More couples are now starting their families later in life, a social trend that coincides with a rise in the number of people requesting referral for treatment of subfertility. In response, the National Institute for Health and Care Excellence (NICE) has updated its fertility guidelines to enable more patients to receive timely, appropriate and successful treatment.
If you have fertility problems, it means you have difficulty in conceiving (becoming pregnant) despite having regular sex without using contraception. Before you begin to worry, remember that many couples take several months to conceive. Over eight in 10 couples conceive within a year of trying, while about nine in 10 conceive within two years.
Over the last 30 years, there has been a trend towards lower parity, older mothers, and a significant rise in the incidence of multiple pregnancies, both spontaneous and induced by assisted reproductive technologies (ART). These developments mean that women receive contradictory information on age-related effects on their ability to conceive. Primary healthcare professionals can play a key role in enabling women to make realistic and informed choices about the risks of deferring childbirth.
The levonorgestrel-releasing intrauterine system (LNG-IUS; Mirena) was first licensed in the UK for contraception in 1995. But it soon became evident that it had other clinical advantages and the LNG-IUS is now also available for the prevention of endometrial hyperplasia in women who are taking oestrogen as part of hormone replacement therapy (HRT).
In the UK about half of women of reproductive age are either overweight or obese. Obesity is known to adversely affect female fertility, as well as the health of mothers and their children. But even modest weight loss can restore fertility and improve a woman’s chances of a successful pregnancy.