What is infertility?

Infertility means difficulty in conceiving (becoming pregnant) despite having regular sex without using contraception. There is no definite cut off point to say when a couple is ‘infertile’. Many couples take several months to conceive. About 17 in 20 couples conceive within a year of trying. About 19 in 20 couples conceive within two years. Looking at this another way, about 1 in 7 couples do not conceive within a year of trying. However, more than half of these couples will conceive over the next year without any treatment.

Doctors usually say that a couple is regarded as infertile if, after regular sexual intercourse, they have not conceived in two years.

As a rule, it is worth seeing a GP if you have not conceived after one year of trying. A GP can check for some common causes, talk things over, and discuss possible options. You may want to see your GP earlier if the female in the couple is over the age of 35 or if either partner has a history of fertility problems.

Some general advice

The chance of conceiving gradually goes down over time. However, for couples where no cause is found for the problem, there is still a good chance of conceiving without treatment. In such couples, without treatment:

About half who do not conceive within one year conceive within the next year.
Those who do not conceive within three years still have about a 1 in 4 chance of conceiving over the following year.

Therefore, the usual ‘pre-conception’ advice still applies. For example, women are advised to:

Take folic acid each day to reduce the chance of a spinal cord problem in a baby.
Have a blood test to check that you are immune to rubella (german measles). You will be offered immunisation to rubella if you are not immune.
Eat a healthy diet.

In addition, the following may be relevant to some people.

Smoking can affect fertility in men and women. It has been estimated that in each menstrual cycle, smokers have about two thirds the chance of conceiving compared to non-smokers. Smoking is also harmful to a developing baby if the mother smokes. Therefore, it is a good time for both partners to stop if you are smokers.
Alcohol in excess may affect male fertility. Also, for women trying to become pregnant, the Department of Health recommend that you do not drink any alcohol. However, the exact amount of alcohol that is safe during pregnancy is not known. This is why the advice is not to drink at all. If you do chose to drink when trying to become pregnant then limit it to one or two units, once or twice a week. (This is the equivalent to one or two glasses of wine, once or twice a week.) You should never binge drink or get drunk.This is because alcohol may harm a developing baby.
Weight control. You have a reduced chance of conceiving if you are very overweight or underweight. For the best chance of conceiving you should aim to have your body mass index (BMI) between 20 and 30. If appropriate, see you practice nurse to measure your BMI and for advice about diet and weight control.
Some street drugs can affect fertility and are best avoided.
Heat and sperm production. It is often advised for men who have a low sperm count to wear loose fitting underpants and trousers and to avoid very hot baths, saunas, etc. This allows your testes to be slightly cooler than the rest of your body, which is thought to be good for sperm production. It is not clear whether these measures actually do improve sperm count, but they seem to be sensible.