Unexplained infertility
Many couples never find out why they can't conceive, as no cause is found for their problems despite extensive tests. In some cases, it is thought that this could be down to age, despite apparently normal test results, but in most eases it is just a matter of doctors not being able to get to the root of the problem. Sixty per cent of those with unexplained infertility will conceive naturally within three years, but that still leaves many others with no idea why they can't have children.
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| Unexplained Secondary Infertility |
Unexplained infertility can be a difficult diagnosis to live with, and some women find it hard not to blame themselves, wondering whether it is something they have done in the past which has caused the problem, or even something they are still doing unawares. Not knowing what you are up against can make the whole experience particularly difficult.
'I have unexplained infertility, which is not reassuring at all. All it means is that they haven't found anything with the tests they have these days. I think unexplained infertility is a bit of a cop out. You think, is it me? Is it my problem I'm not conceiving because I'm stressing out so much? Is it the food l'm eating? Is it because I'rn 37?' Lana, 37
Secondary infertility
Women who have already been pregnant don't expect to have problems conceiving again, but in fact as many as a third of the patients at fertility clinics will have had a child, or a pregnancy, in the past. This is known as secondary infertility.
Some conditions which affect fertility can develop after a first pregnancy, such as endometriosis, hormone imbalances or sperm problems. An untreated infection after a previous delivery can leave scar tissue, or block the fallopian tubes. Women who have had a caesarean section, especially during the later stages of labor, are at slightly greater risk. Sometimes secondary infertility is simply down to age. If a couple have relatively minor fertility problems and start trying for a first child when they are fairly young, they may still manage to conceive, but if the minor problems are combined with age, it can make all the difference. In some cases, secondary infertility will remain unexplained.
It is important not to assume you cannot possibly have a fertility problem just because you've already conceived before. If you've been trying unsuccessfully for another baby for more than a year, it is worth having some basic tests carried out.
Possible causes from your male partner
Most male fertility problems involve sperm. There may be a low sperm count (not enough sperm in the semen), there may be problems with sperm motility (the sperm aren't moving properly) or with sperm morphology (the sperm may be abnormal). Having a varicocele in the testicles, which is a bit like a varicose vein, can damage sperm, as it affects the blood flow. Some sperm problems are hormonal and some may be genetic, whereas others are caused by infection, but quite often there is no obvious cause for the problem.
Sometimes there is agglutination in the semen sample, which means the sperm are stuck together in clumps and can't fertilize an egg. This is often caused by anti-sperm antibodies in the blood, which may be the result of injury or surgery.
In some cases, there are simply no sperm in the semen sample at all. This is usually due to some kind of blockage, but can also happen when a man doesn't have a tube linking his testicles to his penis (the vas deferens), when the muscles that pump the sperm out aren't working properly or because no sperm are produced in the testicles.
It is important to remember that smoking, excess alcohol and recreational drugs can all affect sperm production, and male fertility problems can be caused by these lifestyle factors.
'My partner has poor sperm morphology. There were a very tiny percentage of normal sperm, and all the rest were not normal. I think sometimes he felt slightly guilty about it. I would have much preferred it if it had been me. That would have made it a lot easier. But it wasn't. It's nobody's fault, it's just one of those things that happen.' Anna, 33. To find out more, you can check out Unexplained Secondary Infertility.
