Infertility is defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. It is a common condition affecting about 1 in 6 couples trying to conceive.

The major causes of infertility include:

Male factors

• Sperm problems: low count, motility, vitality and/or morphology
• No sperm present in semen: usually due to obstructions or failure of the testicles
• Sexual dysfunctions: problems with erection or ejaculation

Female factors

• Ovulation problems: polycystic ovary syndrome, ovarian failure, other endocrine problems
• Tubal obstruction due to previous surgery, infection or endometriosis. Sometimes fluid may accumulate in the blocked fallopian tube (‘hydrosalpinx’), which would impact natural fertility and also IVF success.
• Endometriosis
• Sexual dysfunctions: difficulty in vaginal intercourse

Unexplained infertility

• No cause can be identified after investigations.

In some couples, more than one factor may be identified.

However, couples with the following conditions should also seek care from a fertility specialist early:

• Women aged 35 or above, with no conception after six months of regular intercourse
• Women with irregular menstrual periods, previous pelvic surgery, pelvic infection, ectopic pregnancy or other known gynaecological problems
• Men with previous chemotherapy, radiotherapy or previous genital trauma, surgery or infection
• Couple having difficulty in sexual intercourse