Approximately 1 in 8 couples (15%) have infertility. This is defined as no conception after 12 months of unprotected sex. At this stage fertility investigations should be done to assess the cause of the problem. When women have irregular periods or are older than 35 years, investigations should be started after 6 months of unprotected sex.
The cause may be related to one partner or both partners. The cause of the problem is a male factor in 40% and a female factor in 40% of couples. Twenty percent of couples have mixed male and female factors. Unexplained infertility is uncommon.
In women the main problems can be:
– failure to ovulate (not releasing eggs)
– damage to the fallopian tubes after pelvic infection
– endometriosis which can interfere with reproductive function and cause pelvic pain
– uterine problems (for example fibroids growing on the womb)
– poor ovarian function due to advanced age or premature ovarian failure
– problems with the cervix
In Men the main problems can be:
-Reduced sperm cell count from infection or smoking/alcohol
-Reduced sperm cell motility
-Abnormal sperm cell shape
-Absent sperm cell from blockage of semen tube
-Disorder of ejaculation & erection from medical illness like diabetes