Couples urged to talk openly about infertility

This is something that will be addressed during the forthcoming National Fertility Awareness Week (October 27-November 2), which aims to get people talking about fertility, highlight the heartbreak infertility can cause, and outline the options for dealing with the problem.

Susan Seenan, chief executive of Infertility Network UK, which is spearheading the week, says that around 3.5 million people in the UK have trouble conceiving.

"That's a lot of people, and yet they're not talking about it," she adds. "We're asking, 'Are you talking about the F-word?', because we don't think people are, yet almost everybody will know somebody that's affected.

"We just want people to talk about infertility and understand that it's not something to be ashamed of. It's something you're suffering from, and there's help available."

Seenan says many people lie about their reasons for not having children, because they feel embarrassed and a failure if they're unable to conceive. And if there's a medical problem with one partner, that partner often feel they've let the other partner down.

"People shouldn't blame themselves," she says. "You wouldn't be blaming yourself if you got pneumonia or another illness, but people feel their fertility is something they should be able to control and they can't, so they feel ashamed, and want to keep this very personal issue to themselves."

Infertility can have many causes, including blocked fallopian tubes or endometriosis in a woman, a low sperm count in a man, or 'unexplained infertility', when tests find no obvious physical problems in the couple.

"Because there's nothing apparently wrong, and nothing that can be treated, unexplained infertility can be even harder to deal with," says Seenan. "And sometimes the more people worry, and the more focused they are on trying to conceive, the harder it can be to get pregnant."

Various treatments are available, depending on the cause of infertility; for example, drugs may be taken to stimulate ovulation, or surgery may be needed to treat blocked fallopian tubes, endometriosis or male blockage problems. If these aren't suitable or don't work, many couples turn to IVF.

The number of IVF cycles performed each year has increased steadily since 1991, and the latest figures from 2011 show that around 47,000 women received treatment, with more than 60,000 rounds of IVF or ICSI being given; 4.3 per cent more than in 2010.

ICSI (intra-cytoplasmic sperm injection) is where a single sperm is injected directly into an egg to fertilise it. In IVF, fertilisation occurs in a dish.

In 2010, the overall live birth rate per IVF/ICSI cycle was 24.5 per cent, which means that around three quarters of cycles don't result in a baby - although clearly the more cycles a couple have, the better their chances are.

NICE guidelines recommend offering three full IVF treatment cycles to women aged under 40. who've failed to get pregnant after two years of trying - although, largely due to costs, not every area offers this.

"Of all the people referred for IVF, some will be successful and a lot won't, and many people aren't prepared for that," says Seenan. "You want people to be positive, but sometimes you have to be realistic as well. And there's a postcode lottery for treatment, which is very cruel."

Some couples feel they have no option but to pay for IVF privately. Costs vary, but can be anything from £5,000 per cycle upwards.

The process can be far more involved and draining - both physically and emotionally - than people realise, and can also put a strain on relationships.

Staying relaxed can help couples' cope with their fertility struggles, as well as possibly generally improve their chances of having a baby, but of course, it's not easy.

"It's very, very hard to do that," says Seenan, "and the more you think about it, the harder it is."