Fertility booklet – Exploring fertility and assisted reproductive technologies

Part 1
Exploring fertility statistics
What is fertility?
Fertility is the ability to naturally reproduce and have children. Men who are fertile are able to father children and
fertile women are able to conceive a pregnancy and give birth to a live baby. Fertility naturally starts to decline with
age, so it becomes harder to start a family the older we get. This decline occurs earlier for women than men.

When does male fertility start to decline? When does female fertility start to decline?
40 30
After turning____________ years old After turning____________ years old

Sperm quality starts to decline with A woman is born with the total
age. This can increase the time it number of eggs she will have for her
takes to fall pregnant and possibly lifetime. As she ages, the number of
introduce genetic problems. healthy eggs starts to run out.

Can lifestyle factors affect fertility?

The three couples below have been trying to start a family for at least 12 months without success. Infertility is
described as the inability to become pregnant after 12 months of unprotected sexual intercourse, so the couples have
sought medical help. Learn about what lifestyle factors can affect fertility though the ‘Can lifestyle factors affect
fertility?’ page, and use the body mass index calculator to check the BMI of each individual record their body mass
index (BMI) results and recommended lifestyle changes below for each individual.

Couple 1

Rosa José
Age: 25 Height: 162cm Weight: 66kg Age: 27 Height: 176cm Weight: 77kg

Cigarettes per day: 13 Cigarettes per day: 14

Alcoholic drinks per week: 4 Alcoholic drinks per week: 15

25 25
BMI: __________ (‘normal’ range = 20-25) BMI: __________ (‘normal’ range = 20-25)
Lifestyle stop smoking and drinking Lifestyle stop drinking and smoking
changes:______________________________ changes:_______________________________

Couple 2

Blanca Felix
Age: 32 Height: 162cm Weight: 52kg Age: 36 Height: 190cm Weight: 90kg

Cigarettes per day: 0 Cigarettes per day: 0

Alcoholic drinks per week: 14 Alcoholic drinks per week: 25

20 25
BMI: __________ (‘normal’ range = 20-25) BMI: __________ (‘normal’ range = 20-25)
Lifestyle stop drinking Lifestyle stop drinking
changes:______________________________ changes:_______________________________
Fertility booklet – Exploring fertility and assisted reproductive technologies
Couple 3

Summer David
Age: 28 Height: 167cm Weight: 48kg Age: 25 Height: 168cm Weight: 110kg

Cigarettes per day: 0 Cigarettes per day: 0

Alcoholic drinks per week: 1 Alcoholic drinks per week: 2

17 39
BMI: __________ (‘normal’ range = 20-25) BMI: __________ (‘normal’ range = 20-25)
Lifestyle gain weight Lifestyle lose weight
changes:______________________________ changes:_______________________________

Implementing lifestyle changes to improve fertility

Each couple has made changes to their lifestyles in different
ways with the hope that this will improve their fertility and
chances of conceiving. Use the Year 2 pregnancy interactive in
the online course (see picture to the right) to explore if any of
the couples are able to make it through the first three months
of pregnancy to remain pregnant in December (if yes, they will
successfully carry the pregnancy for the full nine months and
have a healthy baby). Mark the correct box for each couple to
record your findings below.

Year two pregnancy results

Not Not Not

Pregnant Pregnant Pregnant

✔ ✔ ✔
Pregnant Pregnant Pregnant

Physiological factors affecting fertility: semen analysis

Some couples continue to experience fertility issues even after altering
their behaviours to improve their chances of conception. When this
occurs, doctors refer people to fertility specialists. Medical tests are
performed to determine if there is a physiological factor that is
affecting their fertility.

Physiological factors that can affect fertility in men and women include:

1. Production of sperm and eggs

2. The structure and function of the male and female
reproductive system
3. Conditions related to hormones
4. Conditions related to the immune system

Men and women are equally likely to experience issues with their fertility, but sometimes the tests show there is no
physiological explanation for why a couple is having fertility issues. This is described as unexplained infertility.
Fertility booklet – Exploring fertility and assisted reproductive technologies

Semen analysis record

Watch the semen analysis video in the online course and record David and Felix’s test results in tables 1-3.
Concentration of sperm in the semen
Table 1: Sperm concentration results for Felix and David
Semen analysis Normal values: average Felix David
parameter (normal range)
12 million/mL – 16 14 million/mL12 12 million/mL
Sperm concentration
million/mL
Sperm morphology and progressive motility
A total of 100 sperm are analysed from the semen sample supplied by each male. The results of 90 sperm have already
been recorded in table 2. Add data to this table as you analyse the final 10 sperm for each male. Then calculate the %
progressive motility and the % of sperm with normal morphology.

