If you have been trying for a baby for a year or more, without any success, you may be diagnosed as infertile. It’s not such an uncommon problem: according to the NHS, around one in seven couples may have difficulty conceiving, with 16 percent of couples failing to conceive naturally within a year after having regular unprotected sex.
There are two types of infertility:
Primary infertility is when you have difficulty conceiving and have never conceived before.
Secondary infertility is when you have difficulty conceiving but you have conceived one or more times in the past.
So what are the causes? Experts claim that for about 25 percent of couples there is no reason, while in four out of 10 cases, it involves problems with both the man and the woman.
In women, the most common cause of infertility is problems with ovulation, where an egg isn’t released at all or only during some months and not others. Conditions such as polycystic ovary syndrome (PCOS) and thyroid disorders (including underactive and overactive thyroid) can be responsible for problems with ovulation, as can premature ovarian failure (this is when the ovaries stop working before a woman reaches the age of 40). Discover how PCOS can affect fertility in our guide. You can find out more on our PCOS hub.
Being very underweight or overweight, or doing excessive amounts of exercise can also affect the hormones required for ovulation. Some long-term illnesses can affect ovulation too, including uncontrolled diabetes.
There are several other medical conditions that may affect female fertility, such as endometriosis, pelvic inflammatory disease (which can often be the result of a sexually transmitted infection) and fibroids (benign tumours that develop in or around the uterus).
Certain medicines may also affect fertility in women, including those used to treat cancer (chemotherapy), some types of antipsychotic medicines and even painkillers such as ibuprofen or aspirin (non-steroidal anti-inflammatory drugs, or NSAIDs) if taken in high doses or over a long period of time. Age is also a factor when it comes to female fertility and experts believe fertility levels start to drop in women when they reach their mid-30s.
Unlike in women, infertility in men isn't linked to how old you are. It is, however, caused by problems with your sperm, such as a low sperm count, decreased sperm mobility and abnormal sperm. Damage to the testicles can often cause sperm problems, as can having an abnormally low level of testosterone – a condition known as hypogonadism. Certain types of medicines can sometimes cause infertility problems in men too, including anabolic steroids, chemotherapy and an anti-inflammatory medicine used to treat conditions such as rheumatoid arthritis and Crohn's disease.
Meanwhile, things that may affect fertility levels in both men and women include smoking, drinking excessive amounts of alcohol and taking some illegal recreational drugs.
Treatments for infertility
If the cause of your fertility problems has been diagnosed, there are treatments available. Medicines that are used to boost fertility are usually prescribed for women (though sometimes for men too), and include drugs that help to stimulate or encourage ovulation.
Surgery may be the best option if a woman has problems with blocked or scarred fallopian tubes, or if she has a condition such as endometriosis, polycystic ovary syndrome or fibroids.
Men who have an abnormality of the testes – such as a blocked epididymis (this is the tube inside the scrotum where sperm is stored) or a condition called varicoceles – may also be helped by surgery. Surgeons can also extract sperm from men who have been affected by injury or infection, or by a vasectomy or failed vasectomy reversal.
Several techniques are also used to help couples conceive, the most well-known of which is arguably in-vitro fertilisation (IVF). IVF is often used in couples where the woman has blocked fallopian tubes or when the cause of infertility isn’t known. It involves a woman taking fertility drugs to help her ovaries make eggs, which are subsequently removed and mixed with sperm in a laboratory dish. If the sperm fertilise one or more eggs, one or two embryos are then implanted back into the woman’s uterus.
According to the NHS, the success rate for a cycle of IVF is about 32 per cent for women under the age of 35, and that this rate decreases as the woman’s age increases.
Donor eggs and sperm may be available to couples undergoing IVF treatment where one partner is unable to produce eggs or sperm. If a woman’s fallopian tubes are normal, a technique called interuterine insemination (IUI) may be attempted before IVF. This takes sperm from the male partner or a donor and places them into the female partner’s uterus using a fine plastic tube. The woman may receive fertility drugs beforehand to boost ovulation.
However, while it is a much more straightforward procedure than IVF, the success rate for IUI is lower at around 15 percent for each cycle of treatment in women under the age of 35.
