Causes of infertility in men and women
Table of Contents
The fertility rate which refers to the average number of children a woman gives birth to is on the decline globally. Globally, the average number of children a woman used to have was about 5 in 1950, and in 2020, that number has fallen to about 2.5. In the US and the UK, the number has stayed relatively flat at around 2 children per woman since 1980. These changes in fertility rates have more to do with society and civilization than with issues such as low sperm count or other medical conditions.
However, in recent times, some issues such as low sperm count and others have caused an increase in couples not being able to conceive naturally.
The NHS describes infertility as when a couple cannot get pregnant (conceive) despite having regular unprotected sex. Some other experts consider infertility as not being able to get pregnant (conceive) after trying for one year if you’re under 35. So, in effect, if you have only been trying for a couple of months or weeks then you cannot be described as being infertile.
Medical research has shown that for a healthy young couple who have regular sexual intercourse, your chances of getting pregnant during one menstrual cycle is about 20 percent (one in five). The figure gradually starts to decline for a woman in her late 20s and early 30s and decreases even more after age 35. For men, the rate of decline is slower than what women experience.
In England and Wales, the average age of first-time mothers increased to 30.7 in 2019 while that of fathers was around 33.6. This follows a general trend where the average ages of mothers and fathers have risen consistently since they were at their lowest points in the 1970s.
This also means that if you are around the age of 35, you still have decent chances of getting pregnant naturally as 35 is still close to the average mean age. In the US for example, about 20% of first-time mums are over the age of 35.
Assuming race could be defined by geography, then your racial background may affect your chances of getting pregnant naturally. Statistically, Africa has had the highest number of average children per woman of about 4 children per woman in 2020. This is about twice the number of children women in South America, the UK, and the USA had in 2020. These differences could be ascribed to things such as socioeconomic factors like wealth, education, nutrition, or healthcare rather than strict racial issues. For example, women in places like the West may choose to delay parenthood because of things like career or finance and this may affect the chances of conceiving naturally.
On the other hand, a research study that looked at Racial Differences in Self-Reported Infertility and Risk Factors for Infertility in a Cohort of Black and White Women concluded that black women were more likely to have experienced infertility. This study was carried out on 764 women whose ages were between 33–44 with complete data in the United States.
So in summary, it appears that race alone is not a defining factor for conceiving naturally.
The inability to conceive naturally has many causes and it may sometimes be very complex in trying to figure out the exact cause that applies to you. Traditionally, women were known to bear the brunt of the blame for infertility, but in reality, both males and females are equally responsible when it comes to infertility. Consider the following stats;
- A third of infertility is caused by female factors
- A third of infertility is caused by male factors
- About 20% of infertility is unexplainable
- About 10 to 15 percent of infertility is as a result of both male and female factors
So, for example, if you take about 10 couples who have challenges with natural conception, only 3 women will be primarily responsible for infertility.
Among women, the main causes of infertility are
Ovulatory disorders – Issues around the monthly release of an egg from the ovaries. Ovulation disorders can be caused by polycystic ovary syndrome (PCOS), thyroid problems, or premature ovarian failure where the ovaries stop working before the age of 40
Tubal disorders – This is when the fallopian tubes become blocked or infected
Uterine Issues – This relates to issues such as fibroids, polyps (Endometriosis), or adhesions
Health and lifestyle choices – Some lifestyle choices including nutrition may affect fertility in women. What you eat and the nutrients (vitamins, minerals, etc) you get may affect your menstrual cycle, ovulation, and overall hormonal balance.
Drugs and medicines – The long-term use of some drugs and medicines can affect fertility. For example, medicines used for chemotherapy can sometimes affect fertility. Illegal drugs such as cocaine may also affect fertility and make ovulation more difficult.
