One in six Australian couples experience infertility – defined as taking longer
than 12 months to conceive for those under 35 and six months for over 35s.
The age of peak fertility for both genders is from their late teens to early thirties.
The following chart of the fertility-age link is an average estimate of the likelihood
of conception where both partners in a couple are the same age, after one year of
unprotected intercourse. Causes of infertility are many and varied and involve both
the male and female or a combination of contributing factors.
Low sperm count
A low count can be caused by blocked tubes, exposure to toxins, chronic disease
or over-heating of the testes. But a poor count doesn’t necessarily mean infertility
– it may just mean that it takes longer than average to conceive.
A healthy sperm has a long, whipping tail that helps it swim through the female
reproductive system. Sperm with poor motility may swim poorly or not move at all.
Abnormally shaped sperm may also have problems penetrating the surface of the egg.
Healthy sperm creation relies on the pituitary gland producing testes and follicle-stimulating
hormones. If the pituitary gland isn’t releasing enough of these hormones, the production
of sperm will be impaired. Underactive or overactive functioning of the thyroid
and adrenal glands can also have a negative impact on sperm. Blood tests will show
if this is an issue.
Defective genetic material
Research has shown men who have fertility problems have a high number of sperm with
broken or damaged DNA, the molecular chain that makes up a gene. DNA damage makes
it harder to conceive. Lifestyle changes, such as an improvement in diet, reducing
exposure to toxins and taking a vitamin supplement aimed at improving sperm quality,
such as Menevit, can help. Each Menevit capsule contains vitamin C, zinc, vitamin
E and folic acid. The product label has a full list of ingredients.
The most significant functional problem that can contribute to male infertility
is impotence, the inability to achieve or maintain an erection. There are many treatments
out there for impotence – some good, some not so good – so it’s best to shelve the
embarrassment and consult your doctor if this is a problem.
This generally refers to problems with releasing a mature egg from the ovaries each
month. Erratic or no ovulation can be due to hormonal problems, a disturbance in
the pituitary gland, chronic illness or being either excessively underweight or
overweight. If a woman’s menstrual cycle is inconsistent, this may be a sign that
ovulation is a problem. Treatment usually involves fertility drugs.
Polycystic ovarian syndrome
When a woman ovulates, her ovaries produce small follicles which ripen to release
an egg. But for a sufferer of polycystic ovarian syndrome (PCOS), the follicles
fail to ripen, forming little ovarian cysts. This results in unpredictable ovulation
patterns and irregular periods, making pregnancy more difficult. PCOS affects about
10% of women with fertility problems. Fertility drugs or in-vitro fertilisation
(IVF) may be viable options.
Blocked or damaged fallopian tubes could either prevent sperm reaching the egg or
stop the fertilised egg making its way to the uterus. Tube damage can be the result
of pelvic inflammatory disease, previous surgery or an ectopic pregnancy. Treatment
may involve surgery to open the tubes and IVF if surgery is unsuccessful or the
tubes are too badly damaged to repair.
Poor quality eggs
In some cases, ovulation occurs, but the eggs are damaged or have chromosomal abnormalities,
so a pregnancy can’t be sustained. While there are no outward signs to check egg
quality, age is a significant factor. A woman is born with her entire egg supply
of around two million immature eggs, and only around 400 mature. As she ages, the
quality of her eggs diminishes.
This is a condition where cells from the lining of the uterus (the endometrium)
grow in other parts of the pelvic area, such as the fallopian tubes, ovaries and
abdomen, which can result in fertility problems. Endometriosis is often treated
with surgery to remove the abnormal tissue or unblock tubes. Fertility drugs or
IVF are other options.