Failure of the woman to ovulate is the cause in about 30% couples with infertility. In some women this is a permanent problem. In some women it is intermittent: some months ovulation occurs, and some months it doesn’t. There are various reasons for this anovulation they are Polycystic ovarian syndrome (PCOD),Hormonal problems, Premature menopause ,obesity etc.
Fallopian tube, cervix or uterine problems
These are the cause in about 20% couples with infertility, and include the following:
Endometriosis: It is a disease where tissue that lines the uterus (endometrium) is found outside of the uterus. It is ‘trapped’ in the pelvic area and can affect the ovaries, uterus, and nearby structures. It often causes lower abdominal pain and/or painful periods.
Pelvic inflammatory disease(PID): Previous infection of the uterus and fallopian tubes is another common cause. Previous surgery to the fallopian tubes, cervix or uterus can cause scarring.
Large fibroids may also cause problems, although this is debated by some experts.
These occur in about 40-50 % cases.The most common reason for male infertility is a problem with sperm due to an unknown cause. The sperm may be reduced in number, less mobile (less able to swim), and/or be abnormal in shape. Some men are born with testes that do not make any sperm, or very few sperm. Some are born without testes or without a vas deferens.
No cause can be found in about 10% couples with infertility.
Age and stress can be a factor
Older women tend to be less fertile than younger women. The ‘fall off’ of fertility seems to be greatest once you are past your middle 30s. For women aged 35-39, the chance of conceiving is about half that of women aged 19-26.
Some studies have shown that stress at work may reduce the chance of a woman conceiving. If the male or the female partner is stressed, this can affect libido and how often the couple have sex.
Pre-conceptional advice to all couple
Take folic acid each day to reduce the chance of a spinal cord problem in a baby.
Have a blood test to check that you are immune to rubella (german measles). You will be offered immunisation to rubella if you are not immune.
Eat a healthy diet.
Smoking can affect fertility in men and women.It is a good time for both partners to stop if you are smokers.
Alcohol in excess may affect male fertility.
Weight control. You have a reduced chance of conceiving if you are very overweight or underweight. For the best chance of conceiving you should aim to have your body mass index (BMI) between 20 and 30.
Heat and sperm production. It is often advised for men who have a low sperm count to wear loose fitting underpants and trousers and to avoid very hot baths, saunas, etc. This allows your testes to be slightly cooler than the rest of your body, which is thought to be good for sperm production.
Sex and fertility
It is best not to try and time when you have sex to coincide with expected ovulation. This may cause anxiety, which can sometimes lead to sexual or relationship problems.
Sperm survive up to five days after having sex. Therefore, even though an ovum (egg) only survives 12-24 hours, having sex two or three times a week is sufficient if you are trying to conceive. In fact, studies have shown that having
sex every two to three days is likely to maximise your chance of getting pregnant. You may want to have sex more often,
which is fine, but it probably will not increase your chance of conceiving. It is thought that the more relaxed and spontaneous your sex
life is, the more likely you will conceive.