Drawbacks of treatment
There are several possible complications that may arise as a result of having infertility treatments, such as multiple pregnancy (twins, triplets etc), ectopic pregnancy (a pregnancy that develops in a fallopian tube instead of the uterus) and ovarian hyperstimulation syndrome. The latter can cause cysts on the ovaries, which may lead to symptoms such as stomach pain, nausea and vomiting. Rarely, it can lead to more serious problems such as liver and kidney problems or thrombosis.
Some fertility drugs can also cause side effects such as hot flushes and other menopause-type symptoms. And of course, as many couples can confirm, infertility treatment can be incredibly stressful.
Foods that boost female fertility
Eating a healthy balanced diet that includes at least five portions of fruit and vegetables a day is a good idea if you want to have good fertility levels, whether you’re a man or a woman. Certain foods, however, may benefit women who want to make the most of their fertility, including the following:
Foods that boost your hormones
Many of the B vitamins as well as zinc and essential fats are essential for healthy hormone functioning in women. Yeast extract (such as Marmite) includes many of the B vitamins your hormones need, or you could eat more nuts, seeds, wheat bran, eggs, bananas, asparagus and fortified breakfast cereals. For extra zinc eat Quorn, pumpkin seeds, liver, peas and nuts, plus oily fish for omega-3 fats*.
Some nutritionists claim that having plenty of beneficial bacteria may help your digestive system absorb the nutrients you need from food to help keep your reproductive system healthy. So eat plenty of live bio yoghurt.
Foods rich in iron
Researchers believe that not getting enough iron in your diet may affect ovulation and also possibly the health of your eggs. When you do fall pregnant, you’ll need an iron-rich diet to help prevent anaemia. So stock up on foods such as liver, kidneys, sesame seeds, tofu, mussels and seaweed.
Meanwhile, there are also a few things you could consider avoiding, such as…
Medical experts widely believe that smoking can affect fertility levels in women because of the way it affects your hormone levels.
According to the Department of Health, it’s a good idea to cut out alcohol if you’re trying to conceive.
Though the evidence on whether or not caffeine can affect fertility is mixed, it may be worth cutting back or cutting it out completely if you’re having problems conceiving, as caffeine may interfere with the absorption of certain nutrients.
If you have polycystic ovary syndrome (PCOS) – which is a common cause of female infertility – eating too much sugar may lead to insulin resistance, making your symptoms worse.
Putting on weight (or losing too much)
Being within the healthy weight range for your height is the best shape you can be in if you want to have a baby, as being overweight or underweight can affect your production of fertility hormones.
* If you’re a woman who’s pregnant or trying to get pregnant, the NHS advises you should not eat more than two portions of oily fish a week because of the pollutants fish such as salmon, mackerel, sardines, herring and pilchards may contain.
Lifestyle tips for better sperm
There’s strong evidence that lifestyle factors have a detrimental effect on sperm health, including the following:
Being overweight can affect the quality of sperm, and experts believe men who are obese are less likely to father children than those who are healthy in terms of weight. Losing weight can help boost male fertility as well as general health.
Too much alcohol
According to the National Institute for Health and Care Excellence (NICE), drinking too much alcohol can affect sperm production. The good news is that having the odd drink or two isn’t thought to harm male fertility. You should, however, stick to the government’s guidelines for health alcohol intakes (three to four units of alcohol per day if you’re a man, a unit being the equivalent of half a pint of beer or a pub measure of spirits).
Smoking tobacco has been shown to lower sperm numbers and potentially damage sperm DNA. So if you want the best sperm possible, consider giving up as soon as you can. If you’re worried that giving up may be difficult, why not try a stop smoking aid such as patches, gum or lozenges that can help you to manage your nicotine cravings?
Too much stress
Being under severe stress may also hinder sperm production, not to mention the effect it could have on your relationship. If you’re under a lot of pressure, try to find ways to relax on a regular basis. Alternatively, ask your GP about stress management if things are really getting on top of you.
