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Infertility

4-minute read

What is infertility?

The term infertility is used if a woman is not pregnant after 12 months or more of regular unprotected sex. Having regular sex means having sex every 2 or 3 days throughout the month.

Infertility is common. Whether you are trying to fall pregnant for the first time, or are already parents who would like more children, infertility can be a stressful and frustrating experience for everyone involved. It takes time for many people to fall pregnant. Many couples with fertility problems go on to get pregnant, with or without fertility treatment.

What are the causes of infertility?

There are many causes of infertility. Sometimes the problem is with the woman, sometimes the problem is with the man, sometimes with both, and sometimes there is no obvious reason for it.

For example, a woman may have:

  • hormonal disorders
  • damaged or blocked fallopian tubes
  • endometriosis
  • very thick cervical mucus

A man may have:

  • low sperm count
  • poor sperm movement or shape
  • no sperm released due to a blocked tube, or ejaculation failure

Age is an important factor. From the age of 32, a woman’s chances of getting pregnant start to decrease, and from age 35, the rate of that decrease speeds up.

Men aged 35 are half as fertile as they were at the age of 25, and from the age of 55, their fertility decreases dramatically.

Your weight will also affect your fertility. Both women and men who are overweight have changes to their hormones that make it harder for them to be fertile.

Smokers are more likely to be infertile than non-smokers.

The more alcohol men and women drink, the less likely a successful pregnancy is.

Some sexually transmitted infections such as chlamydia and gonorrhoea can reduce fertility in both men and women.

Read more about good fertility health.

How do I talk about infertility with my partner?

For couples trying for a baby, it is normal to have feelings of uncertainty, disappointment, and anxiety. It may affect a couple in the same way or in different ways.

It is good to talk through any problems and for both of you talk about how you feel.

If there are difficulties between you, talk to your doctor as a couple. Your doctor may refer you both to a counsellor if necessary.

You can also access support services like Your Fertility and Relationships Australia.

What are my options for treating infertility?

If you are infertile and want to have a child, there are many treatment options.

You may increase your chance of falling pregnant if you know your most fertile days.

You can treat any underlying causes like endometriosis or sexually transmitted infections. You can use artificial insemination, or you can seek a fertility treatment like in vitro fertilisation (IVF). You may consider surrogacy or adopting a child.

When should I visit my doctor?

If you’re under 35 years and have been trying to get pregnant for 12 months or more you should think about seeing your doctor.

If you’re over 35 years, you should think about seeing your doctor if you’ve been trying to get pregnant for 6 months.

You should see your doctor straight away if you would like to have a child and think you or your partner may have problems with fertility because of endometriosis, testicular problems or anything else.

If you’ve been having regular unprotected sex for more than 12 months, your doctor may recommend a range of tests to determine what's stopping you from conceiving.

If the tests determine that either you or your partner are infertile, there are a number of fertility treatments that are available to you, such as in vitro fertilisation (IVF).

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Last reviewed: May 2022


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Need more information?

Fertility tests and treatments

There are different tests available to determine your fertility, and a number of fertility treatments available to both and your partner if you are struggling to fall pregnant.

Read more on Pregnancy, Birth & Baby website

Twins and multiple births - Better Health Channel

betterhealth.vic.gov.au

Read more on Better Health Channel website

Female infertility - MyDr.com.au

There are several factors that can affect a woman's fertility. Treatments are available for many of the causes of female infertility and assisted reproductive technology such as IVF can help some women get pregnant.

Read more on myDr website

Male infertility: Symptoms, causes & diagnosis | Healthy Male

As a male, your fertility generally depends on the quantity and quality of your sperm. If the number of sperm you ejaculate is low, or if the sperm are of a poor quality, it will be difficult, and in some cases impossible, to get pregnant. In most cases, there are no obvious signs of infertility.

Read more on Healthy Male - Andrology Australia website

Male infertility - MyDr.com.au

Male infertility is a major factor in 30-50 per cent of difficulties conceiving. It usually results from low numbers of, or poor quality, sperm.

Read more on myDr website

Infertility treatment | Jean Hailes

There are many reasons a woman may have difficulty becoming pregnant. There are a number of things you can do to increase the likelihood of becoming pregnant including lifestyle changes, surgery, hormone treatment and Assisted Reproductive Technology (ART).

