Starting a Family: What is infertility?

Infertility affects one in six couples in Ireland, and the psychological distress that accompanies it has been likened to bereavement

It is estimated that one in six couples in Ireland is affected by infertility. The World Health Organisation (WHO) defines infertility as “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse” in couples who have no obvious problems. It may be diagnosed sooner in couples with an obvious known problem.

The organisation also states that infertility “generates disability”, and therefore “access to healthcare falls under the Convention on the Rights of Persons with Disability”.

The WHO’s 2011 World Report on Disability ranked infertility in women as the fifth most serious global disability among populations under the age of 60.

Where women under the age of 40 stop having periods; is also a cause of infertility and in this case the only option is IVF using donor eggs.

Infertility can be broadly separated into: primary infertility – when a woman has never been pregnant; and secondary infertility – when a woman has previously borne a child or has had a miscarriage or pregnancy loss but cannot now conceive.

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According to the 2005 Commission on Assisted Human Reproduction, infertility can cause considerable social, emotional and psychological distress . . . For those who want to have children, infertility can be an extremely traumatic experience, characterised by feelings of guilt, low self-esteem, depression, and sometimes consequent relationship difficulties and sexual dysfunction. These psychological effects have been compared to those following bereavement.”

Dr Mary Wingfield, clinical director of Merrion Fertility Clinic and consultant obstetrician gynaecologist at the National Maternity Hospital in Holles Street, Dublin, says for couples with no obvious problems (ie women with regular periods etc) it is generally recommended that they try to conceive naturally for about a year. However, if the woman is 37 or older, then couples should think about consulting with their GP if they are unsuccessful after six months.