Fertility FAQs

How common is infertility in Ireland today?

More than 1 in 7 Irish couples will have difficulty trying to conceive a child.

This is not well-known, as an individual’s fertility can be a very private and personal matter.
Thankfully there are a lot of fertility support groups. Some of these are highlighted on our links page.

Some basic advice and tips on simple things that can be done to improve fertility are covered on this page.
You can become more informed about infertility and its prevalence by continuing to read.

What basic things can be done to improve fertility?

Fertility Tips:
Reduce or eliminate processed and refined foods from the diet. This includes white flour, polished white rice, fast foods, sugar and caffeine.
Avoid saturated fats and hydrogenated oils. Instead of using butter or margarine, consider substituting with such oils as flaxseed, hempseed, rapeseed, sunflower or canola.
Eat more fresh vegetables (dark and leafy), liver, fruits, whole grains, seeds (pumpkin is very good), fish, legumes, brown rice, nuts, evening primrose and fish oils.
Drink plenty of water. It is recommended that a man should drink 2.6 litres of fluid daily (water/milk/other drinks).
Avoid hot baths and tight fitting pants.
Avoid resting laptops on your lap for prolonged periods of time.
Avoid smoking or drinking excessively. Smoking seriously damages sperm health and alcohol can reduce testosterone affecting sperm quality.
Take regular exercise. A BMI over 30 seriously affects your reproductive health. To calculate your BMI click "HERE"
Reduce stress in your life. Stress will generate harmful substances in your body which damage sperm.
Consider Acupuncture or Yoga.
Take a course of supplements for 3→4 months before receiving any fertility treatment. It takes 3 months for sperm to mature in the testes and benefits to take effect.

The more important nutrients relating to sperm health are combined in Male Fertility supplement pills.
Fertility Check sells nutritional supplements online and recommends NHP Fertility Support (Men) and NHP Fertility Support (Women).

For a more comprehensive look at Nutrition & Supplements in relation to Reproductive Health, please read our section entitled 'Nutritional Info'.
Some poorer quality supplements contain nutrients in a form that our bodies find hard to absorb. Avoid supplements containing oxides, carbonates or sulphates. Supplements with citrate and ascorbate combinations have a much higher bioavailability.
For example, if you had the same amount of magnesium oxide as magnesium citrate in two supplements, then you would absorb nearly 15 times more magnesium from the supplement with the magnesium citrate. So, even if a supplement says it has 100% of your magnesium RDA, it might not have it in a form that your body can easily absorb.

Fertility Facts - Infertility and its prevalence in more detail

The following figures were obtained from UK fertility clinics (2008) and outline the reasons for couples seeking IVF treatment.

  • male factor - 29.7%
  • female factor - 28.5%
  • multiple male & female factors - 10.3%
  • unexplained - 23.9%
  • other factors - 4.7%

According to these figures male infertility was the main reason for couples seeking IVF treatment, and this was largely due to a low sperm count.
The male sperm count declined by an average of 50% worldwide in the 50 years between 1940→19901, 2, 3

What can cause male infertility?

Other reasons besides a low sperm count include:

  • Poor sperm motility (progression) and morphology (appearance)
  • High levels of sperm DNA fragmentation
  • Obstruction of the sperm ducts
  • Varicocele (distended veins)
  • Medical treatment i.e. drug treatment or radiotherapy
  • Surgery for e.g. hernia, undescended testes or twisted testicles
  • Genetic problems e.g. Cystic Fibrosis, Y-chromosome microdeletions or an abnormal set of chromosomes e.g. Klinefelter syndrome
  • Orchitis (inflamed testes)
  • Diabetes
  • Mumps
  • Retrograde ejaculation
  • Problems getting an erection or ejaculating
  • Lifestyle factors such as being overweight or smoking
  • Work environments that involve contact with chemicals or radiation
  • Stress
  • Male fertility also declines with age
What should women be aware of?

A woman’s ability to conceive a child is also reduced with age.
UK statistics (2009) recorded the chance of delivering a child through IVF, based on age:

  • 32.3% for women aged below 35
  • 27.2% for women aged 35→37
  • 19.2% for women aged 38→39
  • 12.7% for women aged 40→42
  • 5.1% for women aged 43→44
  • 1.5% for women aged 45 and over

Infertility is more relevant for couples today because the trend is to delay starting a family until later in life.

