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Factors Behind Infertility; Optimum Ages for Becoming Pregnant

by Dr Marcos Ferrando(more info)

listed in fertility, originally published in issue 230 - May 2016


The subject of fertility has remained high on the news agenda in recent years and is understandably a topic many people will think about when first deciding to start a family.

While every couple hopes the process of conceiving will be simple for them, unfortunately this is not always the case. More and more people are seeking additional help from fertility experts, with the UK’s NHS recently suggesting this figure to be around one in seven couples, approximately 3.5million people in the UK.

The IVI Group is a European leader in assisted reproduction, and to date has helped over 100,000 children to be born all across the globe. With 40 clinics, in 10 different countries IVI are pioneers within the fertility industry and are at the forefront of medical development and advancement within the field. Many people choose to seek assisted reproductive treatment at IVI due to their high pregnancy success rate, with 9 out of 10 patients who visit an IVI clinic becoming parents. Fertility specialist Dr Marcos Ferrando from IVI Fertility has shared his expert insight into some of the key reasons why couples may struggle to conceive, what warning signs to look out for, and how to seek appropriate assisted reproductive treatment if necessary.

Ferrando 230 Factors Behind Infertility

Infertility - Common Causes

Dr Ferrando says: “The most common cause of female infertility we see at the IVI clinics is to do with the age of the patient. In today’s society it is common for women to want to delay starting a family until their thirties or forties, however this is when their ovarian reserve and quality of eggs has gone into decline. When females reach the age of thirteen they have roughly 300,000 oocytes, and from this age they start to lose around 1,000 oocytes each month. After twenty-eight years of age the annual loss of oocytes becomes greater, and then when a woman reaches her forties the rate increases yet again.

“Other common causes of infertility in women are because of gynaecological problems such as endometriosis and Polycystic Ovarian Syndrome.

“In men, infertility is often caused by the quality of the semen and the number of strong sperm in each sample. The quality of the sperm is linked to genetics but also some lifestyle factors may play a role too, for example it is important to keep the testicles cooler than the rest of your body, around 34.5 degrees, so tight underwear should be avoided, and a regular break from sitting down for long periods of time is recommended.”

Is Infertility More Prevalent in Men or Women

Dr Ferrando says: “Infertility is equally prevalent in men and women, and there are many fertility treatments for both sexes to help them become pregnant. Based on the cases we see at IVI, infertility is split evenly between the sexes - one third of infertility cases are women, one third men, and one third is a mixture of the couple both experiencing problems with their fertility.”

What Are The Signs of Infertility?

Dr Ferrando Says: “In many cases there are no obvious symptoms which would suggest that a couple could be infertile, and men in particular will not experience any symptoms regarding the quality of their sperm. However, if a couple have been trying for their first baby for one year with no success, we suggest they seek expert help as this length of time usually indicates that there is a problem.

“There are also some medical conditions in women such as endometriosis which can be associated with infertility, and these do have symptoms which you can look out for. For example women with endometriosis will experience a lot of pain during menstruation. The condition PCOS is associated with irregular periods. If women experience any of these signs they should speak to their doctor.”

What to Do If You Suspect a Problem

Dr Ferrando says “For couples trying to conceive their first baby I recommend they try for a year before they seek help from a fertility specialist. Women are most receptive to conceiving roughly between day 12 and 16 of their menstrual cycle, which is a small window month on month and therefore a year is a very common length of time for couples to try for a baby. If a couple are trying for their second baby after natural conception the first time, then I usually recommend waiting two years before seeking specialist help as we know that it is possible for them to conceive naturally.”

Do Lifestyle Choices Have An Impact?

Dr Ferrando Says “Whether or not eating certain foods can help to boost fertility has been a widely debated topic within the industry for some time now. Unfortunately, there is no scientific link between food or drink and fertility, but undoubtedly leading an overall balanced lifestyle and maintaining a healthy weight is very important.

“There are a few factors however that have been proven by credible studies to impact on fertility. The main lifestyle factor is smoking, which has been linked to conception rates, and also the health of unborn babies. I recommend to my patients who are smokers that they should either cut down on the amount they smoke or quit altogether when trying to conceive.

Caffeine and alcohol can also affect fertility, when consumed at a high level. However, if you use these substances in moderation it shouldn’t have an impact on your fertility success.”

What Are The First Steps Towards Treatment?

Dr Ferrando says “If you have been trying to conceive for a year or two, or you have any pre-existing conditions like PCOS or endometriosis, then I would recommend visiting a fertility specialist for help.

“In the first instance, at IVI Clinics we run a series of tests to find out why the couple are struggling to conceive and to help us decide the best course of treatment for each patient.  

The first thing we do is ask the female patient whether she is menstruating regularly every month. Once we know this we then check how the semen is performing. We do this by taking a sample of semen from the male patient and analyse it under a microscope to check the quantity, movement and morphology of the sperm, and in some cases we perform tests to see how many chromosomes are in the semen. 

