Deciding to have a baby may be one of the biggest decisions you and your partner ever make. But having a baby may not be as simple as merely deciding you are both ready to try for one. It is also a question of whether you and your partner together are physically capable of conceiving a child.

The first thing to bear in mind is that you and your partner may not conceive immediately but you shouldn't panic! It can take a while and if it does not happen straight away it is not always a sign that there is a problem. However, with biological clocks ticking, women tend to start worrying and thinking that time is running out. As you both get older your fertility levels drop, although women's fertility levels decrease quicker than men's. Women are born with a finite number of eggs, and therefore your eggs are the same age as you. The younger the egg, the more likely it will be that it is undamaged or have any abnormalities. A woman in her 20s is twice as likely to conceive as a woman in their late 30s.

Fertility facts*

Women can normally conceive from the time of their first period to about 47 years of age
Women aged 20 years have around 50,000 eggs
By the time a woman turns 35, she has 15,000 eggs left
Women in their mid-40s have a 5% chance every month of conceiving
* Source: The Family Planning Association

As more and more couples are postponing having children until later in life, reported cases of fertility issues are increasing. Age is the single biggest reason for fertility issues.

Your cycle

It is really important to understand your monthly cycle to be able to time ovulation accurately. Ovulation is the release of an egg from the ovary into the fallopian tube where it waits to be fertilized. The egg will remain here and is capable of being fertilized for around 36 hours after release. Sperm live for up to 72 hours, so the optimum chance for conception is the 3-4 days around ovulation – the day before, and 36 hours after release. Approximately 20% of women in the UK wrongly believe that they are likely to conceive just before or just after their period. Many also believe that it's possible to conceive during any one of the 28 days of their cycle.

Use a day planner or a calendar to mark the day your period begins each month. Also track the number of days each period lasts. If you have a consistent 28-day cycle, ovulation is likely to begin about 14 days after the day your last period began.

Fresh sperm It is also important that sperm has maximum energy and life. Sperm dies after about 7 days in the testes and therefore ejaculation every 3-4 days is essential to ensure maximized chances of conception.

It is also important to consider certain recognized medical conditions that can affect your fertility.

Polycystic ovary syndrome (PCOS)

This condition - where a woman's ovaries contain a large number of little cysts - cause hormonal imbalances and makes it difficult for eggs to be released. This causes irregular periods, weight gain, hair growth on the body and acne. If you suffer from PCOS talk to your GP for treatment - up 50% of women may conceive within 6-9 months of taking the prescribed drug treatment.

Blocked Tubes

Damaged, blocked or twisted tubes can cause fertility problems for both men (blocked tubes that carry the sperm) and women (fallopian tubes that carry the egg to the womb). An infection such as Chylamdia blocks the fallopian tubes and may lower the sperm count. Chylamdia is usually undetectable, so it's always advisable to have regular pap smears with your Family Planning Centre. At home Chlamydia tests are now available over the counter at leading chemists.

Endometriosis can also cause tubal blockages as the womb lining comes away and adheres to the lining inside the fallopian tubes. This is usually accompanied by painful, irregular and heavy periods. It's advisable you speak to your GP for advice.

Hormonal imbalance

As we age hormone levels change. A key hormone Follicle Stimulating Hormone (FSH) increases as we get older. This hormone helps the follicles containing the egg within the ovary to ripen and push mature eggs to the surface of the ovary to be released. As the quality of eggs declines, increasing amounts of FSH are released in order to produce eggs capable of fertilisation. More and more FSH is produced to try and produce eggs capable of fertilisation, and indicates that egg quality (ovarian reserve) has decreased and the chances of the egg being fertilised are reduced. FSH is one of the key hormones that at a significant raised level, indicates the onset of menopause.

Poor sperm quality

The most important factor is a low concentration of motile sperm. Motile sperm are sperm that swim well. These sperm need sufficient energy and motility to reach, penetrate and fertilise an egg. If concentration of motile sperm is low, there is a reduced chance of conception. Sperm motility is affected by a number of things:

Misshapen sperm (poor morphology). If sperm are poorly formed this will affect their ability to swim well and in the right direction
Obstructions in the vas deferens (the tubes that carry the sperm) will affect the concentration of healthy, motile sperm ejaculated.
Various lifestyle factors can also affect the concentration of motile sperm:
Smoking, drinking alcohol and using recreational drugs are all known to reduce sperm quality.
Your diet also plays a part, for example, men who are healthy and are taking vitamin supplements (vitamin E and Vitamin C) have been shown to have a higher quality of motile sperm than men not taking vitamin supplements
2 of the major factors affecting male and female fertility – FSH level in women and concentration of motile sperm in men – are detected by a new, at-home fertility screening test – Fertell.

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