The struggle to conceive can take an emotional toll on even the strongest and healthiest relationships.
Going through the disappointment, heartbreak and frustration of trying and failing to fall pregnant – often multiple times and over the course of several years – can push partners to their breaking points and the relationship to fall apart.
Around 17.5% of the adult population – roughly 1 in 6 worldwide – experience infertility according to a 2023 report from the World Health Organisation.
The new estimates show limited variation in the prevalence of infertility between regions. The rates are comparable for high, middle and low-income countries, indicating that this is a major health challenge globally.
Lifetime prevalence was 17.8% in high-income countries and 16.5% in low and middle-income countries.
“The report reveals an important truth: infertility does not discriminate,” said Dr Tedros Adhanom Ghebreyesus, Director-General at WHO.
Infertility is explained by the WHO as a disease of the male or female reproductive system, defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. It can cause significant distress, stigma and financial hardship, affecting people’s mental and psychosocial well-being.
However, this does not mean couples afflicted by infertility are doomed. With the right information and approach, couples can successfully navigate and survive infertility.
Dr. Bradley Wagemaker, Medical director at Lamelle Pharmaceuticals shares his insights on how a couple can navigate struggling to conceive.
Infertility affects a significant portion of the global population, and South Africa is no exception.
According to a study published in the South African Medical Journal, infertility is estimated to affect 15-20% of South African couples, with the burden of infertility being higher in some parts of the country.
The most common reported infertility issues in South Africa include:
Ovulatory disorders
These are among the leading causes of infertility in women. They can be due to polycystic ovary syndrome (PCOS), which is a condition that affects hormone levels and ovulation.
Tubal factors
Tubal blockage or damage, often caused by infections such as pelvic inflammatory disease (PID), which can result from sexually transmitted infections (STIs) like chlamydia and gonorrhoea, are significant causes of infertility.
Uterine factors
Conditions such as fibroids, which are common among African women, including South Africans, can lead to infertility by distorting the uterine cavity or blocking the fallopian tubes.
Endometriosis
This condition can cause infertility by affecting the function of the ovaries, fallopian tubes, and uterus.
Male factor infertility
Issues with sperm production or function are common causes of infertility. This can be due to genetic factors, health issues like diabetes, or lifestyle factors such as smoking and alcohol use.
Lifestyle factors
Obesity, excessive alcohol consumption, smoking, and high levels of stress are all associated with decreased fertility.
Age-related factors
Fertility naturally declines as women get older, particularly after the age of 35. Men also experience a decline in semen quality with age, although it usually occurs later than with women.
Unexplained infertility
In some cases, no clear cause is found even after extensive testing.
Cultural and socioeconomic factors also play a significant role in fertility issues in South Africa.
Access to healthcare, limited resources for infertility treatment, stigmatisation, and lack of information can all contribute to difficulties in managing and treating infertility.
Wagemaker continues to highlight the impact of misinformation regarding infertility, urging couples to address the issue together.
Pointing that infertility affects both men and women, with the CDC reporting that one-third of infertility cases stem from male reproductive issues, another one-third from female reproductive issues, and the remaining third from a combination of male and female factors, or other unknown causes.
"Taking the time to research and discuss accurate information around infertility together ensures both partners are on the same page, avoiding blame and resentment from coming between them," said Wagemaker.
He advises couples to prioritise healthy lifestyle choices, as maintaining a balanced diet and regular exercise can create optimal conditions for conception for both partners, while also strengthening their bond.
Additionally, managing expectations is crucial, as the journey to parenthood can bring unexpected challenges. With one in six people globally affected by infertility, acknowledging and preparing for potential setbacks is vital.
He also stresses the importance of prioritising intimacy and maintaining a strong emotional bond during infertility struggles. He suggests options such as over-the-counter supplements to support sexual wellness and emotional closeness.
Moreover, seeking professional guidance early in the conception process is recommended to identify challenges, make necessary lifestyle changes, and explore appropriate treatments.
"Infertility, whether experienced by a male, female, or both, is nothing to be ashamed of," stresses Wagemaker.
"Empower yourselves as partners with the right information, seek expert guidance, build the right support mechanisms, and stay healthy and fit. Most of all, remember that you and your partner are in this together."