Been trying without luck, could I be infertile?

Dear doctor,

I am in my mid-thirties, have been trying to conceive for a while without success and my partner thinks I’m to blame. What could be wrong?

Betty,

Dear Betty,

Men contribute as much as women to infertility. There’s an unfair cultural trend that puts the blame on women. When a couple has faced a delay in achieving a pregnancy, the presumption must always be that either of them could be responsible. Both man and woman must avail themselves for a fertility assessment. There are multiple factors that could explain infertility, ranging from poor quality of sperms (men), to problems with ovulation or damaged tubes.

Do women retain their fertility till the menopause?

No, fertility potential declines with age. Peak fertility is usually in the 20s, then an accelerated decline occurs from the mid-30s. From the 4th decade onward, only a small number of women will conceive spontaneously. Advanced fertility treatment does not compensate for the natural age-related fertility decline. Women should therefore plan pregnancies early if at all possible, or preserve their eggs for future use if a delay in child-bearing becomes unavoidable.

I have heard that men maintain their fertility to very advanced ages?

This is another unqualified myth about men. Fertility decline in men mirrors the decline in women, hence similar advice as for women applies in men too. There’s already a well-publicised observation about a global decline in sperm numbers in men over the years, a fact that shouldn’t be ignored.

I have been offered combinations of herbs, do they work?

This has always been an unfortunate misconception and pretty misleading advice to couples struggling with infertility. If you haven’t undergone a structured fertility assessment, gobbling down a combination of herbs is unlikely to get you anywhere. Unproven therapies attract a lot of undue hype, and are unfortunately a waste of time and money for most. Steer away from unscientific claims of unproven remedies.

Which is the best advice?

If suffering from infertility, you need a common sense approach to help you conceive. Those below the age of 35 years with no apparent problems can try for a year before seeking help. If above the age of 35, don’t wait longer than six months as your fertility potential is on a steep decline. You should be assessed sooner if you have additional issues like irregular periods. Your man is best seen sooner if he also has apparent issues like erectile dysfunction. Keep your fertility potential optimal by maintaining a normal weight, having a healthy diet and avoiding toxins like smoking, other drugs or excessive drinking. Have regular sex especially around the time of ovulation. Avoid sexually transmitted infections which are a

major cause of infertility. Don’t shy away from seeking appropriate help promptly, most couples will conceive once the cause of their infertility is identified.