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Infertility in the UK

Infertility is defined as 'failing to get pregnant after two years of regular unprotected sex' by the National Institute for Health and Clinical Excellence (NICE).

Infertility is the most common reason for women aged 20-45 to see their GP, after pregnancy itself.

Infertility is estimated to affect around one in six or one in seven UK couples - approximately 3.5 million people - at some point.  Although the majority of these will become pregnant naturally given time, a significant minority will not. Of 100 couples trying to conceive naturally about 84 will get pregnant within a year, and about 92 within two years.

Causes of Infertility-UK (2009)
The following reasons for infertility were collected from patient registration forms for IVF treatment. 
male factor - 29.7%
female factor - 28.5%
multiple male and female factors - 10.3%
unexplained - 23.9% (nearly a quarter of all cases)
other factors - 4.7% 

It is usually recommended that for women under 35, the use of ovulation-timing methods should be limited to a year, and women over 35 should not wait over 6 months before consulting a doctor who is expert in infertility. 

Infertility is on the rise in many countries.  This is due to:

  • The proportion of women in the UK having their first baby at or after age 30 has steadily increased since the mid-70s.  This is important because the probability of having a baby decreases by 3 to 5% a year after age 30 and even faster after age 40. 
  • The switch from condoms and diaphragms to nonbarrier methods of contraception can hamper return to optimum hormonal environment, often for many years beyond stopping.  It has also raised the risk that an STD (sexually transmitted disease) will compromise the ability to conceive and bear a child.
  • Alcohol can jeopardize pregnancy.  According to some studies, the risk of miscarriage appears to increase with moderate drinking during the first three months of pregnancy, particularly in the first weeks.
  • Women who smoke are more likely to take longer to conceive, they have an increased risk of miscarriage, and lower oestrogen and progesterone levels.  Men who smoke are likely to have decreased sperm density, less motile sperm, reduced testosterone, and an increase in abnormal sperm.  These risks for both men and women increase with the number of cigarettes smoked.
  • The negative effects of caffeine will only show in women who have four or more cups of coffee every day, an amount that equals about 400mg of caffeine.  This amount can cause a delay in the time it takes to conceive.
  • body weight/Obesity - There is an increase in pregnancy rate for significant weight loss.
  • Stress can have a big effect on fertility.  Stress hormones affect the hypothalamus and pituitary glands and reproductive organs.  In women under stress, the reproductive hormone prolactin is over-produced and this can interfere with ovulation.  The hypothalamus stops secreting gonadotrophin hormone, which in turn will affect the release of both the luteinizing hormone and follicle-stimulating hormone.  As these hormones stimulate ovulation - fertility is affected. 
  • Tight underwear (male)
  • Prescribed drug use
  • Recreational drug use
  • Bad eating habits can lower the reserves of nutrients that are necessary for reproductive hormone systems to work properly.  If you are short of essential fatty acids, vitamin A, vitamin B6, zinc, magnesium, and antioxidants, then your hormone product may be blocked - resulting in an imbalance that makes conception less likely. 
  • Adequate exercise is important for the healthy functioning of our bodies including the reproductve system, but excessive exercise can also reduce fertility.
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