In men, the common causes of infertility are
Lack of sperm – This can be low sperm count or no sperm at all. Generally, between 60 to 100 million sperm are delivered with each ejaculation. Anything lower than this can potentially cause fertility problems
Low sperm motility – This has to do with sperm that are not moving properly as they have to swim to the egg for fertilization
Health and lifestyle habits – In men, some lifestyle habits including nutrition can significantly impact the ability to make a woman pregnant. That is why it is important to be critical about what you consume when trying for a baby. The vitamins, minerals, etc that are obtained from healthy diets can help increase your chances of becoming a parent. Some key nutrients such as vitamin C, vitamin E, selenium, zinc, calcium, and vitamin D are known to have a positive role in producing healthy sperm
Abnormal sperm – Some sperm can have abnormal shape making it more difficult for them to swim and fertilise the egg.
Damaged testicles – The testicles are responsible for producing and storing the sperm and if they are damaged, the quality of sperm produced can be affected.
Drugs and medicines – The use of some drugs and medicines can affect fertility in men
Click to read about the How to improve low sperm count
In today’s world, regardless of your age or situation, current diagnosis and treatments can help increase your chances of successfully becoming a parent. It is reported that one in six couples will seek some form of fertility treatment. The most common one out there is in vitro fertilisation (IVF). There are 3 main types of treatments when it comes to fertility; medicines, surgical procedures, and assisted conception.
Medicines are generally prescribed by a specialist to help address specific fertility issues such as supporting and encouraging the monthly release of an egg for fertilisation. Surgical procedures can also be carried out to investigate the root causes of infertility. An example of such a surgical procedure is a fallopian tube surgery which is carried out to help repair the fallopian tubes. Assisted conception treatment such as IVF where an egg is fertilised outside the body can also be carried out to help treat infertility.
The best treatment option can be prescribed by a specialist after they carrying out a proper diagnosis. In the UK, the average cost of fertility treatment is about £5000 (private treatment) for one treatment cycle with a success rate of about 30% for patients under 35.
A study carried out by the University of Surrey which looked at a group of couples with a prior history of infertility reported that both men and women achieved a massive 80% success rate by simply making changes to lifestyle and diet and taking nutritional supplements. Unlike the treatment methods, these natural ways are relatively inexpensive and may go a long way in improving not just your fertility but your overall health.
Diet and nutrition – Taking a well-balanced diet is very critical in preparing you for pregnancy and also supporting you throughout your pregnancy. Focusing on healthy meals helps to regulate your hormones and nourish your reproductive system. It is recommended that you increase your intake of foods high in essential fatty acids (unsaturated fats) such as oily fish as these can help stimulate the production of reproductive hormones in both men and women.
Healthy weight – Maintaining a healthy weight goes a long way in improving your chances for natural conception. For example, excess body fat increases the production of estrogen which is an important reproductive hormone. Too much of this can throw the menstrual cycle out of balance and may also affect ovulation.
Physically Active – It is important to keep fit if you are considering parenthood as this may help increase your chances of conceiving. For women, keeping fit may also allow you to have and enjoy a healthy and comfortable pregnancy. Simple activities such as walking and yoga can be helpful and not more vigorous ones such as skiing and running that carry a higher risk of injury.
Reduce stress – Infertility can be very stressful and emotionally draining for couples. It is important for partners to be supportive when trying for a baby as stress can interfere with the reproductive process for both men and women. Reducing stress undoubtedly will improve your general health and mood and may also help improve your fertility as well
Fertility/Prenatal supplements – A good prenatal supplement is an inexpensive option that will supply you with the important vitamins and minerals in the right amounts to help increase your chances of conceiving. Balanced diets alone cannot contain all the essential nutrients required to support natural conception for both men and women and this is why it is important to start taking prenatal supplements when you consider becoming pregnant. Fertility supplements for men can help improve semen (sperm) quality that can swim far enough to fertilise an egg. Nutritionists and experts have concluded that even a slight deficiency in any important vitamin or mineral may interfere with egg production or even lead to miscarriage. Examples of some of the important vitamins and minerals that are critical to the reproduction process include vitamin A, vitamin B, vitamin C, zinc, selenium, and l-arginine.
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Perkins, S. and Meyers-Thompson, J., 2007. Infertility For Dummies. Hoboken, NJ: Wiley Pub.
Warhus, S., 2011. Fertility Demystified. New York: McGraw Hill Professional.