“Next, we check the female patient’s ovarian reserve through a blood analysis on the third day of menstruation, and as the second stage we would then carry out an ultrasound. During the ultrasound we will count the number of follicles to check whether the patient has a good level of oocytes.

“Finally, we perform an exam to test whether the fallopian tube is open or closed, as this can indicate why the patient is struggling to conceive.

“After we have completed these tests and received the results we would then review the treatment options - for example IVF, ICSI, egg donation or sperm donation - and discuss with the couple to decide the best course of action.”

Optimum Ages for Becoming Pregnant

For years we have been exposed to a plethora of weird and wonderful tips to help us fall pregnant, based on the female fertility clock. However, on many occasions these pearls of wisdom fail to fulfil their promises, often leaving couples frustrated and confused as to why they are unable to conceive. Most fertility experts would say that there’s no ‘right time’ to start a family - but there are plenty of pros and cons to trying for a baby at different ages. Dr Ferrando of IVI Fertility Clinic discusses the various strengths and challenges of falling pregnant which couples within each age group should consider:

In Your 20s

Dr Ferrando says: “Your 20s are your most fertile years, because your periods are regular and, almost always, ovulatory. Not only is there a high chance of falling pregnant, but pregnancy is often physically easier for women in their 20s because there's a lower risk of health complications such as high blood pressure and diabetes. Generally speaking, at this age you are also at your optimal fitness level, making the delivery of a baby and post-delivery weight loss a lot more manageable.

“From a medical perspective, your 20s are definitely the best decade for conceiving and carrying a baby however, this doesn’t mean to say that 20s is the best time for everyone to fall pregnant - as there are other lifestyle factors that need to be taken into consideration. For example, are you and your partner both emotionally ready for a baby? Are you prepared to pause your career for a pregnancy? Are you financially stable enough to start a family? A lot of people in their 20s are still carving their path in life, so it’s important to consider whether that is the right time for you to embark on parenthood.”

In Your 30s

Dr Ferrando says: “As you grow older and move into your 30s, your ovaries age along with the rest of your body and the quality of your eggs gradually starts to deteriorate. Although there is no ‘magic number’ at which female fertility starts to decline, many experts predict that this process begins once you hit 30. As this is a gradual process, your chances of falling pregnant in your early 30s are only slightly lower than in your late 20s, but once you reach 35 your chance will start to decrease fairly rapidly.

“For those who require assisted fertility treatment, the chances of falling pregnant are also higher in your early 30s. At IVI Fertility we have found that treatments, such as artificial insemination and IVF, are more successful in women aged between 30 and 35 compared to those over the age of 35.

“Body clock aside, there are actually several lifestyle advantages to becoming a mum in your 30s compared to your 20s. The most obvious is that you're more likely to be secure in your career and in your relationship, which will provide a firm foundation for your new family. On top of that, new mums in their 30s tend to have a lot of stamina and resilience due to their life experience, both qualities that come in handy for parenting young children.

“For those who do decide to postpone motherhood for social reasons, or other circumstances which thwart having a child, egg-vitrification - more commonly known as ‘egg-freezing’ - is fast becoming a popular option. At IVI, we suggest the best age to freeze your eggs is in your 30s as the younger the eggs are, the higher the pregnancy success rates.”

In Your 40s

Dr Ferrando says: “Because of the new generation of career-driven women, more and more couples are making the decision to try for a baby in their 40s. Although some women are lucky enough to conceive naturally at this age, there is no denying that the chances of falling pregnant are a lot lower – especially after you reach your mid-forties. 

“But it’s not all doom and gloom for 40-plus women. In fact, there's never been a better time for this age range to try to conceive given the range of fertility options that are available - such as egg donation which is one of the most frequently offered treatments for women of this age group at the IVI clinics. Donated eggs, always taken from a younger female, can offer a much greater chance of a woman conceiving in their 40s when accompanied by IVF (In Vitro Fertilization), where an egg is removed from the woman's ovaries and fertilised with sperm in a laboratory.

“However, similarly to falling pregnant naturally, the chances of falling pregnant through IVF decreases the older you get, which is why we are finding increasing numbers of 40+ women opting for egg donation treatment; in order to give themselves the best possible chance of conceiving. 

“Whatever your age, the best measures you can take to try to protect your fertility and prolong your chances of conceiving is maintaining a healthy weight, leading a non-stressful lifestyle, drinking sensibly and avoiding smoking.”

Further Information

For further information about IVI Clinic or to speak to one of the expert team from IVI please contact Sarah Sharp, Rebecca Younghusband or Amy Humphreys in the UK press office:  Tel: 020 7025 1363;


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About Dr Marcos Ferrando

Dr Marcos Ferrando Speciality: Reproductive Medicine is the Medical Director of IVI Bilbao. He may be contacted via   IVI Clinic Sevilla    IVI Clinic Bilbao    IVI Clinic Saint Sebastian     IVI Clinic Santander .

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