Fertility

Fertility problems affect around 1 in 7 couples, and more than half of cases directly affect women.

This page provides information on fertility challenges and our work to improve awareness and healthcare associated with this issue.

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The following information is based on the lived experiences and priorities expressed to us by our community. If you need medical/health advice, please contact a GP or medical professional. Read our medical disclaimer

What are fertility issues?

9-15% of couples in Wales will experience problems conceiving (getting pregnant)
According to NHS Wales, infertility is only usually diagnosed when a couple has not managed to conceive after a year of trying

There are two types of infertility:

primary infertility – where someone who’s never conceived a child in the past has difficulty conceiving
secondary infertility – where someone has had 1 or more pregnancies in the past, but is having difficulty conceiving again
Treating infertility

Infertility in women can be caused by a lot of different things. This can include problems with the reproductive system, medical conditions such as endometriosis, PCOS or Pelvic Inflammatory Disease, or medicines someone may be taking. For example, around 30 – 50% of women and people registered female at birth living with endometriosis will experience fertility issues. Sometimes, the cause of fertility issues is never found.

Medical treatments are available, depending on the cause of infertility. This may include medication to make ovulation more regular, surgery to repair damage or problems with the reproductive organs and treatment to assist conception such as in-vitro fertilisation (IVF).

More information about infertility and treatments can be found at on the NHS Wales website here.

What are we calling for?

Our overall aim is to highlight how some gynaecological conditions can affect fertility and ensure that patients’ concerns are taken seriously, that they are supported, and that they can access timely joined-up care.

Many women and people registered female at birth describe having long-term health conditions for which poor or delayed treatment has resulted in fertility problems.

Many non-cancerous conditions affecting females, such as endometriosis and PCOS, are associated with gender stereotypes which see those living with these conditions describinh not being taken seriously. They can experience long diagnostic delays because the impact of symptoms is not widely recognised. One of these impacts can be on fertility.

Also, some patients can find themselves offered medical or surgical treatments which mean they are no longer able to conceive. A significant number report not feeling like they had adequate counselling or support about potential infertility. They tell us that infertility can have a hugely detrimental impact on their mental health and wellbeing, with some of them experiencing relationship breakdowns as a result.

In Wales, there are long waits for referrals into gynaecology services, sometimes reducing patients’ chances of natural conception.

Delays in diagnosing and treating pre-existing conditions can mean that some patients in Wales find themselves nearing the age-related cut-off point for fertility services on the NHS.
NICE guidance on fertility recommends three full cycles of IVF for those who are eligible under the age of 40, and a single cycle for those aged 40-42. This guidance is not always followed in Wales, which results in inequity between patients in Wales and those elsewhere in the UK.
Many women don’t meet NHS Wales criteria for fertility treatment due to their BMI (body mass index or weight to height ratio) – but this doesn’t always take into account the disabling impact of chronic health conditions which can make it harder to lose weight.
Lots of patients tell FTWW that they would like to lose weight to help them on their fertility journeys but haven’t always been able to access support from their local health services to do this, despite the Wales Fertility Institute in Cardiff offering a weight loss course tailored to fertility patients.

We need to:

Ensure earlier diagnosis for gynaecological and other health conditions that affect fertility.
Ideally, patients should have the cause of their fertility problems identified and treated as soon as possible because, for some of them, this would improve the chances of conception, either naturally or as a result of fertility treatment.
Ensure that there is seamless, joined-up care for those who might experience infertility as a result of their pre-existing conditions, including enabling routine access to additional services close to home, like weight management and mental health support, as part of an holistic package of care.
Ensure that all patients are able and empowered to make an informed decision about the treatment of their health issues.
This includes enabling patients to say whether or not fertility is a priority for them, and have their choices respected and supported.
Ensure that evidence-based guidance is followed in Wales, and that postcode lotteries to optimum care and other inequities are addressed.

Our champion: Emma Williams-Tully

“I campaign on this issue due to having severe endometriosis and previously adenomyosis where my fertility was severely compromised to the point of my possibly not being able having any children. I was incredibly fortunate that we were able to have our daughter, but there are so many who are not. The complexity of non-cancerous gynaecological conditions needs to be highlighted and care improved, including where it impacts on fertility.

On behalf of FTWW, I recently attended Fertility Network UK’s 20th anniversary event in London where I met some incredible people who shared their inspirational stories. Struggling with your fertility shouldn’t be a taboo. No one should ever be made to feel alone.”

Read Emma's story

What have we achieved?

Our campaign activity to improve the lives of those struggling with fertility issues is extensive. Some of our achievements are outlined below:

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We raise awareness through events, media, training and fundraising

We support our members and volunteers to have their stories heard about topics related to fertility struggles. Some examples of our stories from our community in the media can be found on the BBC website here and here.
We have coproduced a webinar with Fertility Network UK Wales about patient choice in fertility and related healthcare spaces, and how to raise concerns if not happy with the care offered here.

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We take part in consultations, advisory boards and co-production of healthcare

We help to facilitate North Wales Gynae Voices meetings with Betsi Cadwaladr University Health Board (BCUHB), including supporting volunteers to participate in discussions and plans about Fertility pathways
We have worked with BCUHB on its groundbreaking Preconception Strategy, which includes references to the impact of chronic health conditions and the need for information and support
We collaborate with third sector organisations like Fertility Network UK to raise awareness of people’s experiences, inequities in care, and best practice.

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We engage directly with policy makers and researchers

We have worked with the Welsh Government on its perinatal engagement framework, which includes opportunities for women and service-users to share their experiences and have their say on service development
We meet regularly with the Welsh Government’s Women’s Health Policy Team and NHS Wales Clinical Strategic Network for Women’s Health to raise awareness of issues around chronic conditions and fertility
We included evidence about fertility in the Women’s Health Wales Coalition’s report to Welsh Government
We made sure fertility management featured in the Welsh Government’s Quality Statement for Women’s and Girls’ Health ahead of the publication of the NHS Wales 10-year Women’s Health Plan.

Advocating for yourself or someone else

Many women find it difficult to discuss health issues and seek support, even if these health issues are having a significant impact on their lives.

We're working with our community to develop tools and tips to help women to speak up, and provide guidance for people who would like to support their loved ones, friends, colleagues or patients who are living with health conditions.

Get tips and advice