Fertility Issues and Infertility: Everything You Need to Know
According to the World Health Organisation, roughly 1 in 6 people worldwide are affected by infertility. However, despite how common this condition is, fertility issues is still a poorly-discussed topic.
Whether you’re struggling to get pregnant with your first child or you’re having trouble conceiving after a previous pregnancy, it can be really difficult to open up about your experiences and find helpful information.
In this article, we will cover common fertility issues, and potential ways to improve fertility, offering insights and explanations for those who may be struggling to conceive.
What is fertility?
Fertility refers to a person’s natural ability to conceive children – which does not come easily to everyone.
For those born with female anatomy, fertility is focused on your ability to ovulate and get pregnant, with fertility issues being primarily concerned with egg and uterine health. On the other hand, those born with male anatomy their fertility focuses on sperm health and its ability to fertilise an egg.
Some people can get pregnant quickly, while others might take slightly longer to conceive. According to the NHS, more than 80% of couples will conceive naturally within a year of regular unprotected penetrative sex, where the woman is under 40.
However, the NHS also reports that 1 in 7 couples will struggle to conceive, experiencing fertility issues while having regular unprotected penetrative sex. This can understandably be a frustrating and worrying experience, so it’s important that you seek support during this uncertain period.
In terms of medical support, it’s recommended you see your primary care clinician if you’ve been trying for over a year and you’re still struggling to get pregnant. However, if you’re a woman over 35 (or you’re already aware of potential fertility issues), it’s best to talk to your primary care clinician sooner to better understand your situation.
What are common causes of infertility?
If you’re struggling to get pregnant or have experienced fertility issues in the past, it can often feel like there’s no clear reason. In fact, according to the NHS, it’s not possible to identify the cause for a quarter of fertility issue cases.
However, it’s still important to talk to your GP or primary care clinician about potential causes of infertility, so you can rule out or better understand the reasons why you’re struggling to conceive. For example, common causes of infertility or reduced fertility in women include:
Endometriosis: With endometriosis, tissue that typically only grows on the inside lining of your womb starts to grow in other parts of the body. If this tissue appears on your ovaries or fallopian tubes, it can change the hormonal environment around your eggs and even alter the quality of those eggs, potentially leading to fertility issues.
Blocked or damaged fallopian tubes: If you’re struggling to conceive, it could be due to blocked or damaged fallopian tubes that interfere with the movement of both the sperm and the egg. These blockages can be caused by endometriosis, pelvic inflammatory disease, or ectopic pregnancy, a pregnancy that occurs outside the uterus.
Ovulation issues: You may be struggling to get pregnant simply because your body does not regularly release an egg. This can be caused by polycystic ovary syndrome (PCOS), which disrupts ovulation, increases androgen hormones, and enlarges your ovaries. Often, PCOS and pregnancy issues are closely linked, so be sure to talk to your GP or primary care clinician about managing any symptoms.
Age: While you can get pregnant until they reach the menopause, your fertility declines naturally as you get older. That’s because your number of eggs decreases as you get older. In particular, women older than 35 are much more likely to struggle to conceive, compared to their late teens and 20s.
If you’ve been trying to get pregnant for more than a year (or for more than 6 months, if you’re over 35), you may want to speak to your primary care clinician about these potential causes of infertility. Similarly, if you have a partner, it can be useful to check up on their fertility too, such as their sperm health. This can help you better understand why you may be struggling to get pregnant.
How to improve fertility
While there are medical treatments that can address specific causes of infertility, both men and women can make some lifestyle changes to improve fertility, if you’re struggling to get pregnant:
Stop smoking: Smoking reduces the quality of the eggs you produce and can also speed up the loss rate of eggs. Studies have also shown that women who smoke are at an increased risk for struggling to get pregnant. Other research has also revealed that tobacco smoke reduces semen quality.
Stop drinking alcohol: Drinking alcohol can disrupt hormone levels and the ovulation process, which makes it harder to conceive. For those struggling to conceive, cutting out alcohol completely can help keep your cycles regular, helping to improve your fertility. In terms of male fertility, alcohol can lower testosterone levels, as well as sperm count.