What is the difference between infertility and subfertility?

NICE guidelines define infertility as a failure to conceive after regular unprotected sexual intercourse for 2 years. Subfertility refers to couples trying unsuccessfully to conceive during a shorter period of time.

Assisted Reproductive Technology (ART) allows subfertile and infertile couples the chance to conceive a child.

When a couple encounter problems trying to conceive a child, then the male partner should consider having a Semen Analysis done and the female partner should have various bloods checked (See our page on 'Hers' Female Fertility Testing →). The female partner may also have to arrange an Ultrasound Scan, SIS (Saline Infusion Sonohystogram), HSG (Hysterosalpingogram), Laparoscopy or Hysteroscopy.

Depending on both partners test results, their age and the length of time spent trying to conceive, a couple will be recommended different options either by their GP or fertility clinic. Treatments will either attempt to restore fertility using medication, surgery or ART.

What medications are used to treat infertility?

Fertility drugs are used to regulate or induce ovulation in the female, or testosterone in the male.
Follicle-stimulating hormone (FSH) and Luteinizing hormone (LH) can be prescribed to individuals with hormonal imbalances e.g. Hypogonadotropic hypogonadism.

Clomiphene citrate (Clomid) is a drug taken orally which stimulates ovulation in women who have PCOS (Polycystic Ovary Syndrome) or other ovulation disorders. It targets the pituitary gland to release FSH and LH.

Gonadotropin medications do not target the pituitary gland but target gonads (testes/ovaries) directly. These injections can contain FSH, LH, Human menopausal gonadotropin (hMG) or Human chorionic gonadotropin (HCG).

What are the types of surgery that can be performed?

Surgery in the male may involve a biopsy of testicular tissue to collect sperm directly from the testes (TESE). This can be performed when part of the ducts, through which sperm swim, is blocked or absent.
Surgery in the female may involve the removal of endometrial tissue, pelvic adhesions or the unblocking of fallopian tubes.

What is involved in ART?

A range of ART options are available to couples, including Ovulation Induction(OI), IUI, IVF and ICSI. A team of fertility experts (including clinicians, embryologists and nurses) will recommend the treatment most suitable for an individual couple.

What is IUI and what is the difference between IVF and ICSI?

A simpler initial treatment that may be offered to couples is IUI (Intra-uterine Insemination). A woman would take a lower dosage of fertility medication and would be monitored throughout her cycle. When she is about to ovulate a small catheter is threaded into the womb through the cervix by either a nurse or clinician. The male partner’s prepared sperm is inserted directly into her womb, through the catheter. Preparing the sperm involves taking the best quality sperm from the ejaculate and placing them in a nutrient rich liquid just prior to the IUI procedure.

IVF (In Vitro Fertilization) is a more complex and intense treatment. It involves collecting mature eggs from a woman’s ovaries and fertilizing them with a man's sperm, in a dish, in a laboratory. The resultant embryo is transferred to the woman’s uterus three to five days after fertilization.

ICSI (Intra-cytoplasmic Sperm Injection) involves injecting a single sperm directly into an egg to fertilize it. The embryo is cultured in the laboratory in the same way as for IVF, and is transferred to the woman’s womb three to five days after fertilization.
ICSI makes it possible for men with severe oligozoospermia (low sperm numbers) or surgically retrieved sperm (TESE), to conceive a child.



Reference
  1. Carlsen E., Giwercman A., Keiding N., Skakkebaek NE. (1992) Evidence for decreasing quality of semen during the past 50 years. British Medical Journal; 305:609-13.
  2. Swan S.H., Elkin E.P., Fenster L. (2000) The Question of Declining Sperm Density Revisited: An Analysis of 101 Studies Published 1934–1996. Environmental Health Perspectives; Volume 108:10.
  3. Merzenich H., Zeeb H., Blettner M. (2010) Decreasing sperm quality: a global problem? BMC Public Health; 10:24.

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