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 in their 20s and early 30s, the chance of conceiving in any given month is only around 1 in 4. 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 up to about 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 usually survive in the female reproductive tract for about 3 days, and sometimes up to five, which means the "fertile window" is longer than just the day of ovulation.

Of the tens of millions or more sperm released during ejaculation, only a few thousand make it to the fallopian tubes. 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 embryo travels down the fallopian tube and into the uterus, where it needs to implant itself into the uterine lining. In successful pregnancies this usually happens 8 to 10 days after ovulation. This is when pregnancy truly begins.

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 around 1 million egg-containing follicles. By puberty, that number drops to about 300,000. 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. Infertility is due wholly or partly to male factors in about half of infertile couples.

How Sperm Are Made

Unlike eggs, sperm are constantly being produced. It takes roughly two months for a new sperm cell to develop and be ejaculated. This means lifestyle changes take about three months to show up in sperm quality.

What Makes Sperm "Healthy"

When doctors evaluate sperm, they look at:

Sperm count: The WHO reference value is at least 16 million sperm per milliliter (and at least 39 million in total).

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: Higher scrotal temperature (for example from frequent hot tub use) is linked to poorer semen quality, though it's uncertain how much changes like looser underwear help.
• 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

These figures combine ACOG's estimate for women in their 20s with two published studies of couples trying to conceive (see our age and fertility guide for details). They 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 gradually with age
• 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 has been associated with better fertility outcomes in some studies.

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. (In the UK, NICE recommends referral to a specialist straight away from age 36.)

See Someone Sooner If...

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 (now also called PMOS) is one of the most common hormonal disorders in women of reproductive age. The WHO estimates it affects 10-13% of women worldwide, and studies suggest it may be more common in the Gulf, where a 2021 review found an average of about 19% using one set of diagnostic criteria. 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.

Fertility in the UAE

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

Recent Law Changes

UAE fertility law has been reformed twice in recent years:

• 2019: Single women can freeze their eggs for medical or personal reasons (Federal Law No. 7 of 2019, in force from 2021)
• 2023: Unmarried non-Muslim couples can access IVF with their own eggs and sperm, and the federal ban on surrogacy was lifted (Federal Decree-Law No. 17 of 2023)
• Donor eggs and sperm remain prohibited, and each emirate can add its own rules

See our guide to UAE fertility law for details.

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

Published IVF prices range from AED 14,000 at the government Dubai Fertility Center (excluding medication) to AED 39,000 for an all-inclusive private package with genetic testing. Thiqa, Abu Dhabi's health programme for UAE nationals, covers IVF for eligible patients. Dubai's basic Essential Benefits Plan excludes IVF, and only some private plans offer fertility benefits. See our IVF cost guide and insurance guide.

Frequently Asked Questions

Sources

• ACOG: Having a baby after age 35 (checked October 2026)
• ACOG: Fertility awareness-based methods of family planning (checked October 2026)
• ASRM: Age and fertility, a guide for patients (PDF) (checked October 2026)
• ASRM: Definition of infertility, a committee opinion (2023, PDF) (checked October 2026)
• NICE NG257: Fertility problems: assessment and treatment (March 2026) (checked October 2026)
• AUA/ASRM: Diagnosis and treatment of infertility in men (2020, amended 2024, PDF) (checked October 2026)
• Dunson et al. Increased infertility with age in men and women. Obstet Gynecol 2004 (checked October 2026)
• Steiner and Jukic. Impact of female age and nulligravidity on fecundity. Fertil Steril 2016 (checked October 2026)
• Wilcox et al. Time of implantation of the conceptus and loss of pregnancy. N Engl J Med 1999 (checked October 2026)
• Suarez and Pacey. Sperm transport in the female reproductive tract. Hum Reprod Update 2006 (checked October 2026)
• WHO: Polycystic ovary syndrome fact sheet (checked October 2026)
• Mousa et al. Prevalence of common gynecological conditions in the Middle East. Front Reprod Health 2021 (checked October 2026)

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.