Long considered a female problem, infertility is nevertheless equitably shared between the sexes: it is in about a third of cases exclusively female, in another third exclusively male, and mixed (or unexplained) the remaining third. Among the possible causes, some are purely physical, even irreversible – such as age – or require medical, nutritional or lifestyle intervention (for this, read the following pages of this file). Others, such as the unconscious dynamic of the couple, can be explored before starting any heavy and complicated medical course.
A question of age… for both men and women
If doctors insist so much on reminding couples that “the clock is ticking”, it is because our bodies ignore societal advances and still operate according to ancestral rules. Advancing age remains the first source of difficulty in procreating, and even infertility. definitively, in both sexes. For a fertile couple in which both partners are 25 years old, the chances of ending up with a pregnancy at each new cycle of the woman are 25%. Between the ages of 30 and 35, the probabilities drop to less than 15%, then decrease drastically in women after 37. (read box below). However, while a woman had her first child on average at the age of 25 in 1977, she has it today at over 30, and in 2020, a quarter of children born in France have a mother aged 35. and over and a father aged 38 and over.
Read also
Women: boost your fertility naturally
For men, age matters too, and the fact that the father is over 40 years old can be one of the reasons for the failure of a pregnancy, especially if the mother is between 35 and 40 years old. A study published in the British Medical Journal reveals that children whose father was 35 at the time of conception are more likely to be preterm, and those whose father was 45 are overall likely to be in poorer health.
From the age of 30, testosterone levels drop and sperm are fewer and of poorer quality. So, the peak of male fertility would be between 30 and 35 years old ; beyond that, its fertility decreases. As a result, as soon as the father is over 40, it is not uncommon for the conception time to exceed twelve months.
Read also
Sterility of the couple tracking down the causes as a sleuth
What are the chances of conceiving at 35, 40 or 45?
Many women worry about not being able to get pregnant after 35. What are the numbers?
Environ 65% of 35-year-old women get pregnant within a year, 45% at age 40 (versus 75% at age 30), according to a study by the Upsala Journal of Medical Sciences. But other studies show that a woman aged 35 to 40 has a 70 to 80% chance of conceiving in one year, 80 to 95% in two years. In any case, an attempt at an older age sometimes means waiting longer: 90 to 95% of women aged 35 procreate after three years75% at age 38, and probability becomes almost zero after 45 yearss, because from then on, 80 to 90% of the eggs become abnormal and do not give viable embryos, which generates a risk of miscarriage of 35 to 55% per pregnancy.
Read also
Pregnancy, baby: limit PE!
Unconscious to explore
For Joëlle Desjardins-Simon, psychoanalyst who accompanies infertile couples at the PMA center of the Franche-Comté polyclinic in Besançon, “the psyche is quite capable of setting up physiological barriers to undesirable motherhood or fatherhood on the unconscious level”. The co-author of The unconscious locks of fertility (ed. Albin Michel) quotes those couples who “cannot make room for a third party”in which one of the two already takes the place of the child and for whom, unconsciously, procreating would amount to upsetting this balance and the advantages associated with it.
An unconscious that is all the more interesting to explore (read the article “Infertility, psychology and the brain”), as the PMA does not respond to all infertility problems: « Attempts only result in pregnancy in 16% of cases » (15% for women aged 30 at the start of the attempt, 9.6% for those aged 35 and 0.9% for those aged 40). These numbers are “significantly lower than the success rates achieved by artificial insemination in farm animals”. However, reminds the psychoanalyst, what differentiates the animal kingdom and the human race is the unconscious. So, “temporize” and “let oneself speak” rather than “submitting to the medical act from the outset” can produce “unexpected effects”, like this ” such a common coincidence” where apparently sterile couples procreate spontaneously a few months after the arrival of an adopted child.
Anti-sperm antibodies? Huhner’s test
To detect couple-related infertility, the Hühner test consists of collect cervical mucus (a substance on the cervix that normally helps sperm pass through)a few hours after a report unprotected to observe the interaction between these “little soldiers” and their environment. This makes it possible, for example, to detect the production by the woman of anti-sperm antibodies or of vaginal bacteria which destroy them, and to put in place appropriate solutions.
Read also
Microbiota: an impact on female fertility?
Read also
Fertility: gentlemen, watch out for the cell phone