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What causes infertility?

According to a study published in the Japanese Medical Association Journal, underlying factors of infertility are psychological factors related to the current stress of modern-day society, an increasing numbers of patients with polycystic ovary syndrome, endometriosis, or uterine myoma, weight abnormalities, such as obesity and underweight, and an age related decrease in reproductive function. Eighty to 90% of these factors contributing to infertility are derived from personal lifestyle and are considered to be preventable.

In Australia, 1 in 6 couples are infertile, 1 in 3 women are over the age of 35 years. 40% are female, 40% are male, 10% are combined, and 10% are unexplained. The WHO (World Health Organisation) has changed their reference ranges when it comes to sperm evaluations as you can see in the table below. Is this because sperm quality is decreasing and these are the ranges now considered to be normal? Could this have to do with our lifestyle?

Table 1. Cut-off Values for Semen Parameters as Published in Consecutive WHO Manuals

If 80 to 90% of these factors come from personal lifestyle, then surely we have a major influence on our fertility. According to the BEACH (Bettering the Evaluation and Care of Health) program the table below shows how infertility is managed in Australia.

Table 2. Management of infertility/sub-fertility

As you can see in the table above, nearly 90% are being investigated through pathology test and nearly 50% are referred to a specialist, such as a fertility clinic, which means straight on to ART (assisted reproductive technology), which includes IVF, IUS, ICSI, etc. It is astounding that only 1.7% of women were prescribed Folic Acid and less than 1% received vitamins.

If lifestyle has such a major influence on fertility, wouldn’t it be logical to change your lifestyle before taking drastic and expensive steps such as IVF?


Kubo H., Epidemiology of infertility and recurrent pregnancy loss in society with fewer children. JMAJ – Japan Medical Association Journal, 2009 Vol. 52 No. 1 pp. 23-28

Carmen Zhang, Christopher Harrison and Helena Britt, Family Medicine Research Centre, University of Sydney, New South Wales. Infertility, Management in Australian General Practice

World Health Organisation Reference Values for human semen


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