How does egg and sperm quantity, quality and ovulation impact a person’s ability to conceive? We chat to the Medical Director of Fertility SA, Dr Bruno Radesic, to find out what options are available to men and women who want to improve their chances.

Words by Laura Mappas

How is the quantity and quality of a woman’s eggs measured?

Egg quantity can be measured by a blood test and a pelvic ultrasound in the first six days of a menstrual cycle. However, egg quality cannot be measured. The only indicator of egg quality is a successful pregnancy.

What we do know is that egg quality declines with female aging. Peak fertility for women is around age 24 and egg quality starts to decline from around that time. By age 35, it has reduced to about 80 percent, before starting a steep decline. At age 40, the egg quality has reduced to around five to 10 percent.

The chance of pregnancy is therefore mainly dependent on female age, which is a surrogate measure of egg quality. For women aged 35
or less, scientists predict that for a 50 percent, 80 percent or 95 percent chance of conceiving with frozen eggs, they’ll need to freeze at least six, 14 or 30 eggs respectively. However, for women aged 39 and above, this increases to 15 eggs of a 50 percent change of pregnancy, 33 eggs for an 80 percent chance and 70 eggs for a 95 percent chance.

What about sperm count and motility? How much impact does that have on a couple’s ability to conceive?

Just like female fertility is measured by the quality and quantity of eggs, male fertility is measured by sperm quality and quantity. Semen analysis is a simple test, inexpensive and attracts a Medicare rebate. If a semen analysis result is outside the normal parameters then the male will need to see a fertility specialist.

Male sperm quality also declines with age, although at a less severe rate than female egg quality. Male sperm quality starts to decline from around age 35, with a more rapid decline by age 45. At age 45, male sperm quality would generally be about 50 percent less than before the age of 35.

Men continue to produce sperm throughout their life. By improving lifestyle choices, such as quitting smoking, maintaining a healthy weight, and minimising the consumption

of alcohol and stimulants, men can help to improve the quality of their sperm. If there is a delay in conception (more than six months) and an initial male semen test is normal, a more indepth analysis is undertaken with a Sperm DNA fragmentation test. This test is only available through fertility clinics.

Struggling to conceive? There are options…

Egg freezing

Who’s it for: Females who are not yet ready to have children or do not have a partner could opt to have their eggs frozen.

What you need to know: By age 35, egg quality begins to rapidly decline so egg freezing should be seriously considered before this time.

Ovulation induction

Who’s it for: If you have an irregular cycle you could consider an assessment and support with ovulation management.

What you need to know: Ovulation induction is generally a simple process, which usually requires oral tablets to stimulate ovulation. Thankfully, fertility medications have come long way – current medications used in fertility treatments are prefilled syringes (similar to Epi pen devices) and are very easy to administer at home. Some women may experience side effects such as bloating or breast tenderness (similar to what is sometimes experienced during monthly menstrual cycles).

Egg and sperm donors

Who’s it for: If a woman is unable to produce her own eggs, egg donation may be an option. Similarly, a sperm donor could be used if
a man does not have any sperm (Azoospermia), or sperm quality is extremely low and cannot achieve a pregnancy.

What you need to know: You can use sperm or an egg from someone you know who is willing to donate, or you can select a de-identified donor. If you choose a de-identified donor you will be able to view an in-depth questionnaire completed by the donor about themselves and their family, including physical attributes and a detailed medical history.

IVF

Who’s it for: IVF, or intro vitro fertilisation, helps people who have various forms of infertility.

What you need to know: While there are many success stories, IVF is sometimes a lengthy process, with some couples going through multiple cycles before falling pregnant. Others are unable to fall pregnant at all. Once pregnancy is achieved the average live birth rate per cycle varies.

Fertility SA
Level 9/431 King William Street, Adelaide
08 8100 2900
fertilitysa.com.au