There are many reasons for this, some relating to the male partner, some to the female partner, and sometimes both. For many people, there is no medical explanation as to why they can’t conceive. This is referred to as unexplained infertility.
A diagnosis of infertility often comes as a shock and can be 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.
If you suspect a fertility problem, talk to your GP who will guide you through the steps of an infertility investigation.
There are many reasons why pregnancy does not occur. About 20 per cent of infertility cases are due to male factors and 30 per cent are due to female factors. Sometimes both partners have a fertility problem, and in about 20 per cent of cases, there is no apparent cause of infertility (idiopathic or unexplained infertility).
Many people are delaying starting a family beyond their most fertile years. If you are unable to conceive due to social circumstances, such as relationship, age, financial or practical reasons, and are concerned about your fertility declining, you might want to consider fertility preservation (e.g. freezing eggs or sperm for future use).
The Better Health Channel has helpful information on infertility in men and infertility in women.
Speak to a GP
The first point of contact should be your 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 straight away. The fertility specialist will do more tests to establish the cause of infertility and determine the type of fertility treatment you may need.
The chance of fertility treatment working has greatly improved since the late seventies when the first IVF baby was born. Although your chance of having a baby with fertility treatment 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 success through fertility treatment.
Finding a fertility specialist
Fertility treatment is physically and emotionally demanding, and depending on your needs it can be expensive, so it is important to find a clinic and doctor that is right for you. You can ask your GP for advice about choosing a fertility specialist, but you can also do your own research before committing to a doctor and clinic. You can find out more about choosing a fertility clinic here.
Finding a fertility counsellor
If you want to speak to a private counsellor specialising in infertility, the Australian and New Zealand Infertility Counsellors Association (ANZICA) has a list of independent counsellors.
You can also ask your fertility clinic about the counselling sessions included as part of your treatment.