Fertility overview


A range of factors can affect a person's fertility. Fertility problems may be the result of either the woman or the man, or both, being unable to conceive.

Factors that affect fertility

Some of the common factors that affect fertility in both men and women include:

  • age - fertility naturally declines with age
  • weight - being significantly underweight or overweight
  • smoking - active and passive smoking can harm reproductive health
  • other health issues - endometriosis, fibroids, pelvic disease, certain hormone conditions or cancer.

For more information about how cancer affects fertility, see Key questions.

What is infertility?

Infertility is defined as difficulty conceiving (getting pregnant). For women under 35 years of age, the term usually refers to trying to conceive for 12 months; if a woman is 35 or over, the term is used after 6 months of trying.

Infertility is more common than many people realise - it affects one in six Australian couples. 1 Many couples find it hard to come to terms with infertility. For more information about how infertility can affect emotional health and relationships.

How reproduction works

The female and male reproductive systems work together to make a baby. The process involves two kinds of sex cells called gametes: the female gamete - the egg or ovum - and the male gamete - the sperm.

Ovulation

To have a baby, an egg needs to be fertilised by a sperm. Each month, from puberty to menopause, one of the ovaries releases an egg. This is called ovulation.

Ovulation and sperm production are controlled by hormones, which are chemical messengers that help the body work properly. In females, the pituitary gland in the brain releases hormones that stimulate the ovaries to make the hormones oestrogen and progesterone, and to release eggs. In males, the pituitary gland also stimulates the testicles to make the hormone testosterone and sperm.

Pregnancy

The egg travels from the ovary, down the fallopian tube. Here it can be fertilised by a sperm, which is ejaculated from the penis during sexual climax (orgasm). After the egg is fertilised by the sperm, it's called an embryo. The embryo then becomes implanted in the lining of the uterus (endometrium). If the egg is not fertilised, women have a period (menstruation).

Menopause

Women usually menstruate until the age of 45-55, when monthly periods stop. This is called menopause and it happens because over time the number of eggs in the ovaries declines, and the ovaries stop producing hormones. This is the natural end of a woman's reproductive years. If menopause occurs before age 40, this may be called early or premature menopause.

The female reproductive system

The female reproductive system allows a woman to conceive a baby and become pregnant. It includes the following organs:

  • ovaries - two small, oval-shaped organs in the lower abdomen. They contain follicles that hold immature eggs (oocytes), which eventually become mature eggs (ova). The ovaries also make the female hormones oestrogen and progesterone
  • fallopian tubes - two long, thin tubes that extend from the uterus and open near the ovaries. These tubes carry sperm to the eggs, and the eggs from the ovaries to the uterus
  • uterus (womb) - the hollow organ where a baby (fetus) grows. The inner lining of the uterus is known as the endometrium. The uterus is joined to the vagina by the cervix
  • cervix (neck of the uterus) - the lower, cylinder-shaped entrance to the uterus. It produces moisture to lubricate the vagina. It also holds a fetus in the uterus during pregnancy and widens during childbirth
  • vagina (birth canal) - a muscular tube that extends from the opening of the uterus (the cervix) to the vulva. This is the passageway through which menstrual blood flows, sexual intercourse occurs and a baby is born
  • vulva - the external part of a woman's sex organs.

Female reproductive system

The male reproductive system

The male reproductive system allows a man to father a baby. It includes the following organs:

  • testicles - also called testes, two small, egg-shaped glands that make and store sperm, and produce the male hormone testosterone. This is responsible for the development of male characteristics, sexual drive (libido) and the ability to have an erection
  • scrotum - the loose pouch of skin at the base of the penis that holds the testicles
  • epididymis - coiled tubes attached to the outer surface of the testicles. The immature sperm travel from each testicle to the epididymis, where they mature
  • spermatic cord and vas deferens - the tubes running from each testicle to the penis. They contain blood vessels, nerves and lymph vessels, and carry sperm towards the penis
  • penis - the main external sex organ, through which urine and semen pass
  • prostate - a gland that produces the fluid that makes up a large part of semen. It is located near the nerves, blood vessels and muscles that control bladder function and erections
  • seminal vesicles - glands that lie close to the prostate and produce secretions that form part of the semen.

Male reproductive system

Expert content reviewers:

Dr Yasmin Jayasinghe, Paediatric Gynaecologist, Royal Children's Hospital Melbourne, Co-chair Fertility Preservation Taskforce, Melbourne, and Senior Lecturer, Department of Obstetrics and Gynaecology, University of Melbourne, VIC; Dr Peter Downie, Head, Paediatric Haematology-Oncology and Director, Children's Cancer Centre, Monash Children's Hospital, and Director, Victorian Paediatric Integrated Cancer Service, VIC; Carmen Heathcote, 13 11 20 Consultant, Cancer Council Queensland; Aaron Lewis, Consumer; Pampa Ray, Consumer; Dr Sally Reid, Gynaecologist, Fertility SA and Advanced Gynaecological Surgery Centre, Visiting Consultant, Women's and Children's Hospital, and Clinical Senior Lecturer, School of Paediatrics and Reproductive Health, The University of Adelaide, SA; A/Prof Kate Stern, Head, Fertility Preservation Service, The Royal Women's Hospital and Melbourne IVF and Head, Endocrine/Metabolic Clinic, Royal Women's Hospital, and Co-chair, AYA cancer fertility preservation guidance working group, VIC.

1. A Clark, National Fertility Study 2006: Australians’ experience and knowledge of fertility issues. Available from: fertilitysociety.com.au/wp-content/uploads/preservation-of-fertility-presentation-2006.ppt#1..

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