Preconception series: Infertility

Definition

Infertility is defined as the inability to conceive after 12 months of unprotected sexual intercourse.

Causes

In many cases, after standard medical testing is completed on the man and woman, no reason for their infertility is found. This is described as ‘unexplained infertility’ however there may be many subtle, often lifestyle and dietary, issues that could in fact explain the situation.

The stated causes of infertility among couples treated by assisted conception in Australian and New Zealand are:

Tubal disease (‘blocked tubes’) – may be caused by a past history of sexually transmitted disease such as chlamydia.

Male (sperm) problems - These may include one or a combination of low sperm count, poor motility (movement), poor morphology (quality), and sperm antibodies. It has been estimated that male infertility is a factor in 50% of all infertility problems.

Ovulation disorders – no or irregular ovulation. Approximately 75% of infertility due to lack of ovulation is due to polycystic ovary syndrome (PCOS). This condition is associated with hormonal imbalance, blood sugar regulation difficulties and difficulty conceiving. For more information see www.pcos.org.au

Endometriosis and uterine problems – Endometriosis is found in up to 40% of women who present with infertility. It occurs when tissue like that lining the uterus grows outside the uterus. For more information see www.ecca.com.au. Fibroids, benign lumps of tissue growing in or on the wall of the uterus, can also contribute to infertility.

Combination of male/female – ‘multiple causes’.

Unexplained infertility – no known medical explanation.

Figure 1. Cause of infertility among assisted conception pregnancies,
Australia, 1990-1998

Your doctor may request tests to look for these problems if you have been trying to conceive for some time, you have a history of reproductive conditions or you have symptoms that suggest there may be a problem.