Sexually transmitted infection
Chlamydia was originally thought to affect women’s fertility levels and not those of men. But there is strong evidence to suggest men who have chlamydia may suffer from lower fertility levels too. The problem with chlamydia is many people are unaware that they have it, as it doesn’t always cause any obvious symptoms. Ask your GP about chlamydia screening if you think you may be effected. In the meantime, protect yourself from chlamydia and other STIs by practising safe sex. Discover more on how to tackle infections such as chlamydia in our guide.
Meanwhile, there are some positive things you can do to improve your sperm quality, including…
Having regular sex
Experts believe having sex every two to three days can improve sperm production. That's because experts believe that abstaining from sex can result in a build-up of dead sperm.
Wearing loose underpants
This may sound like a myth, but it isn’t. Avoid wearing tight briefs if you want healthy sperm, as tight clothing is thought to damage sperm production (go for loose underwear, such as boxers).
Eating the right foods
You may have heard that eating foods rich in zinc – such as steak, oysters, liver and wheat bran – are essential for sperm health. But other foods you could add to your diet for a fertility boost include broccoli, spinach and asparagus (for folic acid), nuts, seeds and figs (for magnesium), and fish, seafood and eggs (for selenium).
Natural remedies to boost fertility
Some couples who have been struggling to conceive find they eventually do so without any help or medical intervention. But if you want to give nature a helping hand – without going down the medical intervention route – there are some natural supplements you may want to try, such as the following:
Many natural fertility experts believe the B vitamins are essential for women who are trying to conceive. Not only do they help to keep your hormone production at a healthy level, but the B complex family of vitamins are also thought to help with an egg’s genetic development. Rather than taking individual supplements you can get the right levels of B vitamins in a B complex product.
High-strength multivitamin and mineral
Having the optimum level of vitamins and minerals can support your overall health, but certain nutrients may also be important for both male and fertility – all of which you can get in a good-quality high-strength multivitamin and mineral supplement.
For instance, a report that analysed several studies suggests vitamin D is linked with endometriosis, polycystic ovary syndrome (PCOS) and IVF outcomes in women, while boosting levels of the fertility hormones progesterone and oestrogen; it also suggests vitamin D may be essential for the healthy development of sperm and increase testosterone levels in men (ii). Vitamin C has also been shown to improve sperm count and function (iii), and magnesium is thought to help raise testosterone levels in men, improving male sex drive (iv).
Meanwhile, studies suggest that vitamin E may improve sperm quality and mobility (v), as well as helping to increase cervical mucus in women. Zinc, on the other hand, is one of the most widely recommended nutrients for fertility in both men and women as it’s essential for healthy hormone production in women and healthy sperm in men.
The omega-3 fatty acids found in fish oils are also important for hormone functioning, which may help keep your reproductive system healthy. They are also widely thought to reduce inflammation (some experts believe inflammation may increase some women’s ability to conceive owing to the effect it has on the production of oestrogen and progesterone (vi)). Some also believe omega-3 oils are essential for healthy sperm quality too, because they are needed to produce substances called prostaglandins, which are found in semen.
Panax ginseng – also known as Asian or Korean ginseng – is widely used in traditional Chinese medicine to increase energy, among other things. Nutrition practitioners often recommend it to boost male libido, as studies suggest it may improve erectile disfunction (vii). There is also some evidence that Panax ginseng may boost sperm function (viii).
A vitamin-like substance (also sometimes called a pseudovitamin) found in many natural sources, myo-inositol – often called simply inositol – is a carbohydrate with a molecular structure similar to that of glucose. There is some evidence to suggest taking myo-inositol in combination with the B vitamin folic acid in therapeutic doses may help with menstrual regularity, ovulation and higher quality eggs (ix).
Trying for a baby can be an emotional period for everyone involved, but this guide should help to make it a little easier. For more information on how to manage a range of other health conditions, our health library has a number of helpful articles.
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Disclaimer: The information presented by Nature's Best The Pharmacy is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.
Christine Morgan has been a freelance health and wellbeing journalist for almost 20 years, having written for numerous publications including the Daily Mirror, S Magazine, Top Sante, Healthy, Woman & Home, Zest, Allergy, Healthy Times and Pregnancy & Birth; she has also edited several titles such as Women’ Health, Shine’s Real Health & Beauty and All About Health.