Is infertility on the rise? The high chances of having a baby
Infertility: a growing concern?
Human beings are among the least fertile of any species on earth. There are just a handful of days each month when a couple can achieve pregnancy. The chances of conception during any month of unprotected intercourse are just about 20% when a woman is 30 years old and decrease to 5% by the age of 40.1
And yet amazingly here we all are, giving rise to optimism!
| Infertility is defined by the “failure to achieve a successful pregnancy after 12 months or more of unprotected intercourse. Earlier evaluation and treatment may be justified based on medical history and physical findings and is warranted after 6 months for women over age 35 years”.2 |
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From the 1960s until the 1980s, the incidence of primary infertility increased in many Western countries. It’s widely believed that this was caused by an increase in the incidence of pelvic inflammatory disease in women, which causes damage to the fallopian tubes.
During the 1980s, the percentage of couples with primary infertility was relatively stable. However, the number of women reaching reproductive age increased. This meant that there were considerably more infertile couples in the late 1980s than there were at the beginning of the decade.
Since then, the birth rate in Western countries has fallen considerably. In part, this is due to couples postponing pregnancy, or deciding not to have children because of social factors. At the same time, the number of women over the age of 35 giving birth for the first time has more than doubled. This is despite the fact that fertility begins to decline in women of the same age, quite rapidly.2
What may at first seem a contradiction can be explained by:
- Women postponing pregnancy for career considerations or other factors.
- An increase in the female population aged 35 to 49.
- The trend towards smaller, later families.
- Advances in reproductive technology.
What it’s not however, is proof that women can postpone childbirth until their late 30s and expect to become pregnant with the same ease they might have experienced in their 20s.
| Infertility is a couple issue affecting both men and women. Male infertility is the primary diagnosis in approximately 25% of cases and contributes to a further 15–25% of the remaining cases.3 It is important that both partners are investigated to determine the right course of action. |
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Is there a reason to be optimistic?
Sterility is rare. In a large UK survey only 2.4% of women aged 40–55 years reported unresolved infertility with no pregnancies over their reproductive years. A further 1.9% never gave a birth despite achieving pregnancy.4 For most couples, expectations of a successful pregnancy are realised even if a little help is needed along the way.
| Fertility declines with age, as do treatment success rates.1 If you need to seek medical advice it’s important not to postpone the decision. |
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1. Age and Fertility. A Guide for Patients. ASRM 2003; http://www.asrm.org/Patients/patientbooklets/agefertility.pdf 2. Definitions of fertility and recurrent pregnancy loss. Fertil Steril 2008;90:S60. 3. Collins J.A. Evidence-based infertility: evaluation of the female partner. International Congress Series 2004;1266: 57–62. 4. Oakley L et al. Lifetime prevalence of infertility and infertility treatment in the UK: results from a population-based survey of reproduction. Hum Reprod 2008;23(2):447-450.
