Infertility is characterised by the inability to conceive despite having regular, unprotected sexual intercourse. When I began medical school in 2010, it was commonly stated that infertility affected 1 in 8 couples. In 2023, the World Health Organization estimated that around 1 in 6 people worldwide experience infertility.
Fertility rates, which track the number of children born per woman of childbearing age, have been steadily decreasing worldwide and have more than halved since 1963.
In 2023, data shows that the total fertility rate in England and Wales has reached a record low, at 1.44 children per woman.
The number of births in England and Wales has been declining over the past decade and is at its lowest since 1977, while the average age of first-time mothers has reached an all-time high.
Factors Contributing to Increased Infertility
- Age: Many individuals are opting to have children later in life, which can reduce fertility, particularly for women, as fertility naturally declines with age.
- Lifestyle Choices: Elements such as poor diet, lack of physical activity, smoking, and excessive alcohol consumption can adversely affect fertility in both men and women.
- Environmental Factors: Exposure to pollutants and toxins in the environment can harm reproductive health and elevate infertility rates.
- Medical Conditions: Conditions like polycystic ovary syndrome (PCOS, now called PMOS), endometriosis, and other reproductive health issues can contribute to infertility.
- Stress: High stress levels can disrupt hormonal balance and hinder conception. In our fast-paced world, constant activity without pause can increase stress levels.
Addressing Infertility
Although infertility can be difficult to manage, there are various approaches to address it:
- Lifestyle Changes: Specific lifestyle modifications, including a balanced diet (which doesn't have to be overly restrictive), tailored dietary supplements, and appropriate exercise, can enhance outcomes.
- Stress Management: During my fertility struggles, I was often advised to 'just relax and let it happen.' This advice was as helpful as a chocolate teapot. Trying to force relaxation can sometimes increase stress, but finding ways to release emotional tension can benefit your well-being. This might involve yoga, meditation, or even counselling.
- Medical Interventions: Options like ovulation induction with various medications, IUI, and IVF/ICSI are available.
- Consulting Specialists: Fertility specialists can offer personalised advice and treatment options based on individual situations. For example, I have developed plans that outline options based on the causes of infertility, helping you make informed decisions about which treatment options are suitable for you.
Where to go next
If you are at the start, the NHS fertility pathway explained walks through referral, tests and funding, step by step. If treatment is coming, a GP's checklist for preparing for IVF covers the run-up. For the evidence on supplements, read what the evidence says about supplements when trying to conceive, and if you have PCOS, three evidence-backed truths about PCOS and fertility.
References
(1)ONS: How is the fertility rate changing in England and Wales? (2024)