Infertility Explained

When trying to conceive it helps to understand how the male and female reproductive system works.

Every month a female ovulates one mature egg from her ovaries. The egg leaves the ovarian follicle and travels down to the end of the Fallopian tube. It then begins to move slowly down the Fallopian Tube to the Uterus (womb). For a pregnancy to occur the egg must be fertilised by male sperm while still in the Fallopian Tube.

Fertilisation can occur during the ‘fertile window’, which is five days before ovulation and the day of ovulation. By approximately 12 – 24 hours after ovulation, fertilisation can no longer take place during that particular menstrual cycle, as the egg is no longer in the Fallopian Tube.

Only about 1 in 14 million sperm will reach the Fallopian Tube during/after intercourse. For the sperm to fertilise the egg it needs to break through the egg’s shell (zona pellucida). Many sperm however only manage to bind to the shell. Over a period of about 16 hours, the sperm -and egg’s genetic material (male- and female pronuclei) move towards the centre of the egg. The egg can now be called a fertilised embryo (day 1 after ovulation).

Embryo development then starts to take place through cell division. This continues over the next two days until the embryo reaches 8 cells. Around day 4 – 6 of cell division, the blastocyst stage occurs (the embryo fills with fluid creating a cavity, outer cells start forming a wall and inner cells start forming a ball).

At the blastocyst stage the embryo enters the womb. Over the next few days it will hatch out of its shell and bury into the womb. It will grow and develop blood vessel connections with the mother. This stage is called implantation. By the stage of implantation, the embryo sends out chemicals into the mother’s blood stream, which will be picked up by a pregnancy test about two weeks after fertilisation. The embryo then continues to grow and develop different cells and structures to become a baby.

Infertility  Definition

Infertility can be defined as the inability to become pregnant. This does not mean that the couple is unable to have children, but assistance might be needed in the process.  The term ‘infertility’ is used in the following cases:

  • Where couples have not conceived after twelve months of attempting to conceive.
  • The female partner is over the age of 35 and the couple has not  been able to conceive within six months of attempting.

Aevitas Fertility Clinic, based in Cape Town, is a well-known leading expert in South Africa, within the field of human infertility. Through the information provided on this page, we hope we can assist you to better understand the causes, as well as treatment used at Aevitas Fertility Clinic.

Infertility Evaluation

At Aevitas Fertility Clinic, equal emphasis is placed on evaluating male- and female fertility. The reason being, approximately one-third of infertility is attributed to the female partner, one-third attributed to the male partner and one-third is caused by a combination of problems in both partners or, is unexplained. The Aevitas Fertility Clinic team values the diagnostic process, in order to determine the causes and contributing factors leading to infertility.

*Our Aevitas team likes to involve both partners in this fascinating journey through reproductive biology.

— General Guidelines of fertility evaluation

Aevitas physicians value the evaluation of lifestyle factors, which could play a role in infertility. Lifestyles factors like smoking and the use of alcohol have been shown to have a negative effect on the outcome of fertility treatment. Being overweight, and therefore having a higher body mass index, does have a negative effect on the success of fertility treatment. This fact applies to both men and women. All medicine, vitamin intake, or drug use, even the use of so called “natural supplements”, should be discussed with your fertility specialist.

— Female Partner fertility evaluation

Your Aevitas fertility specialist will take a thorough history and perform a gynaecological examination. An ultrasound examination is always part of the first visit and will usually be done at follow-up visits to determine response to treatment. The timing of further tests, for example laparoscopy, will also be discussed, if deemed necessary.

— Male Partner fertility evaluation

A basic semen analysis is the cornerstone of evaluation of the male partner. The semen analysis results will be discussed in detail with the patients. Lifestyle evaluation is also of great importance in men. Smoking, alcohol use and certain drugs can affect the semen quality and be a cause of sub-fertility. Of importance is the avoidance of any medication containing androgen or testosterone. These drugs will always suppress sperm production. At times blood hormone levels on the male partner may be indicated.