Parenthood is one of the most universally desired goals in adulthood, and most people have life plans that include children.
However, not all couples who want a pregnancy will achieve one spontaneously and a proportion will need to seek medical treatment to help resolve underlying fertility problems. June is World Infertility Awareness Month and infertility has been recognised as a public health issue worldwide by the World Health Organization (WHO).
According to the European Society of Human Reproduction and Embryology May 2020 factsheet: it’s estimated that 20 to 30 percent of infertility cases are explained by physiological causes in men, 20 to 35 percent by physiological causes in women and 25 to 40 percent of cases are because of a problem in both partners an in 10 to 20 percent no cause is found.
Infertility is also associated with lifestyle factors such as smoking, body-weight and stress. Increasing age in the female partner is one of the most common explanations today.
While the decreases in a man’s fertility appear to occur later in life than in a woman’s fertility. In their mid-to-late 40s, men experience changes in their sperm that can cause issues with fertility, and chromosomal or developmental problems with their children.
“Infertility is when you cannot get or stay pregnant after trying for at least a year and you are under the age of 35,” says Dr Sulaiman Heylen, President of the Southern African Society of Reproductive Medicine and Gynaecological Endoscopy (SASREG).
“Up to 50 percent of all patients who visit a fertility centre are 35 or older. We cannot stress enough how important it is for people not to wait too long when they consider having children. Young women need to be aware that there is a slow decline in fertility from their 20s until the age of 35, after which it starts to decrease rapidly until the age of 45,” says Heylen.
“It’s extremely important for couples to investigate fertility options and fertility preservation earlier in life, rather than leaving it too late. A woman who is not ready to have a child can choose to freeze her eggs to try to preserve her ability to have a child later,” says Heylen.
If you have any of the following risk factors, you may also consider seeking advice earlier:
- Family history (i.e., mother or sister) of early menopause (before age 51)
- History of cigarette smoking in either partner
- Previous ovarian surgery
- Exposure to chemotherapy or radiation to treat cancer in either partner
- Shortening in the time between periods
- Skipped or missed periods
- History of injury to the testicles
- Exposure to toxic chemicals (certain pesticides or solvents)
- Pregnancy is a complex process
Couples, dependent on the ages of the partners, are generally advised to seek medical help if they are unable to achieve pregnancy after a year of unprotected intercourse.
The doctor will conduct a physical examination of both partners to determine their general state of health and to evaluate physical disorders that may be causing infertility. Usually, both partners are interviewed about their sexual habits in order to determine whether intercourse is taking place properly for conception.
“Based on the results of the specific tests, a treatment plan will be made which can include medication, surgery or assisted reproduction,” says Heylen.
It’s also important to note that not all couples who desire a pregnancy will achieve one spontaneously and some will need medical help to resolve underlying fertility problems.
Infertility often creates one of the most distressing life crises that a couple has ever experienced together. The long-term inability to conceive a child can evoke significant feelings of loss. Coping with the multitude of medical decisions and the uncertainties that infertility brings can create great emotional upheaval for most couples.
“If you find yourself feeling anxious, depressed, out of control, or isolated, you are not alone,” says Heylen. “Infertility is more common than you may think, but there is no reason to lose hope. Visit a fertility clinic near you to speak to a doctor about the options available to you and your partner.”