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Fertility General knowledge
Find out when you’re most fertile, where to get help and what tests you can have at the GP. Get the basics.
For a woman to become pregnant:
-Intercourse must take place around the time when an egg is released from the ovary
-The systems that produce eggs and sperm have to be working at optimum levels
-The Fallopian tubes must be open and healthy.
Eggs live (and can be fertilised) for 12–24 hours after being released, and sperm can stay alive and active in your body for 12–48 hours after ejaculation, so you don’t have to have intercourse at the exact moment of ovulation to get pregnant.
It just takes one sperm to fertilise the egg for you to become pregnant. Although millions of sperm are released upon ejaculation, few survive the journey through the cervix, uterus and fallopian tubes.
If fertilisation does not take place, or if the fertilised egg does not attach itself to the endometrium lining of the uterus, it breaks down, the endometrium is shed and you have a period.
What causes infertility
Infertility in women
Conditions affecting a woman’s fertility can include:
- damage to the fallopian tubes
- ovulatory problems
- conditions affecting the uterus
- a combination of factors
- no identifiable reason.
Other factors that may play a part include:
- age – female fertility declines sharply after the age of 32
- Polycystic Ovary Syndrome (PCOS)
- gynaecological problems such as previous ectopic pregnancy or having had more than one miscarriage
- medical conditions such as diabetes, epilepsy, and thyroid and bowel diseases
- lifestyle factors such as stress, being overweight or underweight, and smoking.
Infertility in men
Conditions that may result in infertility include:
- low sperm count or quality
- problems with the tubes carrying sperm
- problems getting an erection
- problems ejaculating.
Other factors that may play a part in infertility include:
- having had inflamed testes (orchitis)
- a past bacterial infection that caused scarring and blocked tubes within the epididymis as it joins the vas
- having received medical treatment such as drug treatment, radiotherapy or surgery – for example to correct a hernia, undescended testes or twisted testicles
- genetic problems
- lifestyle factors such as being overweight or having a job that involves contact with chemicals or radiation.
Male fertility is also thought to decline with age, although to what extent is unclear.
Improve your chances - lifestyle and health:
Find out what lifestyle changes could help increase your chances of getting pregnant.
A balanced diet will help ensure your body is healthy enough to become pregnant and nourish a developing baby.
A healthy diet can also help to keep sperm production at optimum levels. Being under- or overweight can make you less likely to become pregnant, so making changes to your diet can help to improve your chances.
The government also recommends that all women trying for a baby should take 400mcg of folic acid a day to help prevent conditions such as spina bifida in your child.
Regular, moderate exercise of around 30 minutes a day helps to maximise your fitness and keep your weight in check.
It also boosts levels of endorphins, the body’s own ‘happy hormones’, which may help to reduce stress. Some people find relaxation techniques or complementary therapies also help them relax.
Women who are trying to become pregnant should drink no more than one or two units of alcohol once or twice per week. Men should stick within the Department of Health’s recommended daily limit of three to four units. Drinking too much can have a negative impact on semen quality and can harm a developing fetus.
Medication and drugs
Some prescription medication can lessen your changes of conceiving, so if you are taking regular medication and trying for a baby, talk to your GP about alternatives that might be more appropriate.
Some prescription drugs can reduce your chances of conceiving, so if you are taking regular medication, ask your GP about suitable alternatives. All recreational drugs should be completely avoided.
Smoking has been linked to infertility and early menopause in women, and to sperm problems in men. It is also a factor in premature or low birth-weight babies.
Quitting smoking may help to improve your chances of conceiving and having a healthy baby.
Your treatment & storage options
Your treatment options:
I.In vitro fertilisation (IVF)
Eggs are removed from the ovaries and fertilised with sperm in a laboratory dish before being placed in the woman’s womb. IVF literally means ‘fertilisation in glass’, giving us the familiar term ‘test tube baby’.
II.Intra-cytoplasmic sperm injection (ICSI)
ICSI involves injecting a single sperm directly into an egg in order to fertilise it. The fertilised egg (embryo) is then transferred to the woman’s womb.
III.Intrauterine insemination (IUI)
Before fertility treatment, the best quality sperm are selected. They are then inserted into the womb at the woman’s most fertile time, when an ovary releases an egg (ovulation).
IV.Donor insemination (DI)
Sperm that has been screened for sexually transmitted diseases and some genetic disorders from a donor is used to fertilise a patient’s egg. DI is IUI (intrauterine insemination) with donor sperm.
Testing that enables people with a specific inherited condition in their family to avoid passing on this condition to their children. Includes PGD, PGS and sex selection. Testing can also be carried out to find a tissue match for an existing sick sibling (PTT).
Surrogacy is when another woman carries and gives birth to a baby for you.
If you aren’t ovulating properly (producing and releasing an egg each month), fertility drugs – which trigger egg production in much the same way as your body’s own hormones – can help.
Your storage options:
Freezing and storing embryos
During fertility treatment there are normally a number of unused embryos remaining. Some people choose to freeze the good quality unused embryos for use in later treatment cycles or for donation.
Freezing and storing sperm
Sperm can be frozen for future use either in artificial insemination or other fertility treatments, or be donated. Donated sperm has to be stored for six months before it can be used in treatment in order to screen the donor for infections.
Get advice & help:
Having fertility treatment can be an emotionally charged experience. It’s important you get the right help while going through treatment.
How may counselling help?
Counselling can give you:
- the opportunity to talk freely and openly without being judged
- the chance to explore feelings and sensitive issues that are troubling you
- help in understanding the factors that may be contributing to your difficulties
- support in finding your own solutions and new ways of coping.
Anything you share with your counsellor will be treated as confidential unless there are exceptional circumstances.
Supportive aspects of counselling
Counselling can provide emotional support before, during or after fertility treatment.
- What does this mean?
Counselling gives you the opportunity to work through your feelings at specific stages in your treatment. You can also ask for written information and, if you need additional support, your clinic may have information about other services in your area.
- What is it useful for?
Most people find that infertility and assisted conception treatments are stressful. Counselling can be especially useful in helping you to work through the emotions you may experience before, during and after treatment. This may be when you first find out you have fertility problems, when you are waiting for results, if your treatment isn’t successful, or if you are both having to come to terms with the fact that there is no further suitable treatment for you to try.
Making contact with a counsellor
Your clinic should provide you with the contact details of a counsellor.
Different clinics have different costing policies, so check whether you have to pay extra for counselling.
You may choose to have just one or two sessions or more. Sessions usually last for an hour and you can expect to see the same counsellor each time.
If for any reason you don’t feel happy or comfortable with your counsellor, talk to them about what’s worrying you.
If you feel you still can’t communicate, ask to be referred to another counsellor.
Benefits of counselling & how to access it:
Counselling can help you explore your feelings, become clearer about your situation and find new ways of coping.