What is Infertility?
Infertility affects many men and women across the world. In the UK, 1 in every 7 couples experience infertility when trying to conceive.
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Infertility refers to when a couple cannot conceive despite having regular unprotected sex. It is common, affecting 1 in every 7 couples in the UK. It may take longer to conceive naturally depending on your personal circumstances. However, if you have not conceived after one year of trying, we recommend that you see your GP or a fertility specialist. For women aged 36 over, we recommend seeing a GP sooner, after six months of trying. For couples where one or both partners has a known fertility issue, we recommend seeing a specialist before you begin trying for a baby.
For healthy women under the age of 35, there is roughly a 25% chance of getting pregnant each month during ovulation. After turning 35, a woman’s reproductive potential begins to decrease and after the age of 40, the chance of conceiving naturally falls to 10% during ovulation. This continues to decrease with age.
A medical diagnosis of infertility involves a fertility assessment. This consists of a review of your full medical history, a routine physical examination and specific blood analyses. For women, the basic tests include a basal hormone assessment, an ultrasound scan and a hysterosalpingography (an X-ray to assess the uterine cavity and fallopian tubes). The number and range of tests required may be greater depending on your personal circumstances. For men, there is a detailed semen analysis which evaluates its quality, assessed via a seminogram test.
Primary infertility refers to couples who have not been able to conceive despite having regular unprotected sex for at least one year. Secondary infertility in contrast, refers to couples who were able to conceive before, but are having problems or are unable to conceive or get pregnant again.
Ovulation, or a woman’s fertile period, occurs around halfway through each cycle, on roughly the fourteenth day in a supposed 28-day cycle. It has been proven that 24 hours after ovulation there is a rise in base body temperature of between 0.4 and 0.6 degrees. This is the signal on which the control method is based, marking the days on which ovulation occurs.
Once the ovum (egg) is released from the ovary during ovulation, it survives for approximately 48 hours. It is only during this time that it can be fertilised by spermatozoa (sperm). Sperm cells maintain their ability to fertilise eggs for a maximum of 72 hours. If you’re trying to get pregnant, it’s recommended to have sex every one to two days during your fertile window, which begins four days before ovulation until one day after ovulation). While it is very normal to feel the need to carefully monitor ovulation while trying to get pregnant, it is best not to let it control your life completely. This can cause anxiety, which is often counterproductive to getting pregnant, and it can even damage your relationship with your partner.
If you have been trying to get pregnant for longer than one year, the probability of a spontaneous pregnancy after one year of trying is relatively low. At this point, it is best to see your GP or a specialist.
Many women and men have children later in life for a wide variety of reasons. However, due to the nature in which fertility decreases over time, it can be more difficult to conceive as an older age. This is particularly true for women. Female fertility decreases more rapidly after the age of 35, while male fertility gradually decreases after the age of 40. Both men and women are normally most fertile in their twenties.
There is no legal age limit that prevents an individual or a couple from having fertility treatment. However, treatment outcomes depend on the unique circumstances of each person, such as their medical history and their fertility health, which is greatly affected by age for both men and women. For women, 50 years old is a reasonable limit beyond which fertility treatment is not typically recommended unless in exceptional circumstances. This applies for both treatments with own eggs and with donor eggs.
You can find guidance from the NHS here about trying for a baby and also treating infertility.