Cut down on caffeine: Similar to alcohol, high caffeine levels can affect your ovulation and hormone levels, as well as impact sperm quality, which can lead to fertility issues. By reducing your caffeine intake, typically to 200mg a day (one or two cups of coffee), you can look to improve your fertility
Eat a healthy, balanced diet: A simple way to improve fertility is to eat a healthy and balanced diet, ensuring you get all the essential nutrients your body needs. It’s also important to cut out unhealthy or sugary foods too, as research shows that a diet high in trans fats, refined carbohydrate and added sugars can negatively impact fertility.
Exercise regularly: If you’re struggling to conceive, staying active can improve your fertility and help you get pregnant. That’s because regular activity stimulates egg production and increases ovulation rates. Also, being overweight can cause hormonal imbalances, which could result in struggling to conceive. By exercising regularly, you can help maintain a healthy weight and improve your fertility However, it’s important to not overdo it, as some studies link excessive exercise with fertility reduction. Instead, try low impact exercises to improve your fertility.
Reduce stress levels: While telling someone to reduce their stress levels is easier said than done, especially if they’re struggling to get pregnant, it’s still important to try some stress-busting techniques. That’s because chronic or extreme stress can disrupt your ovulation, preventing eggs from being released. For men, higher stress levels have been linked to lower testosterone and decreased sperm count.
Remember, these lifestyle changes should not replace any medical treatment for fertility issues. Instead, think of them as health and wellbeing tips that can increase the likelihood of getting pregnant.
When should I get help with fertility issues?
Struggling to get pregnant can be an anxious experience. That’s why it’s important to seek support, both medically and from your personal support bubble, to ensure your physical and mental wellbeing are being looked after.
In terms of that medical support, you should make an appointment with your primary care clinician if any of the following applies to you:
You’ve not conceived after a year of unprotected regular sex.
You’re a woman over 35.
You or your partner has a known fertility issue, such as endometriosis or low sperm count.
You have irregular or no periods at all.
You have other medical concerns that may cause fertility issues, such as cancer or a sexually transmitted infection (STI).
You are in a same sex relationship.
If you’re comfortable doing so, it’s also important to talk to your friends and family about your struggles to get pregnant. This can be a really difficult step to take, but it can help you feel less alone and make your loved ones more aware of the support you’ll need moving forward.
There are also infertility support groups that let you meet and chat to other people going through similar experiences in struggling to conceive. Take a look at the Fertility Network, Complete Fertility, and the HFEA to find out more.
What fertility treatment options are available?
As there are many potential causes of infertility, there’s no one specific treatment that can solve all fertility issues. That’s why the first step to improving fertility is to complete fertility testing with your primary care clinician.
For men, this is typically a semen test to measure sperm count and quality, whereas fertility tests for women are a bit more in-depth. This may include blood tests to check hormone levels, a chlamydia test, an ultrasound scan, an X-ray, and a laparoscopy to try and determine the potential causes of infertility.
Then, once primary care clinician has a better idea of why you’re struggling to conceive, they may recommend one of three types of treatment:
Medicines: There are many different types of medicines that your GP may prescribe if you’re struggling to get pregnant, including clomifene, tamoxifen, and metformin. Each type of medicine will have different side effects and suitability, so be sure to speak to your GP or primary care clinician about each course of potential treatment.
Surgical procedures: If you’ve got a blockage in your fallopian tubes or endometrial tissue has been found in your ovaries, your secondary care clinician may recommend getting surgery to improve your fertility chances.
Assisted conception: Your secondary care clinician may also recommend assisted conception, which can include intrauterine insemination (IUI), in vitro fertilisation (IVF), or egg and sperm donation. However, there is specific criteria around being offered assisted conception with the NHS, so speak to your primary care clinician to find out whether this treatment is suitable or available for you.
The availability of these fertility issue treatments depends on which area of the UK you live in, being decided by your local commissioners of care. Once approved, you may then be eligible for up to three rounds of fertility treatment. For more information on the process, speak to your primary care clinician.
How can Benenden Health help with fertility issues?
If you’re struggling to get pregnant or are worried about potential fertility issues, you can make an appointment to see a clinician. In the meantime, Benenden Health members also have access to our helpline for medical advice from a qualified UK-based GP, 24 hours a day, 7 days a week. Head over to our 24/7 GP Helpline service page for more information.
To find out more about your menstrual cycle and pregnancy, including the best foods to eat on your period and mental health self-care during pregnancy, head over to our women’s health hub.
Medically reviewed by Cheryl Lythgoe in July 2024.
