Dr Angela McLean
MBBS, Dip. Obs, RACOG, MPH, FAFPHM, MRepM
View Dr McLean’s biography here
Infertility is the inability to conceive after a year of unprotected intercourse, or the inability to carry pregnancies to a live birth. Sadly infertility is very common, and affects around one in six couples. The causes are shared equally among men and women and may be due to a female factor alone, a male factor alone or a combination of the two. Fortunately the vast majority of couples can successfully overcome their infertility with correct treatment, which may include lifestyle changes, medication and/or surgery. Medical knowledge in this field continues to expand and it is pleasing to see excellent success rates where treatments put into practice the results of positive research findings.
The main causes of female infertility include failure to ovulate, hormone imbalance, obesity, polycystic ovary syndrome (PCOS), blocked tubes, endometriosis and low ovarian reserve. Ovarian reserve depletion is particularly common after reaching the age of 35 however can occur in younger women too, especially if there is a family history of early menopause. Both lifestyle and genetic factors play an important role. In our society today, obesity is of increasing concern. The good news is that obese women suffering infertility can significantly improve their chances of conception and reduce the chance of miscarriage by sustained weight loss. Genetic factors also have a significant role, and examples include Turner Syndrome where a woman is missing an X chromosome and translocations where genetic material is exchanged between chromosomes.
Male infertility may be due to inadequate numbers of sperm being produced by the testicles, obstruction of the vas deferens preventing sperm from entering the ejaculate or poorly functioning sperm reducing the ability to fertilise an egg (oocyte). Azoospermia is the term used to describe an ejaculate that contains no sperm at all. The causes of male infertility include hormonal disorders, lifestyle factors causing oxidative stress such as obesity and cigarette smoking, genetic disorders such as Klinefelter syndrome, and failure of the testicle to produce sperm due to testicular damage. Drugs and some medications can adversely impact upon sperm health too.
It often becomes very stressful for a couple finding it difficult to achieve an ongoing pregnancy and counselling can be most helpful in this setting. Fortunately good emotional (mental) and physical health together with the right treatment will give most patients an excellent chance of a successful pregnancy, and a healthy baby.