Common knowledge has it that once married, having babies is a natural outcome of the desire to raise a family. Perhaps this was true up until a few decades ago. Nowadays, it is a different story.

An estimated one in six couples in the UAE are experiencing challenges when it comes to pregnancy, according to a Dubai Health Authority (DHA) report released in 2010. Globally, the infertility average is one in four couples according to the World Health Organisation (WHO).

The total fertility rate — the average number of children a woman of a child-bearing age can conceive in her lifetime — has been on the decline for over 30 years in the UAE. From 4.4 average, it dropped to 1.7 per woman between 1990 and 2010, according to the Health Statistics Report released by the Health Authority Abu Dhabi in 2012 and the World Bank.

However, the situation is not completely bleak, according to Dr David Robertson, Group Medical Director at Bourn Hall Clinic Dubai, the UAE arm of the UK clinic that pioneered in vitro fertilisation (IVF) that gave the world its first test-tube baby in 1978.

“Only about 10 per cent of those people will actually end up needing some kind of assisted reproduction,” Dr Robertson told Gulf News.

“Most problems (in getting pregnant) are fairly straightforward, and can be solved with medication or advice,” he says.

The fertility issues they are consulted for pertain equally to both genders. In some cases, however, there’s an issue with both the husband’s and wife’s reproductive abilities.

The most important thing when assessing the issue of infertility or an inability to conceive is to examine the underlying medical conditions of couple, says Dr Maria Alonzo, Managing and Medical Director of Dubai Herbal and Treatment Centre. If, despite a clear medical history, they still don’t conceive, the case is unexplained infertility. This too can be tackled using holistic approaches, such as traditional Chinese medicine, for instance.

“We see quite a high number of women who have been diagnosed by gynaecologists as haing no health issues or no medical conditions so to speak, and yet they have problems getting pregnant,” says Dr Alonzo.

“After assessments, most of the time, it comes down to lifestyle: how and what they eat, how much they sleep, stress levels in their jobs, and previous history of medication and habits such as smoking. Based on our experience, all these definitely affect fertility.”

There are no available studies in the UAE showing how these factors impact a couple’s fertility. There is also no one-size-fits-all solution. Both doctors advise couples to consider these common causes before considering high-end treatment.