Learn about fertility

Following the decision to have a baby, couples often expect to fall pregnant immediately. However, this is often not the reality. Understanding the basics about fertility and conception can help you get your head around the highly complex sequence of events that must occur for a new life to begin – and how you can help in this process.

Learn about fertility

Reproduction overview

As the old adage goes, ‘it takes two to tango’. In other words, conceiving a baby requires both the male and female reproductive systems to be functioning properly.

Following sexual intercourse, the egg (from the female) must combine with the sperm (from the male) in an event called fertilisation. The newly formed embryo (fertilised egg) must then embed itself in the wall of the uterus (i.e. womb), where it will grow and develop for a period of approximately 38 weeks. After this time, the baby is fully developed and ready to be born.

  • Female reproductive system

    The ovaries are two almond-shaped organs on either side of your uterus. During a woman’s fertile years, an egg is usually released from one of your ovaries each month in a process called ovulation.

    Ovulation typically occurs every 28 days. However, the length of this cycle varies from woman to woman and normally sits somewhere between 21 to 35 days. While many women experience regular cycles, some women ovulate less frequently.

    Once released from the ovary, the egg travels via the fallopian tubes to the uterus (womb). If unprotected sexual intercourse has recently occurred, the egg may meet a sperm along the way, in which case, fertilisation may occur. If fertilisation has occurred, the fertilised egg (now called an embryo) continues its way to the uterus where it will embed and develop for the duration of the pregnancy (the lining of the uterus has thickened in preparation for this).

    In the event that fertilisation does not occur, the woman sheds the thickened lining of the uterus by menstruating, i.e. she has her period.

    Unlike men who continually produce sperm throughout their life, women have a limited reserve of eggs. Each female is generally born with between one and two million eggs. This reserve falls to around 25% by the time of puberty.

    Declining fertility begins around the age of 32 and accelerates again at the age of 37. Eventually, a woman will reach menopause, signifying the end of ovulation and her fertile years. In Australia, this occurs around the age of 50.

    The ovulation and menstruation processes are driven by hormones. Thus, disruptions in hormonal function can impair fertility. Similarly, successful fertilisation and implantation depend on a clear, open passage between the ovaries and uterus in order for an egg (or embryo) to travel to the womb – this means that any structural abnormalities in the female reproductive tract (e.g. endometrial growths) can block this process.

  • Male reproductive system

    Sperm production begins in puberty. Sperm are produced in the testicles and travel via a series of passages to a structure called the epididymis. Here, the sperm mature until ejaculation, where they will pass through another series of passages to exit via the urethra (opening in the penis). During ejaculation, the sperm combines with fluid produced from a few male reproductive glands to form a fluid called semen.

    Each sperm consists of a head, mid-piece and tail. This structure helps the sperm to propel itself through the female reproductive tract in order to meet the female’s egg and enable fertilisation to occur. This can be a treacherous journey – of the millions of sperm in the ejaculated semen, only a very small proportion will reach the egg and only one sperm will actually fertilise the egg.

    This means successful fertilisation relies on a man having adequate numbers of sperm in his semen, as well as the sperm having normal shape and motility (movement). In the absence of these characteristics, infertility can result. Moreover, while men continue to produce sperm throughout the entirety of their life, the quality of their sperm diminishes with age.

    Similar to females, the production of sperm is also driven by hormones. Therefore, disruption in hormonal function can impair a male’s fertility. Furthermore, anything that prevents the passage of sperm from the testicles into the female reproductive tract can also prevent successful fertilisation and conception.

Learn about fertility

Optimising your fertility and preparing for pregnancy

Unprotected vaginal intercourse every two to three days gives you the best chance of falling pregnant.

Knowing when you are ovulating can help you understand when you’re most fertile and allow you to time sexual intercourse accordingly. You can use our ovulation calculator to help keep track of your cycle.

When planning to conceive, there are a number of lifestyle changes you can also make to help boost your fertility and ensure you’re well-prepared for a healthy pregnancy.

Learn about fertility

Infertility

Infertility is the inability to conceive following twelve months of frequent, unprotected sexual intercourse. If you find yourself in this category, you’re not alone – approximately one in six couples experience infertility.

Causes of infertility

A couple’s fertility rate is influenced by several factors, including age, lifestyle factors and underlying medical conditions. These factors may affect both males and females, which is why a thorough fertility assessment is performed on each partner.

Common factors that may contribute to infertility include:

Female factors
  • Increasing age
  • Extremely high or low weight (body mass index)
  • Structural disorders: endometriosis, fibroids, polyps, pelvic inflammatory disease
  • Hormonal disorders: polycystic ovarian syndrome (PCOS)
  • Chemotherapy
  • Thyroid disorders
Male factors
  • Increasing age
  • Abnormal sperm production
  • Testicular disorders
  • Disorders in sperm transportation
  • Chemotherapy
  • Hormonal disorders.
Learn about fertility

When should I seek help?

Women under 35 are advised to seek help after 12 months of trying. As fertility declines with age, women over 35 are advised to seek help earlier, after 6 months of trying. However, if you’re concerned about your fertility at any point or you have an existing health condition that may affect your fertility, we recommend seeking a specialist opinion as soon as possible.

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