A comprehensive guide to fertility

Fertility is a topic that many people think about when planning to start or grow a family. Understanding how fertility works, the factors that can affect it, and the steps you can take to improve it are essential for anyone hoping to conceive.

Leading consultant gynaecologist and subspecialist in reproductive medicine Mr Rehan Salim delves into the basics of fertility, common causes of infertility, and when it might be time to seek medical advice, helping you take a proactive approach to your reproductive health.

What is fertility and how does it work?

Fertility refers to your ability to conceive a child. For women, this involves the release of healthy eggs from the ovaries, the fertilisation of these eggs by sperm, and the successful implantation of the fertilised egg in the uterus. For men, fertility primarily depends on the production of healthy sperm that can effectively reach and fertilise an egg. Both the male and female reproductive systems play essential roles in the fertility process, and any disruption in these systems can affect your ability to conceive.

What factors affect fertility?

Many factors can influence fertility, some of which are in your control, while others are not. Age is one of the most significant factors, particularly for women. Female fertility naturally declines with age, especially after 35. This is because women are born with a finite number of eggs, and both the quantity and quality of these eggs decrease over time.

For men, age can also impact fertility, but typically to a lesser extent. However, sperm quality (including count, movement, and shape) can decline with age and certain health conditions.

Other factors that affect fertility include lifestyle choices such as smoking, alcohol consumption, and weight. Smoking can reduce sperm count and affect egg quality, while excessive alcohol consumption may disrupt hormone balance. Being either underweight or overweight can also interfere with ovulation in women and sperm production in men.

What are common causes of infertility?

Infertility is generally defined as the inability to conceive after a year of regular, unprotected intercourse (or six months for women over 35). Both men and women can experience infertility, and in many cases, it may be a combination of factors from both partners.

In women, common causes of infertility include problems with ovulation (when the ovary does not release an egg), polycystic ovary syndrome (PCOS), endometriosis (where tissue similar to the lining of the uterus grows outside of it), and blocked fallopian tubes, which can prevent the sperm from reaching the egg.

For men, the most common causes are issues related to sperm production, such as a low sperm count or poor sperm motility (movement), as well as conditions like varicocele, where the veins in the scrotum are enlarged and can affect sperm production.

How can you improve fertility?

There are several steps you can take to optimise your fertility. Maintaining a healthy lifestyle is one of the most important. A balanced diet rich in nutrients can help support reproductive health, while regular exercise can help maintain a healthy weight, which is crucial for both ovulation and sperm quality.

If you smoke, quitting can significantly improve fertility. Limiting alcohol intake and avoiding recreational drugs are also recommended. Additionally, managing stress is essential, as high levels of stress can impact hormone production and, by extension, fertility.

For women, understanding your menstrual cycle and knowing when you're ovulating can help increase your chances of conception. For men, it’s important to avoid overheating the testicles, as excessive heat (from sources like hot tubs or tight clothing) can impair sperm production.

When should you seek help?

If you’ve been trying to conceive without success for a year (or six months for women over 35), it may be time to consult a fertility specialist. It’s also important to seek help earlier if you have underlying medical conditions, such as irregular periods, a history of pelvic infections, or if the male partner has had issues with sperm health. A specialist can conduct tests to diagnose the cause of infertility and discuss treatment options, which may range from medications to assisted reproductive technologies like in vitro fertilisation (IVF).

Being proactive about fertility is key, and seeking advice sooner rather than later can help you make informed decisions about your reproductive health.

If you have fertility concerns and would like to book a consultation with Mr Salim, do not hesitate to do so by visiting his Top Doctors profile today.