Table 2: Analysis of 100 sperm from semen samples provided by Felix and David
Felix David
Progressive Progressive
Sperm Morphology Morphology
motility motility
Yes No Normal Abnormal Yes No Normal Abnormal
90 Already
40 50 6 84 14 76 4 86
counted
91 1 1 1 1
92 1 1 1 1
93 1 1 1 1
94 1 1 1 1
95 1 1 1 1
96 1 1 1 1
97 1 1 1 1
98 1 1 1 1
99 1 1 1 1
100 1 1 1 1
Total 46 54 8 92 18 82 7 93
% 46 8 18 7

Table 3: Semen results for Felix and David

Semen analysis Normal values: average Felix David
parameter (normal range)
Total progressive 46% 18%
32 % or more
motility

4% or more normal 8% 7%
Morphology
forms
Are Felix’s results normal? Are David’s results normal?

YES ✔ NO YES NO ✔

no yes
Abnormal result:________________________ Abnormal result:________________________
Fertility booklet – Exploring fertility and assisted reproductive technologies

The female reproductive system

Blanca and Summer have undergone medical testing to identify any physiological conditions causing their fertility
issues. Medical tests for females can be invasive as some tests involve an internal exam or sample collection (vaginal
ultrasound, STI check, cervical mucus test, biopsy), injecting dye through the cervix into the uterus and fallopian
tubes then taking x-rays (hysterosalpingogram) or keyhole surgery to insert a camera and observe the internal
organs (laparoscopy). A record of their results is below.

Use the ‘Conditions of the female reproductive system’ interactive

on the website (see picture to the right) to learn about the range
of different problems that can develop which may impact fertility.

Using the medical test results and information contained in the

website interactive, diagnose the condition that is causing the
abnormal test results. To do this, find the condition which matches
all of the abnormal test results. Once you have identified it record
your findings below.

Are Blanca’s results normal? Are Summer’s results normal?

YES NO ✔ YES ✔ NO

surgical removal none

Condition diagnosis:_____________________ Condition diagnosis:________________________

Year three pregnancy results

Blanca, Felix, Summer and David have now entered their third year
of trying to conceive. Couples have maintained healthy lifestyles
and had treatment (if possible) for any physiological issues
diagnosed during testing.

Use the Year 3 pregnancy interactive in the online course (see

picture to the right) to explore if either couple is successful in
conceiving. Mark the correct box for each couple to record your
findings below.

Blanca and Felix Summer and David

Not ✔ Not ✔
Pregnant Pregnant Pregnant Pregnant
Fertility booklet – Exploring fertility and assisted reproductive technologies

Part 2 - Assisted Reproductive Technologies

Complete Part 2 of the ‘exploring fertility and reproductive technologies’ course to learn about different ARTs. Use
the questions and information in this course to help the couples decide the best course of action for them.

Couple 3 Which ART will work for me? Fertility issue:

Progressive sperm motility
in vitro fertilisation (IVF)
Household income:60,000

How much does it cost to try?

Savings:0
13,270
What is the success rate? Health insurance:no
30%
Summer & David
Final decision:
Lifestyle factors:live rurally

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Couple 4 Which ART will work for me? Fertility issue:

Sperm donation Kleinfelter Syndrome
Household income:120,000

How much does it cost to try?

Savings:15,000
6,580
What is the success rate? Health insurance:yes
14%
Brette & Ronan
Final decision:
Lifestyle factors:brette has a criminal record

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Couple 5 Which ART will work for me? Fertility issue:

Egg donation Age of couple
Household income:250,000

How much does it cost to try?

Savings:60,000
14,535
What is the success rate?
Health insurance:yes
Petrina & Misha 31%
Final decision:
Lifestyle factors:misha has a child from a previous
relationship