Understanding Fertility

Your fertility questions, answered with care. Whether you're just starting to think about having children, actively trying to conceive, or wondering why it's taking longer than expected, this guide will help you understand how fertility works-without the medical jargon.

What Is Fertility, Really?

At its simplest, fertility is your body's ability to conceive a child. But that simple definition doesn't capture the remarkable complexity behind it-or why fertility challenges are more common than most people realize.

Here's something that surprises many people: even for healthy couples with no fertility issues, the chance of conceiving in any given month is only about 20-25%. That's right-even when everything is working perfectly, pregnancy doesn't happen most months. This is completely normal.

Fertility isn't a switch that's either "on" or "off." It's more like a spectrum that changes over time. Many factors influence where you fall on that spectrum at any given moment-your age, health, lifestyle, and genetics all play a role.

Why Understanding Fertility Matters

Whatever brought you here, understanding how fertility works gives you power. It helps you:

Know what's normal and what might need attention
Have more informed conversations with your doctor
Make decisions that align with your goals
Reduce anxiety by replacing uncertainty with knowledge

In the UAE, where fertility treatments are increasingly accessible and where recent law changes have expanded options for more people, understanding your fertility has never been more relevant-or more important.

The Basics of Conception: How Pregnancy Actually Happens

Think of conception as a chain of events-each link needs to connect for pregnancy to happen.

Step 1: Ovulation

Each month, one of your ovaries releases a mature egg. This is ovulation. The egg travels into the fallopian tube, where it can be fertilized for the next 12-24 hours. Yes, that window really is that short.

Step 2: Sperm Meets Egg

For fertilization to happen, sperm need to reach the egg during that brief window. Fortunately, sperm can survive in the female reproductive tract for up to five days, which means the "fertile window" is longer than just the day of ovulation.

Of the hundreds of millions of sperm released during ejaculation, only a few hundred make it to the fallopian tube. And of those, typically only one will fertilize the egg.

Step 3: Fertilization and Cell Division

When sperm and egg meet, their genetic material combines. This fertilized egg, now called a zygote, begins dividing. Over the next few days, it becomes a ball of cells called a blastocyst.

Step 4: Implantation

The blastocyst travels down the fallopian tube and into the uterus. About 6-10 days after fertilization, it needs to implant itself into the uterine lining. This is when pregnancy truly begins.

Want more detail? Read our full guide: How Conception Actually Works

Female Fertility: What Every Woman Should Know

Female fertility involves the complex interplay of hormones, eggs, and reproductive organs.

Your Ovarian Reserve: The Eggs You Have

Unlike men, who produce new sperm throughout their lives, women are born with all the eggs they'll ever have. This is called your ovarian reserve.

At birth, you have about 1-2 million eggs. By puberty, that number drops to around 300,000-500,000. Each month, many eggs begin developing, but typically only one matures and is released during ovulation.

This means your egg supply is finite. By the time you reach your late 30s, your reserve has diminished significantly-and the eggs that remain are more likely to have chromosomal abnormalities.

The Hormonal Orchestra

Female fertility depends on precise hormonal coordination:

FSH (Follicle Stimulating Hormone) stimulates your ovaries to develop follicles, each containing an egg.

LH (Luteinizing Hormone) triggers ovulation-the release of a mature egg.

Estrogen builds up the uterine lining and signals when an egg is ready.

Progesterone maintains the uterine lining after ovulation, making it ready for implantation.

Your Reproductive Organs

For natural conception, you need:

Ovaries that produce and release healthy eggs
Fallopian tubes that are open and functioning (this is where fertilization happens)
A uterus with a healthy lining where an embryo can implant

Male Fertility: The Other Half of the Equation

Fertility isn't just a women's issue. Male factors contribute to about 40-50% of all infertility cases.

How Sperm Are Made

Unlike eggs, sperm are constantly being produced. It takes about 72-74 days for a new sperm cell to fully develop. This means lifestyle changes can affect sperm quality within about three months.

What Makes Sperm "Healthy"

When doctors evaluate sperm, they look at:

Sperm count: A normal count is at least 15 million sperm per milliliter.

Motility: How well the sperm swim. They need to move efficiently to reach the egg.

Morphology: The shape and structure of the sperm.

Volume: The total amount of semen produced.

Factors Affecting Male Fertility

Heat exposure: Frequent hot tub use, tight underwear, or laptop use on the lap can temporarily reduce sperm production.
Lifestyle factors: Smoking, excessive alcohol, and obesity all negatively affect sperm.
Medical conditions: Varicoceles, hormonal imbalances, and previous infections can all play a role.
Age: While men can father children later in life, sperm quality does decline with age.

