Infertility
Infertility means a couple has not been able to get pregnant after 12 months of regular sex without contraception (6 months if the woman is over 35). It affects about 1 in 6 couples. The cause can be in the woman, the man, or both — in about one third of cases the problem is with the man — so both partners should be checked. Many causes can be treated.
Symptoms
- Not getting pregnant after 12 months of trying
- Irregular periods or no periods
- Very painful periods
- In men: problems with erection or ejaculation, or swelling of the testicles
- Often there are no other symptoms
Causes
- In women: eggs not being released (ovulation problems), often from PCOS or thyroid problems
- Blocked tubes after a pelvic infection, an unsafe delivery or abortion, or tuberculosis
- Endometriosis or fibroids
- In men: low or weak sperm, sometimes after mumps, infection or a varicocele
- Age — fertility in women falls after 35
- Smoking, naswar, or being very overweight or underweight
Prevention
- Treat vaginal and pelvic infections early and fully
- Give birth and have any procedures in a safe health facility
- Keep a healthy weight
- Avoid smoking, naswar and drugs
- Mumps vaccination, where available, protects boys from testicle damage
- Do not delay seeing a doctor if you have irregular periods
Treatment
- Tests for both partners: a semen test for the man, hormone tests and ultrasound for the woman
- Treating the cause, such as thyroid problems, infections or PCOS
- Medicines to help ovulation (for example clomifene) — only under a gynaecologist
- Surgery for blocked tubes, fibroids or varicocele in some cases
- Assisted methods such as IUI or IVF where available
- Avoid unproven treatments, and do not take hormones without a doctor
Common questions
Is infertility always caused by the woman?
No. In about one third of couples the cause is in the man, in one third it is in the woman, and in the rest it is in both or unknown. A simple semen test for the man should be done early.
How often should we have sex to get pregnant?
Every 2 to 3 days throughout the month gives the best chance. The most fertile days are usually about 14 days before the next period.