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Fertility and infertility

Fertility is a word to describe whether someone is capable of making a child. For a woman this refers to the health of your eggs and ability to get and stay pregnant.

For men fertility refers to whether your sperm are healthy and potent. Most healthy people who want to get pregnant can.

Only when a woman ovulates during her menstrual cycle is there an unfertilised egg waiting for a sperm cell. Once an egg comes into contact with sperm, it becomes fertilised and attaches itself to the womb. This starts the conception process and you become pregnant.

If you have sex before you ovulate, sperm can hang around for days in your fallopian tube waiting for an egg to pop out. If you have sex after you ovulate, the egg will be ready and waiting for the sperm to arrive.
But remember, having sex only at other times of the month is not a reliable way to avoid getting pregnant!

Fertile and most fertile

What’s the difference between being ‘fertile’ and being ‘most fertile’? If you’re fertile, it means you’re able to get pregnant – you’ve reached puberty and your ovaries are working properly. You’re most fertile around the time of ovulation, so you’re most likely to get pregnant if you have sex at this time.

Ovulation roulette

You can get pregnant from the first time you ovulate, so even before you have your first period. On the other hand, just because you’ve started your periods doesn’t mean you can get pregnant.

In the first year you have your periods, an egg might only be released one in five times. By the time you’ve been having periods for six years, an egg will be released nine out of ten times.

But remember, if you don’t want to get pregnant, don’t play ovulation roulette – use contraception.

Less fertile

As you get older, especially over the age of about 30, you tend to become less fertile, and eventually you stop ovulating and having periods. On average, women are able to get pregnant between the ages of 15 and 49.

Fertility and weight

If you’re too big or too thin it can affect your chances of getting pregnant.
To get a rough idea of whether your weight could be affecting your fertility, you can work out your BMI.

BMI the complicated way
Your BMI is your weight (in kilos) divided by your height (in meters) squared. So if you weigh 72 kilograms and your height is 1.72 metres, your BMI is 72 divided by 1.72 x 1.72 = 24.9.

BMI the easy way
All that arithmetic sounds too much like hard work? Don’t worry, just go to an online BMI calculator like this one and it will do the maths for you!

Your BMI is considered to be ‘normal’ if it’s between 18.5 and 25 – though this is only a rough guide.

If your BMI is lower than about 18.5 or higher than about 28, you could be less fertile. So it’s important to eat as healthy and varied a diet as you can, and try to get your weight closer to the ‘normal’ range.

Fertility testing

So you've been patiently trying to get pregnant for 18 months or more. And you and your partner have tried all the tips. But you're still not pregnant.

You might want to start trying to find out if there’s some medical problem that’s stopping you getting pregnant.
The easiest place to start is with the man. Men often assume that it’s the woman who’s got the fertility problem if she’s having trouble getting pregnant. But it’s just as likely to be the man.

For men, it’s pretty easy to have your sperm tested to see if you’re producing enough healthy sperm. For women it takes more trouble and detective work, involving a variety of tests. So usually it makes sense to start fertility testing with the man.

Tests for men

Fertility testing for men is pretty straightforward. You need to provide a sample of sperm, and they'll check it out for you in the lab. When you visit your health professional for a fertility test, first of all he may well want to ask you some pretty personal questions about your sex life, and also examine your genitals. Then he’ll send off a sample of your sperm to have it analysed.

Of course, you might want to say no to any embarrassing examinations and just provide a sperm sample. (Though be grateful, it wouldn’t be an option for your partner to skip uncomfortable and intimate examinations!)

Providing a sperm sample

You usually provide a sperm sample just by masturbating and squirting the sperm into a clean container. And if you don’t have to travel too far to the clinic, you may well be able to produce the sample at home.

If for religious reasons you object to masturbating, you can collect the sperm in a special condom when you have intercourse. And if also for religious reasons you don’t want to use a condom, you can always prick a hole in it first.

The result

The lab will give a report on how many sperm are in your semen, and how many of them are healthy – whether they can ‘swim’ well and are able to fertilise an egg.

You may find you have plenty of healthy sperm, so at least you know the problem doesn’t lie with you. But it could also be that you have relatively few healthy sperm, which makes it harder for you to get your partner pregnant.
The best thing then is to make sure you follow all the fertility tips for men – like not smoking or drinking, and keeping your testicles cool. If there are no sperm at all, then you can get medical help to find out what’s causing the problem, and see if something can be done about it.

Home testing

If you really want to avoid any embarrassment, you can now get home kits to test your sperm. These kits aren’t as reliable as a proper test in a lab. They only tell you how many sperm there are in your semen, but not how healthy they are. You can order a kit online for about 30 US dollars plus postage.

Tests for women

Fertility testing for women is more complicated than it is for men, basically just because there are more different reasons you could be having trouble getting pregnant. This means you might need to have various different tests.

They could include:

  • A cervical mucus test, to see if sperm can survive in the mucus at the neck of your womb.
  • An ultrasound scan to check your womb and ovaries.
  • Hormone tests to check your levels of the hormones involved in getting pregnant.
  • An X-ray of your womb and fallopian tubes to see if there is a blockage. First some dye is injected through your cervix.
  • A hysteroscopy, when a flexible tube like a tiny telescope is inserted through the cervix to look inside the womb.

Home testing

You can also buy a home fertility test for women. This measures the level of the FSH hormone in your body, which can show how likely it is that you’ll be able to get pregnant. The test indicates how many eggs you have left in your ovaries, but it’s not necessarily very accurate.
 

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