Last updated on Jun 11th, 2021 at 05:33 pm

“Research shows that up to 20% of South African couples struggle with infertility,” says Urogynaecologist Dr Frances Paterson from The Urology Hospital in Pretoria. A United Nations report notes that fertility rates in South Africa for 2020 are projected at an average of 2.3 children per woman, slightly lower than the global average of about 2.5.

We know that women choose to start their families later in life as they are focusing on establishing their careers before having babies, but age is only one of the factors affecting fertility. So, what else could be causing these declining fertility rates?

While infertility is no blame game, it’s important to know that the problem doesn’t always solely lie with the female partner. There are many factors that can cause infertility in men as well. “In fact, some 30 to 50% of infertility problems are related to men, with 30% identified as being solely a male problem and the other 20% a difficulty that is specific to both partners,” says gynaecologist, obstetrician and fertility specialist, Dr Qinisile Diale from the Family Matters Fertility Centre based at Netcare Unitas Hospital in Pretoria.

ALSO SEE: New hope for infertile men

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Risk factors for infertility

According to Dr Diale the risk factors which could contribute to a couple’s infertility include:

  • Age. A woman’s fertility declines with age, especially from her mid-30s. This is due to the number and quality of her eggs declining and to health problems that may interfere with fertility. In addition, the sperm count of older men is often lower, reducing fertility and the chances of conception.
  • Being overweight. If an individual is overweight and lives a sedentary lifestyle with little exercise, this may increase the risk of infertility. In addition, a man’s sperm count may be affected if he is overweight.
  • Being underweight. Women who have eating disorders, such as anorexia or bulimia, are at risk of fertility problems, as are women who follow a very low calorie or restrictive diet.
  • Tobacco use. If either partner is a smoker, a couple’s chances of falling pregnant are reduced. Miscarriages are more frequent in couples who smoke. Smoking can increase the risk of erectile dysfunction and reduce sperm count in men.
  • Alcohol use. Drinking alcohol increases the risk of birth defects in babies, and may also make it more difficult to become pregnant. For men, heavy alcohol use can cause a decrease in sperm count and mobility.
  • Underlying health conditions such as large uterine fibroids can affect a woman’s chance of falling pregnant.
  • The side effects of some medication can affect one’s fertility. This is why it is important for both partners to mention any prescription medication they are taking, including herbal medicines, to their doctor so that alternative treatment options can be discussed.

When to be concerned

“More than 80% of the overall population can fall pregnant within a year of trying and 90% within 2 years,” says Dr Diale. Dr Jackson Ndhlovu, a gynaecologist, obstetrician and fertility specialist who practises at Netcare Pholoso Hospital in Polokwane advises couples under the age of 35 who have not conceived after a year or more of trying, to consult a medical practitioner. The same applies when the female partner is older than 35 years and the couple has been trying for more than 6 months to conceive. He recommends that women over the age of 40 should, as a general rule, consult a medical professional if they want to have a baby.

Hope for infertile couples

“Fortunately, on-going advances in diagnostic technology and in the discipline of fertility, make it possible to diagnose the cause or causes of a couple’s inability to conceive more accurately, and treatment can be targeted specifically to help address these causes and assist couples on their journey to parenthood,” concludes Dr Ndhlovu.

More about the expert:
Dr Qinisile Diale obtained her bachelor’s degree in medicine and surgery (MBChB) at the University of KwaZulu-Natal in 2006. She obtained her postgraduate diploma in Obstetrics and Gynaecology from the Colleges of Medicine South Africa in 2009. She trained to become an obstetrician and gynaecologist through the University of Pretoria, obtaining her specialist qualification in 2015. Dr Diale obtained her Certificate in Reproductive Medicine and Endocrinology through the Colleges of Medicine South Africa, as well as her Masters in Philosophy (Reproductive Medicine) from the University of Pretoria in 2019. Read more about Dr Qinisile Diale here.