When you want to conceive you may be devastated that it hasn’t happened naturally. The expert team at Hope Fertility Clinic, based at Mediclinic Sandton, answer frequently asked questions about infertility and what solutions exist.

Hope Fertility Clinic specialists Dr Gaontebale Matlhaga, a specialist gynaecologist obstetrician sub-specialising in reproductive medicine, Dr Wynand van Tonder and Dr Neelan Pillay, both specialist gynaecologist obstetricians sub-specialising in reproductive medicine and endoscopic surgery, explain some core facts about fertility.

If you're having difficulty conceiving, it's best to consult a specialist.

What’s the difference between “struggling to conceive” and “infertile”?

Most couples won’t fall pregnant as soon as they decide they want to become parents, and conception usually follows only after several attempts. But, if the female partner is younger than 35 and has been trying without success to fall pregnant for 12 months, it’s a good idea to consult a fertility specialist. If older than 35, see a specialist after six months of trying to conceive.

How common is infertility?

The World Health Organization estimates that one in six people around the world is affected by infertility.

What are the main causes of infertility?

Infertility can affect both men and women and may have many causes.

Male infertility accounts for 40% of all cases and may be caused by a low or absent sperm count, abnormal sperm shape and motility, or a condition where the veins within the scrotum are enlarged.

Female infertility is most often caused by ageing eggs. Women are at their most fertile between the ages of 25 and 35. After this, both the quality and quantity of eggs decreases significantly. Several medical conditions may also contribute to infertility in women, e.g., polycystic ovarian syndrome (PCOS), a condition that causes anovulation (absence of ovulation); or endometriosis, a painful disorder where the tissue that usually lines the inside of the uterus grows outside it on organs like the ovaries, fallopian tubes and tissue lining of the pelvis.

Can infertility be cured?

In cases where infertility is caused by a medical condition, it’s possible to treat the underlying issue. For example, the factors leading to male infertility may be treated either medically or surgically, while women suffering from endometriosis may find the condition is relieved by laparoscopic surgery to remove the endometrial tissue growing outside the uterus.

People who are struggling with infertility may be able to fall pregnant, even if they do not have a condition that can be treated, through processes like in vitro fertilisation (IVF).

Quality of the female eggs and male sperm are major factors to be investigated.

Is it possible to boost fertility?

An important way to safeguard fertility is not to put your family plans on hold. The older a woman is, the more difficult it may be to fall pregnant. It’s also important to live a healthy lifestyle, particularly by exercising – obesity is a major contributor to both infertility and miscarriage; and eating a healthy diet, which includes foods that support fertility, e.g., whole grains, oily fish, full-fat dairy products, a variety of fruit and veg (including iron-rich green leafy veg), and healthy fats, such as olive oil and avocado. Avoid substances like alcohol and tobacco, and try to reduce stress as much as possible, as this can affect the menstrual cycle, making it more difficult to conceive.

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