Fertility is the ability to reproduce naturally – that is, to make a baby. For people with a female reproductive system, or the various components of:1
- The ability to produce a viable egg in the ovary
- Which is able to be fertilised by viable sperm
- Which is then able to be grown in the uterus for long enough so the foetus will survive outside the womb either with or without help
- Then once fully developed, be born either by C-section or vaginally
Infertility affects many people, the result of one or more of these stages being unable to be fulfilled adequately or at all. There are workarounds for many of these, for example, if you aren’t producing quality eggs, to use another person’s egg.
If you have blocked fallopian tubes, using in vitro fertilisation (IVF) or assisted reproduction techniques. If you are producing good eggs, but have an anatomical abnormality that prevents carrying a baby to term safely or at all, using a surrogate.
Terminology regarding the word ‘fertility’ and ‘fecundity’
Fertility measures are different depending on which field you are discussing. For example, in demographics, ‘fertility’ is not a measure of whether you can have a baby or not, but refers to the actual production of a baby.2
This means when the government talks about fertility rates, they are talking about how many babies are actually born, not whether people are capable of producing them.
The ability to produce a baby is actually known as ‘fecundity’. Fecundity is not actually measured or very measurable, but there are some factors that make conception difficult or unlikely.3,4
These include sexually transmitted infections, hormonal disorders, low-functioning ovaries, or poor nutrition/low body weight.
Healthy fertility requires a few key elements:
- The menstrual cycle is the first part of the fertility equation, with a healthy menstrual cycle producing (usually) one viable egg per (month-ish) cycle.
- This egg travels into the fallopian tube, which is the site of fertilisation by healthy sperm.
- Sexual intercourse, with semen deposited into the vagina, is the next step to conception.
- The fertilised egg travels to the uterus, where it attaches to the wall of the uterus.
- The foetus develops.
- The foetus is born and is now called a baby.
Conceiving a baby requires two things:
- A healthy reproductive tract in both men and women
- The correct timing of sexual intercourse
The main factors that impact on reproductive health are:5
- Age
- Hormonal balance
- Diet
- Smoking
- Alcohol use
- Recreational drugs
- Medications
- Sexually transmitted infections
- Polycystic ovarian syndrome (PCOS)
- Endometriosis
- Genetics
- Stress
- Exposure to chemicals, toxins and heavy metals
- Overweight
- Underweight
- 1.Rosner J, Samardzic T, Sarao M. statpearls. Published online March 20, 2024. http://www.ncbi.nlm.nih.gov/books/NBK537132/
- 2.Gurunath S, Pandian Z, Anderson RA, Bhattacharya S. Defining infertility—a systematic review of prevalence studies. Human Reproduction Update. Published online April 14, 2011:575-588. doi:10.1093/humupd/dmr015
- 3.Leridon H. Studies of fertility and fecundity: comparative approaches from demography and epidemiology. Comptes Rendus Biologies. Published online April 1, 2007:339-346. doi:10.1016/j.crvi.2007.02.013
- 4.Smarr MM, Sapra KJ, Gemmill A, et al. Is human fecundity changing? A discussion of research and data gaps precluding us from having an answer. Hum Reprod. Published online January 30, 2017. doi:10.1093/humrep/dew361
- 5.Sharma R, Biedenharn KR, Fedor JM, Agarwal A. Lifestyle factors and reproductive health: taking control of your fertility. Reprod Biol Endocrinol. Published online July 16, 2013. doi:10.1186/1477-7827-11-66
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