Read more on Jean Hailes for Women's Health website

Infertility in men - Better Health Channel

betterhealth.vic.gov.au

Read more on Better Health Channel website

Suspecting infertility | VARTA

What are the causes? Infertility is defined as the inability to conceive after 12 months or more of unprotected sex. If you have been trying to have a baby for a year or more, it is time to speak to your GP. If you are over 35, you should see a doctor if you have been trying to conceive for six months or more. About one in six Australian couples experience fertility difficulties. There are many reasons for this, some relating to the male partner, some to the female partner, and sometimes both. For many people, there is no medical explanation as to why they can’t conceive.  This is referred to as unexplained infertility. A diagnosis of infertility often comes as a shock and can be emotionally challenging. Unlike other adverse life events, which may have a clear resolution, infertility is uniquely distressing because it can last for many years and the outcome is uncertain. If you suspect a fertility problem, talk to your GP who will guide you through the steps of an infertility investigation. There are many reasons why pregnancy does not occur. About 20 per cent of infertility cases are due to male factors and 30 per cent are due to female factors. Sometimes both partners have a fertility problem, and in about 20 per cent of cases, there is no apparent cause of infertility (idiopathic or unexplained infertility). Many people are delaying starting a family beyond their most fertile years. If you are unable to conceive due to social circumstances, such as relationship, age, financial or practical reasons, and are concerned about your fertility declining, you might want to consider fertility preservation (e.g. freezing eggs or sperm for future use). The Better Health Channel has helpful information on infertility in men and infertility in women. Getting help Speak to a GP The first point of contact should be your GP who will start an infertility investigation. This involves a detailed medical history and a physical examination of both partners and some basic tests to make sure that the woman is ovulating and that the man produces sperm. If everything seems in order, your GP may advise you to keep trying for a little longer before consulting a fertility specialist. However, if your test results indicate a problem, your doctor will refer you to a fertility specialist straight away. The fertility specialist will do more tests to establish the cause of infertility and determine the type of fertility treatment you may need. The chance of fertility treatment working has greatly improved since the late seventies when the first IVF baby was born. Although your chance of having a baby with fertility treatment depends largely on factors that are beyond your control, there are some things that you can do to improve the odds. The lifestyle factors that influence the chance of natural conception for both men and women also affect your chance of success through fertility treatment. Finding a fertility specialist Fertility treatment is physically and emotionally demanding, and depending on your needs it can be expensive, so it is important to find a clinic and doctor that is right for you. You can ask your GP for advice about choosing a fertility specialist, but you can also do your own research before committing to a doctor and clinic. You can find out more about choosing a fertility clinic here. Finding a fertility counsellor If you want to speak to a private counsellor specialising in infertility, the Australian and New Zealand Infertility Counsellors Association (ANZICA) has a list of independent counsellors. You can also ask your fertility clinic about the counselling sessions included as part of your treatment.

