June is World Infertility Awareness Month, a time dedicated to raising awareness around infertility challenges faced by a large number of people across the world. According to the World Health Organisation (WHO), around 17.5% of adults – roughly 1 in 6 worldwide – experience infertility. It’s a major health challenge globally, affecting high-, middle-, and low-income countries alike. World Infertility Awareness Month highlights the Importance of access to infertility therapies through effective parenthood solutions at recognised infertility centres.
Causes of infertility
Infertility can affect both men and women and can be attributed to many causes. Male infertility can be caused by abnormal sperm production or function, challenges with sperm delivery, exposure to certain environmental factors (such as cigarette smoking, anabolic steroid use, marijuana, alcohol, and certain medications), and damage from cancer or its treatment. Female infertility may result from ovulation disorders, uterine or cervical abnormalities, fallopian tube damage or blockage, endometriosis, early menopause, pelvic adhesions and cancer or its treatment.
Age is a key factor in the decline of fertility for both men and women. While men over the age of 40 may be less fertile than younger men, a woman’s fertility declines after the age of 35. This decline in women progresses quickly after the age of 37, due to the lower number and quality of eggs. According to Dr Jack Biko, President of the Southern African Society of Reproductive Medicine and Gynaecological Endoscopy (SASREG), infertility can stem from issues present at birth or those that develop later in life, affecting one or both partners. “Infertility is determined after 12 months or more of regular, unprotected sexual intercourse without a pregnancy. Women over the age of 35 should seek an evaluation if they have not been able to conceive after six months.”
An infertility diagnosis can lead to feelings of distress and anxiety and may negatively impact the wellbeing of a person or a relationship. But help is available.
“Early diagnosis by a fertility specialist can identify fertility challenges promptly, allowing for more effective and timely interventions,” says Dr Biko. “Fertility clinics provide medical support as well as counselling and emotional guidance to help couples navigate this difficult time with hope and resilience. Seeking treatment also ensures that you receive a personalised care plan tailored to your specific situation, which optimises your chances of a successful pregnancy.”
Consider fertility preservation
Age is one of the most common causes of infertility, with the growing trend of people starting their families at an older age. Egg or sperm freezing can help to address this issue.
“One option that is becoming increasingly popular with women is elective egg freezing,” says Dr Biko. “It’s a prudent choice for women who wish to preserve their fertility for future family planning. By freezing your eggs at a younger age, typically in your late 20s to early 30s, you may safeguard your chances of conception later in life, when natural fertility starts to decline.”
Dr Biko says this proactive approach allows families, especially women, to focus on personal, professional, or educational goals without the immediate pressure of starting a family. “Advances in cryopreservation technology have improved the success rates of using frozen eggs, making it a viable option for those planning ahead. The success of egg freezing, however, is highly dependent on the age of the woman at the time of freezing, with women under 35 having much better outcomes.”
This option can be especially empowering for women who have not yet decided to have a child, or who are delaying pregnancy to focus on career advancement. Increasing your chances of achieving a successful pregnancy later in life reduces the stress and pressure associated with the natural decline in fertility.
Egg, sperm, or embryo freezing is also used for fertility preservation for medical reasons, such as people with a condition, or facing treatment for a condition, which may lead to infertility. For example, cancer treatments such as radiation, surgery and chemotherapy may either temporarily or permanently impact your ability to produce healthy eggs or sperm, and freezing them prior to starting therapy may improve your chances of starting a family later.
Taking control of your reproductive future
For many people, knowing they have preserved their healthy sperm or eggs provides a sense of security and control over their reproductive futures.
However, there is a lack of awareness about fertility preservation options. Proper counselling tailored to the personal backgrounds of patients is essential, as is the need for accurate information to help people make informed decisions. Empowering yourself through knowledge is a key step in addressing fertility concerns. If you are struggling to conceive or if you would like to preserve your future fertility, don’t delay, have an open conversation about fertility treatment options with your doctor.
References
1. World health Organisation (WHO). 1 in 6 people globally affected by infertility: WHO. Accessed 20 May 2024. Available at:https://www.who.int/news/item/04-04-2023-1-in-6-people-globally-affected-by-infertility#:~:text=Around%2017.5%25%20of%20the%20adult,care%20for%20those%20in%20need.
- Boivin J et al. Tailored support may reduce mental and relational impact of infertility on infertile patients and partners. RBMO 2022.
- Mayo Clinic. Infertility. Accessed 20 May 2024. Available at: https:www.mayoclinic.org/diseases-conditions/infertility/symptoms-causes/syc-20354317.
- Alteri A et al. Elective egg freezing without medical indications. Acta Obstetricia et Gynecologica Scandinavica.
- Panagiota Nakou (20 Mar 2024): Women’s reproductive choice and (elective) egg freezing: is an extension of the storage limit missing a bigger issue? The New Bioethics. DOI: 10.1080/20502877.2023.2300233
