Infertility is defined as 12 months of unprotected intercourse without conception for women under the age of 35. For women over this age, the time frame is reduced to 6 months of unprotected intercourse without conception.
The causes of infertility vary,
- 30% of infertility is caused by female factors
- 30% caused by male factors
- 30% is due to combined male and female factors
- 10% of infertility remains unexplained
Female factors associated with infertility may include:
- Problems with ovulation e.g. polycystic ovarian disease
- Anatomical problems such as blocked tubes, uterine abnormalities
- Conditions such as endometriosis
- Advanced age which can effect the quality of the eggs
Male factors associated with infertility may include:
- Physical problems such as erectile dysfunction or impotence
- Medical problems such as immune disorders
- Problems with sperm such as production,
Your GP may have already started this process if you are having trouble falling pregnant. If you are having problems with your menstrual cycle or ovulation, it may be important to be reviewed prior to attempting conception.
Some investigations that may be ordered include:
- Blood tests to measure hormone levels (estrogen, progesterone, luteinising hormone, thyroid hormones)
- Pelvic ultrasound
- Anti-mullerian hormone (AMH) which may give an idea of your ovarian reserve.
- Semen analysis
Infertility and sub-fertility can be very distressing. There are however treatments available and success rates can be very high.
Miscarriage and Recurrent Pregnancy Loss
About 15% of pregnancies will unfortunately result in a miscarriage before the 20th week of gestation.
Around 2% of women experience recurrent pregnancy loss (three consecutive pregnancy losses).
Miscarriage and recurrent pregnancy loss can be emotionally traumatic and require empathy and understanding and also thorough investigation to try to prevent it from occurring again.
There are many possible causes of miscarriage, including
- Chromosomal abnormalities (problems in the DNA of the embryo)
- Genetic abnormalities (inherited problems)
- Immune causes
- Structural problems of the uterus
- Problems of the uterine environment or hormones
- Medical conditions
- Blood clotting disorders
Miscarriage can occur in spontaneous pregnancies as well as during IVF cycles and sometimes a pregnancy may only be noted on blood tests (biochemical pregnancies)
Some of the treatments to try to prevent future miscarriages include:
- Medication such as blood-thinning medications
- Surgery to correct uterine abnormalities
- Testing of embryos prior to implantation in IVF
Whatever the cause, if you are unfortunately suffering from miscarriage or recurrent miscarriages, we will ensure that you and your partner are well-informed regarding the possible causes, have investigations and management that is tailored to your unique situation. We have a team of counsellors and trained staff that can help you with dealing with the stress and emotions involved in miscarriage.
Fertility treatments encompass a broad range of advice and management. You may seek a Specialist for various reasons such as:
- Optimising natural fertility
- Infertility or sub-fertility
- Advice about fertility under special circumstances (e.g. medical conditions, after chemotherapy/radiation, anatomical abnormalities, known heritable/genetic conditions in the family)
- Fertility potential, freezing eggs or embryos
- Premature ovarian failure
- Egg donation, sperm donation, surrogacy
- Same-sex couples seeking conception
- Recurrent miscarriage
Therefore, fertility treatments can vary from individualised advice, trying to optimise natural fertility to procedures such as in-vitro fertilisation (IVF) and pre-implantation diagnosis (PGD).