Published by Bupa's Health Information Team, April 2010.
This factsheet is for women who are having trouble conceiving, or anyone who would like information about female infertility.
Infertility is when a woman isn't able to get pregnant after two years of having unprotected sex. There are a number of things that can affect fertility although often no cause can be found. This factsheet only considers infertility in women - for information about infertility in men, please see Related topics.
It's thought that one in seven couples in the UK has trouble conceiving. However, it's important to remember that over eight out of 10 couples will conceive within one year of having regular, unprotected sex, and more than nine out of 10 couples will do so within two years.
Infertility has been defined as not getting pregnant within two years of having frequent, unprotected sex. You may have primary infertility - this means you have never been pregnant - or secondary, which is when a couple has previously conceived.
It's thought that in about four out of 10 couples who have fertility problems both partners have a condition that affects their ability to have a baby.
There aren't any specific symptoms of infertility, but if the problem is caused by a particular medical condition, you may have symptoms as a result of that.
It may not be possible to find a cause for your infertility - this is true for about a third of couples who have problems conceiving.
There are various reasons why you may be having trouble getting pregnant. It's important to bear in mind that your fertility decreases as you get older and this may make it more difficult. However, with regular unprotected sex more than nine out of 10 women aged 35 will conceive within three years of trying and nearly eight out of 10 women aged 38 will do so.
The most common reasons for infertility in women are:
There are a number of reasons why you may not be producing eggs. Some of these are described here.
Things that can affect your fallopian tubes and lead to problems with fertility include:
It's possible that your difficulty conceiving isn't a result of a problem with your ovaries or fallopian tubes. Some of the other things that can affect your fertility are:
See your doctor if you're concerned about your fertility. If possible, it's a good idea for you and your partner to go together. Your doctor is likely to ask you for how long you have been trying to have a baby and whether you have had any problems having sex. He or she may ask you about your lifestyle and also about your medical history including:
Your doctor may also need to examine you.
If you have not already been doing so, your doctor is likely to recommend that you have unprotected sex two to three times a week for a year before carrying out any tests. After this time, or sooner if your doctor thinks you or your partner may have a condition that means you're less likely to conceive, there are a number of tests that he or she may do.
Your doctor may carry out blood tests to look at the levels of certain hormones. These can give information about how well your ovaries are working and whether they are producing eggs. Your doctor may also suggest a test to see whether you have been infected with chlamydia. If necessary, your doctor will refer you to a fertility specialist or a gynaecologist (a doctor who specialises in women's reproductive health).
If you haven't previously been diagnosed with a condition that can affect your fallopian tubes such as endometriosis, you may be referred for a test called hysterosalpingography. This can show if your fallopian tubes are blocked. Hysterosalpingography uses a type of X-ray procedure called fluoroscopy. This involves injecting a dye (contrast medium) that shows up on X-rays into your womb and fallopian tubes, and taking a series of X-rays that are displayed on a TV screen. If your tubes are clear, the dye will fill them and spill out.
An alternative to hysterosalpingography is hysterocontrastsonography. This uses an ultrasound scan instead of X-rays to check your fallopian tubes.
If you have a condition that affects your fertility, or your doctor thinks you may have, you may be offered a test called a laparoscopy and dye. This is a surgical procedure that can help your doctor see your fallopian tubes and other organs in this area. Laparoscopy and dye can usually give your doctor more information than hysterosalpingography.
If your infertility is caused by an underlying condition such as endometriosis, there may be specific treatments that can improve your chance of becoming pregnant. If your doctor can't find a particular cause for your infertility, there are a number of options that he or she may suggest.
Having sex two to three times a week is thought to maximise your chance of becoming pregnant. Your doctor may also suggest making certain lifestyle changes, for example, stopping smoking and not drinking more than one to two units of alcohol once or twice a week. You may also be advised to lose excess weight or put some on.
It's a good idea to take a folic acid supplement if you're trying to get pregnant. This can reduce the risk of your baby having certain developmental problems. Your doctor may recommend that you are vaccinated against rubella if you're at risk. He or she is also likely to check that you have had a cervical smear test within the last three years.
If your infertility is a result of a problem with ovulation, you may be prescribed a medicine such as clomifene citrate. This is likely to stimulate your ovaries to produce eggs.
You may be offered surgery if tests show that you have endometriosis or if your fallopian tubes are damaged. However, surgery won't be suitable for everyone so it's important to talk to your doctor about the best option for you.
Surgery may also be an option if you have adhesions (fibrous scars) in your womb, or to remove fibroids, especially if they extend into the inner lining of your womb.
There are several techniques that can be used to help you conceive. These aim to bring a sperm and an egg close together. The three main methods are:
For more information about these procedures, please see Related topics.
If you're having trouble getting pregnant, it can have psychological and emotional effects. Feeling stressed, whether it's caused by your problems conceiving, work or something else, may affect your relationship with your partner. This in turn may have an impact on your libido and how often you have sex, leading to further fertility problems.
You may find it helps to talk to other people - there are support groups where you can meet with couples who are also having treatment for infertility. Alternatively, you may find it helps to talk to someone who isn't closely involved with your situation. Your doctor or clinic can give you details of a specialist fertility counsellor.
For answers to frequently asked questions on this topic, see Common questions.
For sources and links to further information, see Resources.
Male and female doctors make up Bupa's team of highly experienced GPs with all the empathetic qualities you'd expect. Book to see a Private GP today or call 0845 600 3458 quoting ref. HFS GP.
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This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the About our Health Information page.
Publication date: April 2010
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