Fertility

Being fertile means that a person or a couple can have a child through regular sexual activity within a year of trying to conceive¹. Conception depends on a single sperm being able to fertilise an egg, which implants as an embryo in the uterus, grows into a foetus and is born as a baby. A simple enough process you may think, but actually it is an extraordinarily complex process, this making of another human being!

Lifestyle changes that positively affect all your health also improve your fertility, eggs and sperm need tender, loving care too! For example, stopping smoking⁶, reducing alcohol and caffeine, losing weight if you need to, doing exercise and getting enough sleep can all make a huge difference. Testicles don’t like being hot so men should try to wear loose fitting trousers and boxers and take showers rather than hot baths. Working out and exercise is great for both female and male fertility.

Think colour; the more the better. Fresh vegetables, berries, nuts and seeds, fish, eggs, olive oil, pulses and wholegrains are all stuffed full of nutrients that make healthy sperm and eggs. In general, try to follow the NHS EatWell Guide for a healthy, balanced diet.

As soon as you consider having a baby, women should take 400mcg of folic acid or folate which helps to prevent certain birth defects. It could be some time before you realise you are pregnant, and these early weeks can be critical. Vitamin D is important for both partners, especially if you have darker skin. And avoid vitamin A in supplements. Men need nutrients too, like zinc, selenium, folic acid, vitamin C and E. So, if you find it hard to always eat healthily, or you have any dietary restrictions, are vegan or vegetarian, it’s a good idea to take an all-round pre-conception multivitamin¹¹

Infertility is diagnosed if a couple have failed to conceive after one year of regular, unprotected (no contraception) vaginal intercourse¹².

Infertility affects men and women equally. Older age, conditions like endometriosis, polycystic ovarian syndrome (PCOS), fibroids, blocked fallopian tubes, irregular cycles, hormonal abnormalities, being severely overweight or underweight may affect women’s fertility.

For men, low sperm counts, immotile or abnormally shaped sperm, low testosterone levels, undescended testes, varicocele (varicose vein) on the testicle and obesity all affect fertility.

For both, infection, poor diet and lifestyle and stress, either in your life generally or as a result of infertility, doesn’t help and sometimes couples are just not having enough sex¹³.

Investigation is absolutely key, so first see your GP. Hormone tests for both, a pelvic scan, a semen analysis and testicle examination are key. You may be a referred to a fertility clinic for further investigations. And then you just may need a little more help from assisted conception.

IUI 

Intra Uterine Insemination (IUI) involves sperm that has been ‘washed’ to find the best quality and injected directly into the uterus when ovulation is about to occur¹⁴. IUI is the least invasive option, but also the least successful and women often have to undergo multiple cycles so it can be quite difficult to have on the NHS and you may have to go privately.

IVF

In-Vitro Fertilisation (IVF) involves women taking drugs that stimulate the ovaries to produce multiple eggs, which are removed and mixed with sperm that will hopefully fertilise them, and transferred into the uterus, supported by hormonal drugs¹⁵. Intra Cytoplasmic Sperm Injection (ICSI) is used for cases of severe male factor infertility; the best-looking sperm is actually injected into the egg¹⁶. IVF is quite an invasive procedure and the success rate is unfortunately low; about 28%, increasing the more cycles you have and the younger you are.

• If you are conceiving naturally, have plenty of sex.
• Eat a healthy, balanced diet, take exercise, and have good sleep.
• Give up smoking, reduce alcohol and caffeine.
• Get help after one year, or six months if you are a women over 35.
• There are other assisted conception options available.