23 October 2019

Rise in infertility rates in the UK

Medical Director
Cesar Diaz-Garcia
MD PhD Assoc Prof
IVI London

 

Several recent reports have confirmed what many people have suspected for some time: that infertility rates in the UK are rising. This is not a new phenomenon, there has been a dramatic increase in infertility over the last 60 years or so. We are not alone in this, in fact, the rise in infertility is reflected throughout the developed world.

Is this a purely social phenomenon resulting from the fact that better education and career opportunities have led to women delaying motherhood until their mid-30s when fertility starts to decline? Or are there more complex factors at play? Are infertility rates in the UK rising because of environmental factors taking a toll on sperm quality? And what can individuals, who may not even be sure that they want to become parents in the future, do to keep their options open by protecting their fertility?

What is the evidence for rising infertility in the UK?

A report published by the Office for National Statistics in August 2019 confirmed that the birth rate in England and Wales had reached a new low during 2018. The report shows that from a high point of 20.5 live births per thousand population in 1947, the 2018 rate has decreased to 11.1 births. The ONS says that the remarkable decrease could be driven by both an aging population and falling fertility rates.

Their conclusions are echoed in a major IVI study into declining male fertility. IVI fellow Dr. Ashley Tiegs led a study of just under 120,000 men, focusing on the total mobile sperm count, which is the most significant factor in the likelihood of conception. She and her team found that the percentage of men who are at risk of needing fertility treatment has increased quite dramatically from 12.4% in 2004 to 21.3% in 2017, almost twice the percentage in just over a decade.

Social changes leading to the rise in infertility

We hear a lot about social changes being the reason for the rise in infertility. Often cited is the fact that women have more freedom to choose between career and family, plus the social pressures that lead many of them to delay parenthood until they have established a career, financial stability, and have found the right partner. As a result, many women delay motherhood until their mid to late 30s, and it is well known that fertility starts to decline around the early ’30s, decreasing gradually until the early ’40s, after which most women have a poor fertility prognosis.

There is no doubt that these social factors are significant, but there is another reason for the rise of infertility, and this is the widespread decline in sperm quality. A study by the Hebrew University of Jerusalem revealed that sperm counts for men have more than halved over the last 40 years. And the social factors that affect women also apply to men. They too are waiting longer to have children, and there is growing evidence that as men age, the quality of their sperm declines. Their ‘best before’ date is around the age of 40.

Could environmental factors be the cause?

There is a variety of causes of male infertility but in the absence of any specific medical reason, the spotlight is increasingly on environmental and lifestyle factors. Heat, chemicals and toxins can cause a deterioration in the quality of sperm. Specific concerns include:

  • Exposure to industrial and agricultural chemicals such as herbicides and pesticides, organic solvents and painting materials. These can all have an impact on sperm quality.
  • Radiation or X-ray exposure can reduce sperm count and quality on a temporary or permanent basis.
  • Overheating, for example through frequent use of hot tubs or saunas, can reduce sperm quality, as an increased temperature in the scrotum due to sitting for a long time, tight clothing or even using a laptop for long periods.
  • Lifestyle choices such as the use of drugs, alcohol, and tobacco can have a big impact on male fertility. Obesity is a known reducer of fertility and even depression and stress can take their toll on sperm quality.

How can you protect yourself against infertility?

Declining fertility is a widespread phenomenon and not fully understood. The IVI study of male infertility noted the impact of exposure to harmful environmental influences, but it also acknowledges that more research is needed into specific causes. In spite of this, there are steps that people can take on an individual level to safeguard their fertility.

  • Both men and women can optimize their chances of remaining fertile by taking care of their general fitness, maintaining a healthy weight with a BMI between 20 and 25, and taking a reasonable amount of exercise. Avoiding recreational drugs, alcohol, and tobacco will also help protect the quality of both sperm and eggs.
  • For women, as well as general health care, aging is the most obvious cause of declining fertility. Recognizing the reality of this while there is still time to take action can be a very positive step. We at IVI estimate that if eggs are vitrified for later use before the age of 35, there is a 40% increase in the subsequent IVF success rate. You can take a look at our YouTube video about the vitrification of oocytes to find out more about this process.

 

What are the main causes of male infertility?

What are the main causes of female infertility?

If you have any concerns about your own fertility, you could look at the range of treatments available with IVI. Our success rates are excellent and there is a range of possibilities for assisted reproduction techniques targeted for couples with fertility problems, whether male, female or both, as well as single women intending to have children.

Our London branch offers a great chance to take a tour of the flagship clinic in Wimpole Street in an open evening, with our Medical Director available to answer any questions you may have about the various treatments. We look forward to welcoming you!

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