Infertility

Becoming pregnant can take time. Around eight in 10 couples will conceive naturally within a year of trying. If you’re not pregnant after a year of regularly having unprotected sex, one or both of you may have infertility.

One in seven couples in the UK is affected by infertility. It can be the result of several emotional or physical conditions, which may affect the man or woman, or both. For some couples, there are no known causes of infertility.

With both male infertility and infertility in women, treatments are available which will improve your chances of having a baby.

If you’re not pregnant after a year of having regular (every two or three days) unprotected sex, see your GP, ideally with your partner. If you or your partner is a woman over 35, ask your GP about the possibility of infertility sooner.

Your GP will discuss your health, lifestyle and your sex life with both of you. They’ll also ask about previous pregnancies or fertility problems and your sexual history.

Your GP may carry out physical examinations, including checking for conditions that can cause infertility. They may test your blood to measure hormone levels and may also test your blood or urine for chlamydia.

Your GP may refer you or your partner for further tests, including:

• Ultrasound scan – to check ovaries, womb and fallopian tubes
• Laparoscopy - keyhole surgery to identify and remove patches of endometrial tissue in and around the womb and ovaries
• X-ray – to check for blockages in fallopian tubes
• Semen analysis – to check the quantity and quality of sperm as a low sperm count is a common cause of male infertility

Following diagnosis, your GP can refer you to a consultant for fertility treatment or treatment for underlying conditions.

You’re more likely to have fertility problems if you:

• Have undergone cancer treatment
• Have had a sexually transmitted infection (STI), such as chlamydia
• Are overweight
• Smoke or drink alcohol
• Are stressed or depressed
• Have been exposed to chemicals that can cause infertility
• Polycystic ovary syndrome

The risk of infertility in women increases if you:

• Are over 35 – after the mid-thirties, female fertility declines
• Have irregular or very painful periods
• Have had several miscarriages
• Have endometriosis or pelvic inflammatory disease (PID)

The risk of infertility in men increases if you:

• Had mumps during puberty
• Have a low sperm count, small testicles or a swollen scrotum (varicocele)
• Have had testicular or prostate problems

There are three main types of fertility treatment.

Medical treatment

Your GP may prescribe drug treatment to stimulate or regulate ovulation.

Surgery

For women, this can involve removing scar tissue inside the fallopian tubes or cysts or growths from your womb. For male infertility, surgery can reverse a vasectomy, remove blockages preventing sperm release or correct anatomical issues.

Assisted conception

There are three main types of assisted conception:

• Intra-uterine insemination (IUI) – sperm from a woman’s partner or a donor is placed in her uterus so an egg can be fertilised
• In vitro fertilisation (IVF) – eggs are removed from a woman’s womb, fertilised with her partner’s or a donor’s sperm and returned to her womb
• Intracytoplasmic sperm injection (ICSI) ­– performed as part of IVF, where the sperm is injected directly into the egg as a treatment for male infertility
• Gamete intrafallopian transfer (GIFT) – an egg and sperm are inserted into a woman’s fallopian tubes so fertilisation can happen naturally

Your doctor will discuss which treatment is best for you and your partner. This will depend on the causes of your infertility and your general health.