Article: Dr Klaus Wiswedel Image: Images24

There is a multitude of reasons responsible for this and one of them is that young couples are often putting off starting a family until they are well established in their professional life and by the time they find out that they have a problem they are well in their thirties or even early forties. Fertility of a woman declines significantly with age and significantly so after the age of 35.

Multiple environmental factors are responsible for a decline in sperm quality over recent years, like lead in our polluted atmosphere, oestrogen in meat and oestrogenising effects of some plastics. It is for this reason that ever increasing numbers of men are seeking help at fertility clinics around the country.

In the past and even today, the local gynaecologist has always been considered adequate in dealing with the problems of an infertile couple. This is unfortunately no longer the case as it needs very specialised knowledge, a lot of time and patience and, in most cases, the help of a highly sophisticated fertility laboratory to achieve a pregnancy. It is for that reason, that all over the country fertility clinics have sprung up with laboratories and gynaecologists dedicated only or mainly to fertility work.

Defining infertility
Infertility is a medical condition of the reproductive system resulting in the inability to conceive after one year of unprotected well timed intercourse. Infertility also includes the inability to carry a pregnancy to the delivery of a live baby and is then often called reproductive failure.

The question often raised is: why wait for a year? If all is normal, why does one not fall pregnant after having intercourse once at the time of ovulation? The problem is, that even when all is normal, the chance of falling pregnant is less than 20% per month of trying. The reason for this is, that a multitude of abnormal eggs are being ovulated as well as abnormal sperm fertilising normal eggs leading to failure of implantation into the uterus. So, to wait a year sounds reasonable.

On the other hand, though, it does not make sense to wait longer than 6 months, for example, in women over the age of 35, or if there are known infertility problems like endometriosis or poor sperm quality. If there are obvious problems like a very irregular cycle, previous open pelvic surgery, a diagnosis of endometriosis or polycystic ovaries, one should seek the help of a fertility clinic immediately.

Infertility is a problem of the female in about 35% of couples, of the male in 30%, a combined problem in another 30% and the remaining 5% is classified as 'unexplained' infertility, though during the course of investigations at least in another 3% the reason for their infertility can be found.

In spite of the frustrating and seemingly low pregnancy rates and the confusing array of conditions and their interactions leading to infertility, there is hope. In the 21st century science and technology is coming to grips with infertility. In a good fertility clinic, which offers all the latest technologies and advances in the treatment of infertility, more than 90% of all couples should be able to conceive their own baby and the immediate future holds tremendous promise even for the remaining 10%.

Frequently asked questions

Is infertility genetic?
Yes and No.
No – if infertility were genetic in origin, it would breed itself out very fast, as infertile parents would not have children to pass it down to.

Yes – there a few conditions found in parents and their offspring, which are associated with infertility or reduced fertility, for example polycystic ovaries. In general as a guideline, infertility is an acquired problem and does not stem from your parents.

If I have been treated successfully for infertility and I want another baby, will I need the help of a fertility specialist again?
Usually yes. Your fertility problem will not go away with a pregnancy and next time around you will face the same problem. There are exceptions, though, one of them being endometriosis which can completely disappear or improve with pregnancy.