Is there an increase in infertility globally

At Cape Fertility Clinic, one of the most commonly asked questions from our patients is whether there is an increase in infertility among couples around the world. In a recent video Dr Sulaiman Heylen, one of the best-known reproductive medicine specialists in the country, director of Cape Fertility in Cape Town, as well as the President of the Southern African Society for Reproductive Medicine and Gynaecological Endoscopy (SASREG), not only provided an insightful answer but also explained the reasons behind it.

A question often asked by couples who are experiencing infertility is whether there is an increase in infertility around the world today. Dr Heylen says yes, there certainly is. This is both because of more awareness about infertility and because the numbers of people struggling with infertility continue to rise, due to several causes that have been clearly identified.

More people know about infertility than before, because there is growing awareness around infertility. Just 30 or 40 years ago, very few people knew that infertility was a real medical condition, and even fewer knew that it could be treated.

Today, thanks to global and local awareness campaigns and increased media coverage about infertility, more people are aware of this issue, and the fact that it affects as many as one in six couples worldwide. There is also growing awareness of the advanced technology and range of treatments that is now available – with IVF (In Vitro Fertilisation) being one of the most well-known modern fertility treatments. This means that in the majority of infertility cases, couples have access to a range of fertility treatments that can help them conceive.

However, not only is there more awareness about infertility, there is also an alarming increase in the numbers of people facing infertility, with more and more couples struggling to conceive and being diagnosed with infertility each year.

There are several common reasons why infertility among couples is increasing worldwide.

These include advanced maternal age, the global decline in sperm quality, sexually transmitted diseases, the health effects of poor lifestyle choices, as well as conditions such as endometriosis and polycystic ovarian syndrome – or PCOS, as it is better known. We briefly look at each of these issues below.

The age of the female partner

One of the most common reasons for the steady increase in infertility numbers is the age at which many women now choose to start their families.

In today’s modern world, many women put off having children until later in life. This may be because they are building a career, or because of financial pressure, or even because society can view it negatively when a woman gives up a job or career to have a baby.

The physical reality is that women have a prime fertility window that extends to around age 35. It is well known that female fertility slowly decreases until the age of 35. But after this age, there is often a steep decrease in fertility year after year, and so it becomes a bit more difficult to conceive when women become older. In fact, the chances of falling pregnant naturally after the age of 40 is lower than 15%, and most women over the age of 45 are unable get pregnant naturally.

A global decline in sperm quality

There is also grave concern on a global level regarding the decrease in sperm quality over the last few decades. Studies have shown that the quality of sperm today is far lower than it was 40 or 50 years ago.

In fact, over the past 50 years, human sperm concentration decreased drastically from 113 to 61 million/mL, which represents almost 50% decrease, and this has been recognised as a global health challenge.

Poor lifestyle choices

To achieve a pregnancy, a healthy egg and healthy sperm are required. Sadly, however, due to modern lifestyles and poor lifestyle choices, even many young people are not very healthy, and they struggle to fall pregnant naturally.

Certainly one of the best-known causes of reproductive problems is obesity. Weight related problems are often the result of unhealthy food choices including choosing highly processed food. Smoking is another well-known contributing factor in infertility. In fact, infertility rates in both male and female smokers are about double the rate of infertility found in non-smokers. Similarly, alcohol consumption and recreational drugs can affect fertility.

Furthermore, lifestyle diseases like diabetes, obesity and hypertension certainly have an impact on infertility rates.

Environmental factors

Another known contributing factor to poor health and infertility is the wide array of environmental pollutants and toxins people are exposed to in the modern world. Some pollutants and toxins, such as xenoestrogens, heavy metals and air pollution, have been found to have a direct negative impact on fertility.

Sexually transmitted diseases (STDs)

STDs or sexually transmitted diseases can cause infertility in women and also in men. Typically, for women, STDs can cause tubal inflammation and can even block the fallopian tubes, which makes a natural pregnancy impossible.


Along with polycystic ovarian syndrome, endometriosis is among the top reasons for infertility in women, and there has been a definite increase in the number of women who have endometriosis over the last few decades.

Endometriosis is a non-cancerous condition in which the lining of the uterus grows outside of the uterus. Other common symptoms of endometriosis are pelvic pain or pain in the pelvic area, including painful periods and painful intercourse. Endometriosis can severely impact on the quality of life for women, and while it cannot be cured, it can be treated very effectively.

PCOS or polycystic ovarian syndrome

Polycystic ovarian syndrome, along with endometriosis, are the two most common reasons of female infertility. There has also been an increase in the incidence of PCOS, compared to 30 or 40 years ago.

PCOS is one of the most common human disorders, affecting up to 20% of women. It is the most common endocrine (hormone) disorder and a common cause of infertility in women. This is because with PCOS, the little follicles in the ovaries (where potential eggs await the right hormonal signals to grow, after which they are released during ovulation) are not stimulated to grow and release every month.

Which factors could be causing your infertility?

The issues briefly discussed above are among the main reasons for an increase in infertility worldwide.

However, there are also many other possible causes of infertility, and it is important to speak to a specialist with the right expertise, experience and equipment, to determine the exact cause of your infertility as a couple.

Once the exact cause of your infertility as a couple has been established, the right treatment can be provided. The good news is that these days, in the vast majority of infertility cases, there is a treatment available that can help couples to have a healthy baby.

If you are concerned about your fertility, it is highly recommended that you consult with a fertility specialist as soon as possible.

If you would like to meet one of our world-renowned fertility specialists, simply contact us by clicking here

At Cape Fertility, we value each individual patient and we look forward to providing you with individualised and personalised care, affordable quality fertility treatment, and higher success rates at our purpose-built premises in the beautiful city of Cape Town.