Consultant obstetrician and gynaecologist Dr Paul Koigi has advised women struggling to conceive not to delay seeking medical help. According to Dr Koigi, women below 35 who have tried to become pregnant for one year without success should seek medical attention, while those aged above 35 should consult a doctor after six months of unsuccessful attempts. This recommendation is based on the decline in fertility that occurs with age.
Dr Koigi explained that fertility declines with age as ovarian reserve reduces, meaning that the number and quality of eggs start going down. This reduction in the number and quality of eggs lowers the chances of conception, making early assessment important for couples experiencing difficulties. As a result, Dr Koigi urged couples not to wait until fertility difficulties have become more complicated before getting medical attention.
The consultant obstetrician and gynaecologist emphasized the importance of early assessment, stating that it is crucial to start treatment processes early and establish a diagnosis before the problem escalates. Dr Koigi also pointed to sexually transmitted infections (STIs) as another issue that can affect reproductive health, naming gonorrhoea and chlamydia among the infections that can contribute to fertility problems.
Dr Koigi cautioned that having several sexual partners without proper testing or protection can increase the chances of infections being passed between partners. He stressed that condoms remain an important form of protection because they are the only method of contraception that reduces the risk of STIs. Additionally, Dr Koigi advised women against relying too often on emergency contraceptive pills.
According to Dr Koigi, emergency contraception is designed to deal with emergencies and should not replace regular family planning. He recommended that women and couples have several longer-term family planning options available to them, including oral contraceptive pills, skin patches, three-month injections, and hormonal or non-hormonal coils. Some of these options can remain in use for several years, offering women alternatives to frequent emergency contraception.
The World Health Organization (WHO) defines infertility as the failure to achieve pregnancy after 12 months or more of regular, unprotected sexual intercourse, affecting about one in six people globally. WHO's 2025 guideline on infertility recommends evidence-based approaches to the prevention, diagnosis, and treatment of infertility and calls for equitable access to quality fertility care.
In Kenya, the Ministry of Health's 2025 National Family Planning Guidelines define infertility as the inability to conceive after 12 months of regular, unprotected sexual intercourse. The guidelines call for counselling, information, and appropriate referrals for individuals and couples experiencing infertility. The Ministry's clinical guidelines also recommend systematic evaluation of both partners when pregnancy has not occurred after a year of adequate exposure.
Key points
- Women above 35 should seek medical help within six months if they are struggling to conceive.
- Fertility declines with age as ovarian reserve reduces, lowering the chances of conception.
- Early assessment and treatment are crucial for couples experiencing fertility difficulties.
