Fertility explained

Fertility is the ability to become pregnant and have a baby. It depends on healthy sperm, healthy eggs and reproductive organs working well.

For pregnancy to happen naturally, the female body must release an egg (ovulation). The male body must produce sperm able to fertilise that egg. The fertilised egg must then travel through the fallopian tube and implant in the uterus (womb).

Fertility can be affected by many things. These include age, general health, some health conditions and lifestyle factors.

Both partners contribute to fertility. Problems affecting either the male or female reproductive system can make it more difficult to become pregnant. Fertility testing usually involves checking both partners rather than one person alone.

Many factors can affect fertility in females and males. These include age, health conditions, lifestyle factors and genetics.

Age

Age is one of the most important factors affecting fertility.

Female fertility decreases with age. This is because the number and quality of eggs lessen over time. 

Fertility decline is more noticeable after about 35 years of age. This is linked to a higher risk of pregnancy complications.

Male fertility can also change with age. Sperm quality and reproductive health may decline over time. This reduces the chances of getting pregnant.

Health

Your general health and reproductive health can affect fertility.
Some health conditions can make it harder to get pregnant, such as:

• conditions that affect ovulation, hormone levels or the reproductive organs 
• problems with sperm production or function 
• medical treatments, including chemotherapy or surgery — these may damage eggs, sperm or reproductive organs

Lifestyle

Lifestyle habits may affect fertility in both females and males.

Your body weight can affect fertility in both females and males. Being underweight or overweight can affect hormone levels, ovulation and sperm health. This may make it harder to become pregnant. Maintaining a healthy body weight may help improve your chance of pregnancy.

Sperm production, hormone levels and reproductive health can also be affected by:

• alcohol use
• smoking 
• illicit drug use 
• exposure to environmental hazards 

Maintaining good general health can help support fertility.

Genetics or family history

Genetic factors or family history can sometimes affect fertility in both females and males.

Some inherited conditions can affect how the reproductive system develops or how hormones are produced. Hormones control processes such as ovulation in females and sperm production in males.

Certain genetic conditions may affect the ovaries, testicles or reproductive organs. This can make it harder to produce healthy eggs or sperm. Genetic conditions may also affect the body’s ability to support a pregnancy.

Doctors may ask about your family history, including early menopause or inherited conditions. This can help identify possible causes of fertility problems and guide further testing. 

You may want to see your doctor if you have been trying to become pregnant for 12 months without success.

If you are female and 35 years or older, consider seeing a doctor after 6 months of trying, as fertility declines with age.

You should also see a doctor sooner if you have:

• irregular or absent periods
• reproductive health conditions such as endometriosis or polycystic ovary syndrome (PCOS)
• a history of pelvic infection or surgery
• had cancer treatment such as chemotherapy or radiotherapy
• concerns about sperm health or sexual function

Your doctor can assess both partners and may recommend tests to help identify possible causes of infertility. Early advice can help you understand your options and plan the next steps.

If you are having difficulty becoming pregnant, there are options that may help improve your chances. These include lifestyle changes and medically assisted treatments. The best option depends on the cause of infertility, your age and overall health. 

Natural methods

Some people may improve their chances of becoming pregnant by making changes to their health and lifestyle.

Maintaining a healthy body weight can help support normal hormone levels, ovulation and sperm health. Being underweight or overweight may reduce fertility.

Healthy lifestyle habits can also support fertility. These include:

• stopping or avoiding smoking
• reducing or avoiding alcohol
• avoiding illicit drugs
• eating a balanced diet
• staying physically active

These factors can affect hormone levels, sperm production and reproductive health in both females and males.

Timing sex around ovulation may also improve the chance of pregnancy. Ovulation usually happens once during each menstrual cycle, when an egg is released from the ovary. Pregnancy is most likely if sex occurs in the few days before ovulation and on the day ovulation occurs.

Medically assisted options

Medical treatments may help if natural methods are not successful.

Doctors may recommend medicines to stimulate ovulation if ovulation is not happening regularly. Sometimes, surgery may be used to treat conditions affecting fertility, such as blocked fallopian tubes or problems in the reproductive organs.

Some people may benefit from assisted reproductive technologies (ART). These treatments help sperm and eggs come together to help pregnancy happen.

Common examples include:

• intrauterine insemination (IUI) — where sperm is placed directly into the uterus
• in vitro fertilisation (IVF) — where eggs are fertilised with sperm in a laboratory and the embryo is placed in the uterus

Your doctor may recommend one of these treatments, based on the cause of infertility, your age and previous treatments.

A doctor or fertility specialist can help assess your situation and discuss which options are best for you.

Infertility can affect your emotional wellbeing and relationships. Many people feel stress, sadness, frustration or grief when they cannot become pregnant. Some people may also feel guilt, shame or a sense of loss. These feelings are common and understandable.

Infertility and fertility treatment can also affect relationships, work and daily life. Trying to become pregnant or having fertility treatment can be stressful for both partners.

Support can help. Talking with your partner, a counsellor or a support group may help you manage these feelings. Your doctor may also suggest counselling as part of fertility care. 

You may find information and support from these organisations:

• Your Fertility has information on fertility, infertility and reproductive health for females and males.
• Access Australia is a national infertility network. It offers information and support for people experiencing infertility or using assisted reproductive technologies.
• The Victorian Assisted Reproductive Treatment Authority (VARTA) has information about fertility, infertility and fertility treatment.
• Relationships Australia offers counselling and support for individuals and couples experiencing emotional stress related to infertility.

Information for Aboriginal and Torres Strait Islander peoples

• Aboriginal and Torres Strait Islander peoples can access culturally safe health services through an Aboriginal Community Controlled Health Service (ACCHS) or your local GP.
• You can find a local Aboriginal health service through the National Aboriginal Community Controlled Health Organisation (NACCHO).

Languages other than English

• The Multicultural Centre for Women’s Health (MCWH) provides culturally appropriate health information and support for migrant and refugee communities.
• You can also call the Translating and Interpreting Service (TIS National) on 131 450 to ask for an interpreter when speaking with health services.

Information for sexually and gender-diverse people

Sexually and gender-diverse people and families may have different pathways to pregnancy or fertility care. Support and information are available:

• Rainbow Fertility Australia has information and support for sexually and gender-diverse people planning a family.
• QLife is a national peer support and referral service for sexually and gender-diverse people. Call 1800 184 527.