Infertility

Written by: 
Suzi Lewis-Barned, medical writer

For people affected by infertility, a practical guide.

This page covers:

Infertility is usually defined as a condition in which a couple is unable to conceive despite having unprotected sex for more than a year. It is estimated that around one in seven couples have difficulty conceiving.

For women, factors include:

  • Age (female fertility decreases with age)
  • Reproductive health problems (for example, damage to the Fallopian tubes, problems with ovulation)
  • Effects of untreated sexually transmitted infections (for instance, Chlamydia, which can cause pelvicRelating to the pelvis. inflammatory disease and so impair fertility).

For around one in three infertile women, however, there is no clear cause.

For men, factors include:

  • Health problems affecting the reproductive organs (including a low sperm count, erectile dysfunction - that is, failure to get or sustain an erectionThe enlarged, rigid state of the penis during sexual arousal. - or testicular cancerAbnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body.).

In addition, both men and women may be affected by:

  • Lifestyle factors (such as stressRelating to injury or concern., smoking or weight issues)
  • Medical conditions (including diabetes)
  • Effects of previous treatments (such as radiotherapy or surgery for cancerAbnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body.).

How you might be feeling

It can feel devastating to face the possibility of not being able to have a child of your own, but it is important to give yourself time to think through your options and not to feel that you have somehow 'failed'.

Initially, some people may experience denial - they are certain that it's just a matter of time before they will have a baby. It is also common to feel:

  • Embarrassed or even ashamed by other people's insensitive questions
  • Angry, resentful and jealous of others around you who seem to become pregnant so easily
  • A sense of bereavement for the children you imagined you would have
  • As if you are out of control
  • Obsessed with wanting to become pregnant. This can put pressure on your relationships with others, especially your partner. Fertility treatments may also have put you under financial stressRelating to injury or concern.
  • Fearful that your partner won't love you as much
  • Socially isolated.

Your feelings about fertility may be similar to depression. If you are constantly feeling low or stressed, or your sleep or appetite is adversely affected, it is important to talk to your doctor as soon as possible.

Coping with your feelings

  • Acknowledge the way you are feeling: being angry, sad or frustrated is normal
  • Seek help from someone you can trust: counselling gives you the chance to explore the way you feel. Trained counsellors will support you and help you to decide what you want to do next
  • Exercise and relax: taking regular exercise and practising relaxation techniques (possibly attending classes) may help you feel better. Trying to have a baby may have dominated your thoughts for a long time, but it's important to look outwards, to focus on your family, friends and other aspects of your life as well
  • Share your feelings: don't shut out your partner and others around you. Explaining how you feel will help you find the support you need to move forward. There are also online support groups and forums where you can share your experiences with people who are going through the same thing
  • Try to enjoy your sex life: you may have been so focused on becoming pregnant that you have forgotten about spontaneity and enjoying sex
  • Be well informed: not only about why you are infertile but also about the other options explained below, such as adoption or fostering.

Alternatives to having your own children

Some people come to terms with not being able to have children and manage to move on and find fulfilment in many other areas of their lives.

However, if you don't feel able to do this, being infertile certainly doesn't mean that you should lose hope of becoming a parent.

If attempts at in vitro fertilisationFertilisation of the female reproductive cell (ovum) outside the body, before implantation into the uterus (womb). Abbreviated to IVF. (IVFIn vitro fertilisation. Fertilisation of the female reproductive cell (ovum) outside the body, before implantation into the uterus (womb).) or other fertility treatments have failed, there may still be methods that will enable you to have your own baby. These include egg-sharing and receiving eggs from a donor. Your doctor will be able to tell you more about these options. You can also look into the options explained below, surrogacy, adoption and fostering

Surrogacy

Surrogacy involves one woman - the surrogate mother - carrying a baby for another woman, the intended parent. The surrogate gives up the baby immediately after birth. Surrogacy can be arranged privately or through agencies. In some countries, payment is made to the surrogate mother, in others the law permits only expenses to be paid.

The surrogate mother may become pregnant in the following ways:

  • Partial surrogacy - also known as traditional or straight surrogacy - is where the surrogate mother's egg is fertilised with sperm from the intended father
  • Full surrogacy - also known as hostAn animal or plant that supports a parasite. or IVFIn vitro fertilisation. Fertilisation of the female reproductive cell (ovum) outside the body, before implantation into the uterus (womb). surrogacy - is where embryos are created by IVFIn vitro fertilisation. Fertilisation of the female reproductive cell (ovum) outside the body, before implantation into the uterus (womb). using the intended parents' eggs and sperm. These are placed into the surrogate mother's uterus The womb, where embryo implantation occurs and the growing foetus is nourished.(usually more than one embryo is inserted, as it is unlikely that all will survive). If the intended father is infertile, donor sperm can be used.

Laws on surrogacy vary between countries. In some it is illegal for the baby not to be related to one of the intended parents, and DNAThe building blocks of the genes in almost all living organisms - spelt out in full as deoxyribonucleic acid. tests may be used to check that this is the case. In others, it is possible and legal to use both donor sperm and donor egg. It is important to clarify the legal situation in your own country before proceeding. It is also important to check that you will be the legal parent(s) of the child.

Tip: Emotionally, the process of surrogacy can be exhausting. It can be helpful to have counselling before, during and afterwards to help you explore and come to terms with your feelings. There are also support groups where you can share your experiences

Adoption

Adoption laws differ from country to country, but usually offer a legal and binding agreement where all parental responsibilities are transferred to the adopter.

  • Usually the child - which can be any age - becomes part of the new family and takes the family name
  • In many countries, adoption is not restricted to married couples - anyone can apply to adopt
  • Adoption is usually done through an agency, which assesses parents to find if they are suited to adopting
  • Laws vary, but in some countries, including the UK, for example, children have the right to see their original birth certificate when they are 18.

Fostering

Fostering arrangements vary between countries, but foster parents typically work with the child's parents and the relevant government body to share responsibility for the child's upbringing.

  • Carers are often paid by the government body
  • Regular contact frequently continues between the child - who can be any age - and his or her natural parents
  • Fostering can be short or long term. It does not usually provide the same legal security for the child or foster family as adoption.