Read more on Victorian Assisted Reproductive Treatment Authority website

Considering donor conception | VARTA

Your decision to have children with the help of donated eggs, sperm, or embryos is a lifelong one. It will be the result of an extensive process of consultation and discussion. Your fertility specialist and clinic counsellor will provide you with information about using donor gametes (sperm and eggs) or embryos and can help you explore the social and emotional considerations. Am I eligible? Eligibility requirements for fertility treatments in Victoria are outlined in Section 10 of the Assisted Reproductive Treatment Act 2008. According to the Act, a doctor must be satisfied that: the woman is unlikely to become pregnant other than by a treatment procedure; or the woman is unlikely to be able to carry a pregnancy or give birth to a child without a treatment procedure; or the woman is at risk of transmitting a genetic abnormality or genetic disease to a child born as a result of a pregnancy conceived other than by a treatment procedure, including a genetic abnormality or genetic disease for which the woman’s partner is the carrier. What’s involved? There are many reasons why donor sperm, eggs or embryos may be needed. You can read more about the donor conception process and what is involved here. If you are considering donor conception, VARTA recommends following these steps: Speak to your GP or fertility specialist about your fertility assessment and donor conception options. Discuss donor conception with your partner (if any) and family. Find a donor. This could be through your fertility clinic, advertisement, a known or overseas donor. Have counselling sessions with your treating fertility clinic. Complete the required consent forms with your counsellor. This will cover details such as withdrawal of consent and what happens in the event of death. You and your partner (if any) will need to be involved in this. Undertake fertility treatment at your fertility clinic. Finding a donor Once you are ready to proceed with donor conception, the next step is to find the right donor. There are many options depending on your circumstances and preferences, including using a fertility clinic donor, a donor you know, advertising for a donor or using an overseas donor. Using a fertility clinic donor Most fertility clinics have sperm donors, with some also recruiting egg and embryo donors. If donor numbers become low, there may be a waiting list for access. All donations must be altruistic, meaning donors are not allowed to be paid for donating (apart from reimbursement of expenses). Clinic donors are limited to donating to ten women (including their current or former partner). Donors are medically screened. They (and their partner) have counselling to inform them of their rights and responsibilities before donating. All donors consent to their identifying details (name, date of birth, last known address) being released to the donor-conceived person when they turn 18. Donors complete a donor profile giving some information about themselves including why they donated, their hobbies, personality, appearance, and whether they are open to being contacted before the child is an adult. Potential recipients are usually able to read these profiles and, if possible, choose which donor they prefer. You can find out more from your fertility clinic. Using a known donor A known donor could be an acquaintance, friend, or family member. Using a known donor often requires a proactive approach to letting people know you are looking for a donor. Word of mouth or your personal social network can be useful tools. You may want to consider the following questions when finding a known donor: What criteria are you looking for in a donor (e.g. level of ongoing involvement or contact) and what would exclude someone as a potential donor? How important is the donor's appearance, religion, personal characteristics, morals and beliefs, level of education, etc.? Why is the person donating to you? Do they feel obliged to donate to you? The decision to donate may have long lasting implications for the donor, their partner (if any), and their family, so it is a good idea to ensure they do not feel an obligation to donate, but rather want to do it for their own reasons. The relationship between all parties, including the parents and the donor, and the donor and the child, can vary enormously from no contact to occasional contact or an ongoing relationship. It is important that everyone involved including partners (if any) express how they feel about the arrangement, roles and consent. Regardless of the level of involvement, maintaining a positive ongoing relationship can be beneficial for known donors, parents and the child. This is particularly important where there is a co-parenting arrangement in which the donor is actively involved in the child's upbringing. Expectations, feelings, and needs are likely to change over time. As things change, it is important to focus on ensuring positive outcomes. Some factors that can help contribute to positive relationships are: a high level of trust and a capacity to communicate openly and honestly an ability to manage change and conflict a solid grounding of shared values and priorities holding each other in high regard a level of emotional maturity. Using advertising In Victoria, it is a legal requirement to have an advertisement for a donor approved by the Health Minister before it is published. This includes sending your draft advertisement for approval to: Minister for Health Department of Health and Human Services GPO BOX 4541 Melbourne VIC 3000 Email Address: art.enquiries@dhhs.vic.gov.au Generally, advertisements: Stand out by uniquely reflecting you and your situation. Describe you and why you need a donor. Clearly state what you are seeking in the title and/or the opening sentence. Include a short explanation of what reasonable expenses (e.g. medical, travel) will be reimbursed. Consider privacy (use a non-identifying email address, PO box, mobile number rather than home number). It may take some time before your advertisement is successful. Not everyone who responds will be a suitable donor for you. You can find examples of advertisements here. Using an overseas donor If you would like to import donated eggs, sperm, or embryos (created using donor eggs or sperm) to Victoria for treatment, you need to apply to VARTA for approval to import donated material. In considering your application, VARTA will determine whether the imported eggs, sperm, or embryos will be used in a way that complies with Victorian law. You can find more information including import criteria in the Victorian guidelines. It is important to note that you cannot use donations from anonymous donors within Australia. Anonymous donation does not comply with Victorian law. Although anonymity may seem appealing, it is important to consider the impact of this on your potential child. With overseas unknown donors, no contact or further exchange of information (e.g. medical, biological or cultural background) is possible between the donor and child.

Read more on Victorian Assisted Reproductive Treatment Authority website

Fertility and cancer

Some cancers and cancer treatments can affect your fertility. Before starting a treatment, you might want to consider the options for preserving your fertility.

Read more on Pregnancy, Birth & Baby website

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