The truth about infertility revealed

In most cultures a woman is often blamed when she cannot conceive, overlooking that the man can also struggle with fertility issues. According to experts, 1 in 4 couples in developing countries struggle with infertility. Between 20 and 30 percent of infertility cases are explained by physiological causes in men and between 20 and 35 per cent by physiological causes in women. Between 25 and 40% of cases are due to a problem in both partners and unfortunately, in 10-20 per cent no cause is found. It’s therefore understandable why infertility has been recognised as a public health issue worldwide by the World Health Organization (WHO).

What is infertility?

According to Dr Sulaiman Heylen, who is the president of the Southern African Society of Reproductive Medicine and Gynaecological Endoscopy (SASREG), not all couples who want a pregnancy will achieve one spontaneously and many will need to seek medical treatment to help resolve underlying fertility problems. “Infertility is when you cannot get, or stay pregnant, after trying to conceive for at least a year, and you are under the age of 35,” the doctor explains, adding that causes of infertility include. stress, depression and anxiety.It doesn’t make matters any easier that in some cultures, name calling is rife when you can’t have a baby.

Factors that contribute to infertility

Age is a key factor: A woman’s age is one of the most important factors affecting whether she is able to conceive and give birth to a healthy child. Dr Heylen says up to 50% of all patients who visit a fertility centre are 35 years or older. She highlights that a man’s fertility appears to decline later in life than in a woman’s. If you and your partner do want children, but are not ready to take this step yet, it might be worth looking into fertility options and fertility preservation such as freezing your eggs, for when you are ready to start a family.

Lifestyle factors: Infertility is also associated with lifestyle factors such as smoking, body weight and stress.

Her eggs: The number and quality of eggs decreases and deteriorate naturally and progressively from the time a woman is born until the time she reaches menopause.

Reproductive conditions: Fibroids, endometriosis and tubal disease are more common and can affect fertility.

Family history: If you have any of the following risk factors, you should also consider seeking advice earlier:

• Family history of a mother or sister who experienced early menopause- before age 51.
• Previous ovarian surgery
• Exposure to chemotherapy or radiation to treat cancer in either partner
• Shortening in the time between periods
• Skipped or missed periods
• History of injury to the testicles
• Exposure to toxic chemicals like pesticides.

 When to seek advice

After a year of unprotected sex and you still struggle falling pregnant, it is advisable to seek help as couple. The doctor will conduct a physical examination of on the both of you to determine your general state of health and to evaluate physical disorders that may be causing infertility. Usually both partners are interviewed about their sexual habits in order to determine whether sex is taking place properly for conception.Dr Heylen says, “If no cause can be determined at this point, more specific tests may be recommended. For women, these include an analysis of ovulation, x-ray of the Fallopian tubes and uterus and laparoscopy. For men, initial tests focus on semen analysis.”

Treatment options

In recent years, the number of couples seeking infertility treatment has dramatically increased and Dr Heylen attributes this to factors such as women having children later on in life due to work and financial commitments, development of newer and more successful techniques for infertility treatment. This increasing participation in fertility treatment has also raised awareness.Before a treatment option can be decided on, you and your partner will need to be evaluated by your fertility specialist to find what is causing your infertility. “If you find yourself feeling anxious, depressed, out of control, or isolated, you are not alone,” says Dr Heylen. “Infertility is more common than you might think, but there is no reason to lose hope. Visit a fertility clinic near you to speak to a doctor about the options available to you and your partner.”