Fertility
Fertility is not often at the forefront of a person’s mind until they start trying to conceive. Unexpected challenges with infertility can be devastating and cause feelings of frustration, hopelessness, and isolation – but you’re not alone.
Dr Simon Nothman is an experienced fertility specialist practising at Genea, a leading fertility clinic in Bondi Junction and Sydney CBD. He has supported many couples through their fertility journey, helping them to optimise their fertility through natural means, and offering assisted fertility treatments where appropriate.
What is infertility?
Infertility is defined as being unable to conceive a pregnancy after 12 or more months of regular unprotected sexual intercourse. Regular intercourse is generally understood to mean every two or three days, particularly around ovulation.
Millions of people worldwide are affected by infertility. In Australia, it’s estimated that about 1 in 6 couples trying for a pregnancy will experience infertility.
What causes infertility?
Conception (falling pregnant) is a complex process, as is carrying the baby to term. There are numerous factors that contribute to fertility and the ability to conceive.
Approximately:
- One-third of infertility cases are due to fertility issues with the female partner
- One-third of infertility cases are due to fertility issues with the male partner
- One-third of infertility cases are from a combination of fertility problems with both partners, or the cause is unknown
Male factor infertility
This refers to fertility concerns associated with the male reproductive system. Factors causing infertility in men can include:
- Abnormal sperm motility (movement) and morphology (shape)
- Low sperm count
- Blocked tubes or failure to ejaculate resulting in no sperm being released
- Conditions relating to the testicles, such as testicular torsion or undescended testicles
- Hormonal dysfunction
- Sperm DNA damage, or other causes for sperm dysfunction
Female factor infertility
- Disrupted ovarian function, such as polycystic ovarian syndrome
- Damaged or blocked fallopian tubes
- Hormonal dysfunction
- Endometriosis
- Abnormalities of the uterus, such as fibroids or adhesions
Factors affecting fertility in both men and women
- Smoking
- Alcohol consumption
- Recreational drugs
- Increasing age
- Dietary patterns and physical activity
- Sexually transmitted infections
- Medical conditions such as autoimmune diseases and diabetes
- Genetic factors
How to naturally optimise fertility
Though many factors contributing to infertility may be outside of your control, such as age, there are steps you can take to maximise your reproductive health and improve your chances of conceiving naturally.
Work towards a healthy weight: Being overweight or underweight affects your hormones and can have negative impacts on your fertility. Nutrition and exercise are important factors in optimising fertility, both for natural fertility and assisted reproductive techniques. The aim is not to “be thin” but to ensure appropriate nutrition for you and your baby, and achieve a healthy body and mind that support optimal reproductive health.
Avoid tobacco, alcohol, and illicit drugs: All these substances, including second-hand (passive) smoke, have been demonstrated to increase the risk of infertility. Rates of infertility in men and women who smoke are about double the rates found in non-smokers.
Exercise regularly: Regular moderate-intensity exercise supports a healthy weight and reduces stress, all of which can aid optimal fertility. Additionally, exercise has the potential not only to improve our health, but also that of our children.
Adhere to a healthy diet: A well-balanced diet is good for everything, including your reproductive health. Fresh fruit and vegetables, wholegrains, limited meat, oily fish, and plant-based proteins provide you with the nutrients needed to support optimal fertility.
Infertility and assisted reproductive technology
If infertility concerns persist even after making all the recommended lifestyle and dietary changes, you and your partner may wish to consider assisted reproductive technologies (ART). There are several options for ART.
In vitro fertilisation (IVF): Retrieved eggs, whether from the female partner or a donor, are fertilised by sperm (from a male partner or donor) in a laboratory environment. The resulting embryo is then transferred to the woman’s body to be carried through pregnancy.
Intracytoplasmic sperm injection (ICSI): This is a special type of IVF procedure, involving fertilising an egg with a single sperm in a laboratory environment. As such, it can facilitate fertilisation of eggs even with very a poor sperm count.
Frozen embryo transfer (FET): During an IVF cycle, excess embryos (formed once an egg has been fertilised by sperm) may be frozen for implantation at a later time. A FET procedure involves thawing the embryo and placing them in the woman’s uterus, and can be performed on the basis of her natural ovulation or hormonal treatment.
Intrauterine insemination (IUI): Sperm from the male partner (or donor) is injected into the uterus around the time of the female partner’s ovulation, for fertilisation within her body. This can be performed on the basis of a woman’s natural ovulation or following hormonal stimulation to increase the production of eggs.