If you're ready to start planning to conceive but have concerns about infertility, you're not alone. According to the World Health Organization, approximately one in every six people of reproductive age worldwide experience infertility in their lifetime. While these statistics are concerning, understanding your fertility status and how to improve your chances of conceiving can empower you.

To help you learn more about infertility, we spoke to Dr. Sheana Jones, obstetrician and gynaecologist at Life Vincent Pallotti Hospital in Cape Town.

What is considered poor fertility?

‘On average, 80% of couples get pregnant within six months of timing intercourse during the most fertile time, while 90% manage to get pregnant within a year,’ says Dr. Sheana. ‘If a couple does not conceive after one year of timed intercourse, then this indicates poor fertility.’

What are some common causes of infertility?

‘In males, infertility is most commonly caused by problems relating to the ejaculation of sperm, low sperm levels, or even the absence of sperm,’ shares Dr. Sheana. ‘Some common risk factors for this are chronic conditions, lifestyle factors such as smoking, and excessive alcohol consumption.’

Other risk factors in men could include hormonal disorders leading to abnormalities in hormones produced by the pituitary gland, hypothalamus, and testicles.

Hormones such as testosterone regulate sperm production. Examples of disorders that result in hormonal imbalance include pituitary or testicular cancers.

‘The most common risk factor for infertility in women is issues with ovulation. 15% of women have PCOS (polycystic ovary syndrome), which is a hormonal imbalance that occurs when your ovaries create excess hormones,’ says Dr. Sheana. ‘Some signs of this condition or issues with ovulation include erratic period cycles, facial hair, hormonal acne, and weight around the waist area,’ she says.

What steps can one take to improve fertility when actively trying to conceive?

For men:

The most important step to improving fertility in men is to ensure you're producing healthy sperm. Some ways to increase your chances of healthy sperm include:

• Managing your stress levels, which can help maintain hormone levels
• Exercising regularly
• Following a healthy diet rich in fruits and vegetables
• Limiting alcohol intake
• Not smoking
• Reducing sitting
• Wearing loose-fitting underwear.

For women:

While medical treatment is required for conditions such as PCOS, including contraception and surgery, there are lifestyle changes that can help improve your fertility:

• Limiting or avoiding alcohol intake when trying to conceive
• Not exercising excessively or too intensely (e.g., running or HIIT) as this could impact your progesterone levels
• Not smoking, as this can age your ovaries
• Maintaining a healthy weight by exercising regularly and following a healthy diet 

What happens if you are unable to conceive?

When Amelia Peck and her husband embarked on their journey to conceive, they sought the guidance of a gynaecologist, who diagnosed Amelia with PCOS.

‘When I was diagnosed, the doctor cautioned that achieving pregnancy might be challenging and could even be impossible,’ shares Amelia.

For two years, they grappled with the difficulties of conception for their first child. However, perseverance paid off, and they were blessed with a healthy pregnancy within two years. When the couple decided to expand their family further, going through it all again was daunting, recounts Amelia.

‘We tried to conceive naturally for years, facing the disheartening prospect that it might not happen again,’ said Amelia. ‘After five long years, against the odds, I finally became pregnant with our second child,’ she concludes.

If, like Amelia, you are still struggling to conceive after a year, you may need to undergo certain tests to check for any underlying conditions. Depending on your test results, your doctor will recommend a treatment plan and other options to conceive.

Treating infertility

There are three main types of treatment for infertility, including surgery, assisted conception such as intrauterine insemination (IUI), and in vitro fertilisation (IVF). Certain medications may also be prescribed, depending on the condition you’re diagnosed with.

For PCOS, you may be prescribed ovulation medication and, for severe cases, a surgical procedure. Laparoscopic surgery (a surgical technique in which short, narrow tubes are inserted into the abdomen through small incisions) is often used to treat endometriosis, while laparoscopic ovarian drilling is used to treat PCOS.

For more about Life Healthcare’s fertility services, click here.

The information is shared on condition that readers will make their own determination, including seeking advice from a healthcare professional. E&OE. Life Healthcare Group Ltd does not accept any responsibility for any loss or damage suffered by the reader as a result of the information provided.