Age and Fertility: What the Numbers Actually Mean

Age is the single biggest factor affecting fertility, particularly for women. Here's what the research actually shows.

Female Fertility and Age

Age Range	Monthly Conception Rate	Annual Conception Rate
Under 25	25-30%	90%+
25-30	20-25%	80-90%
30-35	15-20%	70-80%
35-40	10-15%	50-65%
Over 40	5% or less	30-40%

These are averages. Many women conceive quickly in their late 30s, while some struggle in their 20s.

Why Age Matters for Women

The age-related decline isn't just about having fewer eggs-it's also about egg quality. As eggs age, they're more likely to have chromosomal abnormalities, which increases the risk of difficulty conceiving and miscarriage.

Male Fertility and Age

Men don't have a hard biological deadline like menopause, but age does affect male fertility:

Sperm quality (motility and morphology) declines after 40
Testosterone levels decrease gradually
Time to conception increases when the male partner is older

Lifestyle Factors That Genuinely Make a Difference

Factors With Strong Evidence

Body weight: Both being significantly underweight and significantly overweight can affect fertility.

Smoking: Smoking damages eggs, reduces sperm quality, and increases miscarriage risk.

Alcohol: Heavy drinking affects fertility for both men and women.

Factors With Moderate Evidence

Exercise: Regular moderate exercise supports fertility. However, excessive intense exercise can disrupt ovulation.

Diet: A Mediterranean-style diet is associated with better fertility outcomes.

Stress: The relationship between stress and fertility is complicated. While extreme chronic stress may affect ovulation, normal life stress probably doesn't prevent pregnancy.

When Should You See a Fertility Specialist?

Standard Recommendations

If you're under 35: See a specialist if you haven't conceived after 12 months of regular, unprotected intercourse.

If you're 35-40: See a specialist after 6 months of trying.

If you're over 40: Consider seeing a specialist right away.

See Someone Sooner If...

Don't wait for standard timelines if you have irregular or absent periods, known conditions like PCOS or endometriosis, previous pelvic infections or surgeries, history of multiple miscarriages, or known male factor issues.

What a Fertility Specialist Does

A reproductive endocrinologist will:

Take a detailed medical history from both partners
Order tests to identify any issues
Discuss your results and options
Create a personalized treatment plan if needed

Seeing a specialist doesn't automatically mean you need IVF. Many people conceive with simple interventions like medication or lifestyle changes.

Common Conditions That Affect Fertility

PCOS (Polycystic Ovary Syndrome)

PCOS is the most common hormonal disorder in women of reproductive age, affecting an estimated 25-30% of women in the UAE and Middle East. The good news: PCOS is very treatable, and most women with PCOS can conceive with appropriate support.

Endometriosis

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus. Treatment ranges from medication to surgery to IVF.

Male Factor Infertility

Conditions affecting male fertility include low sperm count, poor motility, abnormal morphology, and no sperm in ejaculate. Many are treatable.

For in-depth information on specific conditions, visit our Conditions Guide.

Fertility in the UAE

The UAE has a well-developed fertility treatment landscape with some unique characteristics.

Recent Law Changes

The UAE updated its fertility laws in 2023, expanding access:

Single women can now freeze their eggs
Unmarried non-Muslim couples can access IVF under certain conditions
Regulations vary somewhat between emirates

Treatment Options Available

UAE clinics offer the full range of fertility treatments: fertility medications, IUI, IVF and ICSI, egg/sperm/embryo freezing, and genetic testing (PGT).

Costs and Insurance

Treatment costs range from AED 20,000-50,000 or more per IVF cycle. Thiqa insurance (for Abu Dhabi residents) includes IVF coverage, and some private plans offer fertility benefits.

For comprehensive UAE-specific information, see our UAE Fertility Guide.

Frequently Asked Questions

How do I know if I'm fertile?

There's no single test that definitively says "you're fertile." Regular ovulation (indicated by regular periods) is a good sign, but many factors affect fertility. If you have concerns, fertility testing can provide more information.

Can lifestyle changes really improve fertility?

Yes, to an extent. Maintaining a healthy weight, quitting smoking, and limiting alcohol can improve fertility outcomes. However, lifestyle changes can't overcome all fertility challenges-some conditions require medical treatment.

Is infertility always permanent?

No. Many causes of infertility are treatable. Even couples with significant fertility challenges often have options, whether through medical treatment, assisted reproduction, or other paths to parenthood.

Will IVF definitely work?

IVF significantly improves chances of conception for many people, but it doesn't guarantee pregnancy. Success rates depend on age, diagnosis, and other factors. Your doctor can give you personalized success rate estimates.

This content is for educational purposes only and should not replace professional medical advice. If you have concerns about your fertility, please consult with a qualified healthcare provider.