Infertility is when a couple cannot conceive or become pregnant despite having regular unprotected sex.
Infertility can be an issue for the man, the woman or both partners.
Infertility is fairly common with around one in six couples having difficulty getting pregnant.
A person who has infertility has a reduced ability to have a child. It usually doesn't mean a person is sterile - that is, physically unable ever to have a child.
For many couples, infertility is a crisis. Fertility problems often come with feelings of guilt or inadequacy, but a diagnosis of infertility is not necessarily a verdict of sterility.
Men and women are equally likely to have a fertility problem. In about one in five infertile couples, both partners have contributing problems, and in about 15% of couples, no cause is found after all tests have been done, called 'unexplained infertility'.
See your GP if you've been trying for a baby for a year without getting pregnant.
Infertility symptoms in women
In women, changes in the menstrual cycle and ovulation may be a symptom of a disease related to infertility. Symptoms include:
- Abnormal periods. Bleeding is heavier or lighter than usual.
- Irregular periods. The number of days in between each period varies each month.
- No periods. You have never had a period, or periods suddenly stop.
- Abnormal ovulation. If your ovaries do not release eggs, you cannot get pregnant.
- Painful periods. Significant pelvic pain. Back pain and cramping may also occur.
Sometimes, female infertility is related to a hormonal imbalance. In this case, symptoms can also include:
- Skin changes, including more frequent acne
- Changes in sex drive and desire
- Dark hair growth in a male distribution (hirsutism), such as on the lips, chest and chin
- Loss of hair or thinning hair
- Weight gain
Other symptoms that may result from disorders linked to infertility include:
- Insulin resistance
- Milky white discharge from nipples unrelated to breastfeeding
- Pain during sexual intercourse
- Structural problem in the reproductive organs. This may be found during a pelvic examination or imaging test.
- Many other conditions can lead to infertility in women. Symptoms vary, depending on the disorder and where it affects the reproductive tract. Your doctor can run tests to see how well your ovaries and fallopian tubes work.
What causes fertility problems in men?
In men, the most common reasons for infertility are sperm disorders. These problems include:
- Low sperm count. This means there are too few or no spermatozoa in the semen.
- Low sperm motility. This means that the sperm don't move as well as they should.
- Malformation of the sperm.
- Blocked sperm ducts.
Another common problem is a temporary drop in sperm production. This happens when the testicles have been injured, such as when the testicles have been too hot for too long or the man has been exposed to chemicals or medications that affect sperm production.
Spending a long time in a hot tub, for example, or wearing pants that hold the testicles too close to the body can increase the testicular temperatures and impair sperm production. Sometimes there is a physical reason. In the relatively common condition called varicocele, veins around the vas deferens (the duct that carries sperm from testicle to urethra) becomes dilated - similar to a varicose vein in the leg. The pooling of blood in these veins keeps the temperature inside the scrotum too high.
Certain lifestyles such as increased alcohol intake and smoking can also have a negative effect on sperm count. Men who are 40 or older often have decreased fertility.