What is fertility?

Fertility is the ability to have a baby (conceive). Most couples who have unprotected sex every two to three days will get pregnant naturally within a year.

What is infertility?

Infertility is when you cannot get pregnant, despite having regular unprotected sex. This affects around 1 in 7 couples.

There are two types of infertility:

• primary infertility – when you have never been pregnant and are struggling to conceive
• secondary infertility – when you have been pregnant before but are struggling to get pregnant again

Infertility can affect both men and women.

What causes infertility?

There are many causes of infertility. If you have a partner, these issues can affect either or both of you.

Common causes of infertility in women include:

• lack of regular ovulation (the monthly release of an egg). This could be caused by conditions like polycystic ovary syndrome (PCOS)
• blocked or damaged fallopian tubes (the tubes that carry the egg from the ovary to the womb)
• endometriosis – where tissue similar to the lining of the womb grows outside of the womb
• fibroids – these are non-cancerous growths in or around the womb. They are common, affecting 2 in 3 women in their lifetime

Common causes of infertility in men include:

• Low or no sperm
• Abnormal sperm
• Ejaculatory or erectile dysfunction

Doctors do not always know why some people have fertility problems. For about a quarter of couples the cause is unknown.

Are there risk factors for infertility?

There are some risk factors that can affect fertility. These include:

• age - your fertility declines as you get older
• being overweight
• sexually transmitted infections
• smoking
• alcohol
• environment factors, like exposure to certain pesticides, solvents and metals
• stress

Researchers have found no link between Covid-19 vaccines and fertility issues in men or women.

How is infertility diagnosed?

If you have not got pregnant after a year of unprotected intercourse, see your GP.

You should see your GP sooner if:

• you are aged 36 years or over
• you know you have a fertility problem
• you have irregular periods

If you have a partner, you will both need to have investigations. As infertility can affect either or both of you.

Your GP will talk to you and examine you to check for common fertility problems.

You might need to go for some tests. For women this might include:

• blood tests
• a check for chlamydia and gonorrhoea (sexually transmitted infections)
• transvaginal ultrasound scan. This is where a slim camera is put inside your vagina to get a closer look at your reproductive organs.

Men will have their semen analysed and may have an examination.

What treatment is available for infertility?

The main types of fertility treatment are:

• medicines
• surgical procedures
• and assisted conception (like IVF)

If you have a problem with ovulation, the doctor may give you medications to help release an egg after checking that your fallopian tubes are patent.

If you have damaged fallopian tubes, endometriosis, fibroids or PCOS, you may need surgery.

Different types of assisted conception include:

• intrauterine insemination (IUI) - where sperm is inserted into the womb via a thin tube
• in vitro fertilisation (IVF) - when the egg is fertilised outside of the body and then returned to the womb
• intracytoplasmic sperm injection (ICSI) – a type of IVF where sperm is injected into the egg to fertilise it
• egg and sperm donation - having donor eggs or sperm to help you get pregnant if there is a problem with egg or sperm following investigation.

Fertility treatment funded by the NHS depends on where you live. It also depends on your health including your BMI and whether you smoke.

Your personal circumstances will also be taken into account, including whether you or your partner have any children. Speak to your GP about funding and treatment times in your area.

Connecting with others that know how you’re feeling can be a positive step. Fertility Network UK runs support groups so that you can talk to others who know what you are going through.

The impact on you

When trying for a baby, it can be confusing and upsetting when things don’t go to plan. Feeling like a failure, sadness, frustration and anger are all common.

If you are going through emotional difficulties, you’re not alone. Talking to family, friends or other people you trust can help. See other ways to cope in Looking after yourself and getting more support. <anchor links to section below)

The impact on your life and relationships

The stress of trying for a baby can take a toll on your relationship. Some couples find that they argue more.  Some people find sex is less pleasurable and fun. Try to focus more on other ways of feeling close to each other. This could be going out somewhere special, trying something new together or just making time to be close.

The emotional impact of infertility affects men too. Men may benefit from online support groups as a chance to talk to other men about how they’re feeling.

Having time off work for fertility treatment can be positive for some people and  Fertility Network UK has a factsheet on employment issues that might help.

Find out about other support. <anchor link to section below>

Becoming a parent when you are LGBTQ+

LGBTQ+ people who want to have children can face extra practical and financial difficulties.

The NHS has more information about ways to become a parent if you are LGBTQ+.

Looking after yourself and getting more support

Looking after yourself may help you feel less stressed. Leading an active lifestyle can improve your mental health.

Being kind to yourself by eating well, moving more and making time to relax can boost your mood and self-esteem.

If you’re not getting treatment, or you’re finding treatment difficult, you might want to get some counselling. Speak to your GP about counselling on the NHS.

Mind mental health charity provides low-cost talking therapies or you can go private. The British Infertility Counselling Association has a directory of accredited therapists.

The charity Fertility Network UK can provide support and information. Help is available whether you are trying to get pregnant, going through treatment or living without children.

Our research to tackle infertility

As a women’s health charity, part of what we do is fund research to save and change the lives of women, girls and babies.

We are funding research into whether vaginal ultrasound scans are the best way of finding out if a woman going through fertility treatment is likely to have twins, triplets or more.

Women who take a fertility medication called clomifene are more likely to have a multiple pregnancy.

Doctors currently use a vaginal ultrasound scan to work out if a woman who has recently taken clomifene has a high chance of a multiple pregnancy. These tests can be uncomfortable and are expensive. And doctors aren’t sure if they are the best thing to do. Our research aims to find out once and for all.

Read about this research and our other projects below.