Female infertility means not being able to get pregnant despite having frequent, unprotected sex for at least one year of trying (or six months if a woman is 35 or older). Women who can get pregnant but are unable to stay pregnant may also be infertile.
Although female infertility problems in general aren’t tied to any single medical condition, some women are more predisposed to having them. About 10 percent of women (6.1 million) in the United States ages 15-44 have difficulty getting pregnant or staying pregnant, according to the CDC.
What causes female infertility?
Most cases of female infertility are caused by problems with ovulation. Because, fertilization cannot occur without ovulation. These include hormonal disorders such as polycystic ovary syndrome (PCOS). PCOS is a hormone imbalance problem which can interfere with normal ovulation. PCOS is the most common cause of female infertility. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.
Other causes of female infertility include:
- Problems with your reproductive system. These includes: fallopian tubes, cervix, uterus, ovaries. This might include a blockage, scarring and enlarged ovaries.
- Disease and disorders such as pelvic inflammatory disease, endometriosis, or surgery for an ectopic pregnancy
- Abnormalities with the opening of the cervix, polyps in the uterus or the shape of the uterus.
- Uterine fibroids, which are non-cancerous clumps of tissue and muscle on the walls of the uterus.
- Certain cancers such as ovarian cancer, cervical cancer and its treatment.
- Medical conditions associated with delayed puberty or the absence of menstruation (amenorrhea), such as celiac disease, poorly controlled diabetes and some autoimmune diseases such as lupus.
What things increase a woman’s risk of infertility?
Many things can change a woman’s ability to have a baby. These include:
- Excess alcohol use
- Poor diet
- Athletic training
- Being overweight or underweight
- Sexually transmitted infections (STIs)
- Health problems that cause hormonal changes, such as hyperthyroidism, hypothyroidism
Symptoms of female infertility
The main symptom of female infertility is not being able to get pregnant. There may be no other symptoms. For women, if there are symptoms, they are usually related to the cause of infertility.
Certain factors may interfere with getting pregnant. However, these factors do not guarantee you will be infertile.
How does age affect a woman’s ability to have children?
Many women are waiting until their 30s and 40s to have children. So age is a growing cause of fertility problems. About one-third of couples in which the woman is over 35 have fertility problems.
Aging decreases a woman’s chances of having a baby in the following ways:
- Her ovaries become less able to release eggs
- She has a smaller number of eggs left
- Her eggs are not as healthy
- She is more likely to have health conditions that can cause fertility problems
- She is more likely to have a miscarriage
How long should women try to get pregnant before calling their doctors?
Most experts suggest at least one year. Women 35 or older should see their doctors after six months of trying. A woman’s chances of having a baby decrease rapidly every year after the age of 30.
Some health problems also increase the risk of infertility. So, women should talk to their doctors if they have:
- Irregular periods or no menstrual periods
- Very painful periods
- Pelvic inflammatory disease
- More than one miscarriage
It is a good idea for any woman to talk to a doctor before trying to get pregnant. Doctors can help you get your body ready for a healthy baby. They can also answer questions on male infertility and give tips on conceiving.
How to diagnose female infertility?
Your doctor will conduct a routine medical exam. He or she will ask you questions about your general health. Your doctor will also ask how long you have been trying to have a baby. He/she will decide what additional testing is necessary.
Additional testing would likely begin with blood tests. These will check hormone levels, genetics and egg quality. These could include:
- Physical examination – including medical history
- Transvaginal ultrasound. A medical technician will insert a small wand, covered with latex, into your vagina. The wand is connected to a screen, where the technician can view images of the inside of your uterus and fallopian tubes. The technician will send the images to your doctor to review.
- An X-ray that involves injecting dye into your uterus to look for blockages inside your fallopian tubes. It does not require anesthesia.
- Laparascopy. This surgical procedure is performed in a hospital. A thin, flexible scope is inserted into your abdomen to give your doctor a better look at your uterus and fallopian tubes. It helps look for polyps, growths, and blockages.
- Doctors can also check ovulation with blood tests.
However, finding the cause of infertility can be a long and emotional process. It may take time to complete all the needed tests. So don’t worry if the problem is not found right away.
How do doctors treat female infertility?
Treatment can also include medicine or surgery, depending on the underlying problem. The most common medicines used to treat female infertility stimulate the ovaries. This helps the ovaries produce more eggs and increases the chances of getting pregnant. Surgery can be done if there are blockages or problems with the fallopian tubes. It also is used to remove areas of endometriosis (when uterine tissue grows outside the uterus), fibroids, polyps, or scarring, which all can affect fertility.
Assisted Reproductive Technology (ART)
ART uses different technologies to help a couple get pregnant. It may help people who have gone through various infertility treatments but still can’t get pregnant. Some options include:
- Intrauterine insemination (IUI). This procedure inserts healthy sperm into the woman’s uterus around the time of ovulation. It uses a long, narrow tube to insert the sperm. It can be done in the doctor’s office.
- In vitro fertilization (IVF). This is more expensive and complex than IUI. It requires stimulating the ovaries with hormones and removing eggs from the woman. The eggs are fertilized with sperm in a laboratory. Once an embryo develops, it is placed into the woman’s uterus. While they can be successful, there is no guarantee that IUI or IVF will result in a pregnancy.
- Third party-assisted ART. This is when another person helps a couple get pregnant. They can help by donating sperm, donating eggs, or donating embryos. They may also serve as a surrogate or gestational carrier. This means another person actually carries the baby for you.
- Quit smoking.
- Avoid alcohol and street drugs.
- Exercise moderately, but not so much that it interferes with your periods.
- Maintain a healthy weight.