Infertility

Infertility is defined as not being able to get pregnant despite having frequent, unprotected sex for at least a year for most couples. Infertility may result from an issue with either you or your partner, or a combination of factors that interfere with pregnancy. 

Symptoms

The main symptom of infertility is not getting pregnant. There may be no other obvious symptoms. Sometimes, an infertile woman may have irregular or absent menstrual periods. Rarely, an infertile man may have some signs of hormonal problems, such as changes in hair growth or sexual function. 

You probably don’t need to see a doctor about infertility unless you have been trying regularly to conceive for at least one year. Talk with your doctor earlier, however, if you’re a woman and:

  • You’re age 35 to 40 and have been trying to conceive for six months or longer
  • You’re over age 40
  • You menstruate irregularly or not at all
  • Your periods are very painful
  • You have known fertility problems
  • You’ve been diagnosed with endometriosis or pelvic inflammatory disease
  • You’ve had multiple miscarriages
  • You’ve undergone treatment for cancer

Causes

Female infertility may be caused by:

  • Autoimmune disorders such as antiphospholipid syndrome (APS)
  • Birth defects that affect the reproductive tract
  • Cancer or tumor
  • Clotting disorders
  • Diabetes
  • Drinking too much alcohol
  • Exercising too much
  • Eating disorders or poor nutrition
  • Growths (such as fibroids or polyps) in the uterus and cervix
  • Medicines such as chemotherapy drugs
  • Hormone imbalances
  • Obesity
  • Older age
  • Ovarian cysts and poly-cystic ovarian syndrome (PCOS)
  • Pelvic infection resulting in scarring or swelling of fallopian tubes (hydrosalpinx) or pelvic inflammatory diseases (PID)
  • Scarring from sexually transmitted infection, abdominal surgery or endometriosis
  • Smoking
  • Surgery to prevent pregnancy (tubal ligation) or failure of tubal ligation reversal (reanastomosis)
  • Thyroid disease

Risk Factors

Risk factors that increase the risk include:

  • Age: The ability to conceive starts to fall around the age of 32 years.
  • Smoking: Smoking significantly increases the risk of infertility in both men and women, and it may undermine the effects of fertility treatment. Smoking during pregnancy increases the chance of pregnancy loss. Passive smoking has also been linked to lower fertility.
  • Alcohol: Any amount of alcohol consumption can affect the chances of conceiving.
  • Being obese or overweight: This can increase the risk of infertility in women as well as men.
  • Eating disorders: If an eating disorder leads to serious weight loss, fertility problems may arise.
  • Diet: A lack of folic acid, iron, zinc, and vitamin B-12 can affect fertility. Women who are at risk, including those on a vegan diet, should ask the doctor about supplements.
  • Exercise: Both too much and too little exercise can lead to fertility problems.
  • Sexually transmitted infections (STIs): Chlamydia can damage the fallopian tubes in a woman and cause inflammation in a man’s scrotum. Some other STIs may also cause infertility.
  • Exposure to some chemicals: Some pesticides, herbicides, metals, such as lead, and solvents have been linked to fertility problems in both men and women. A mouse study has suggested that ingredients in some household detergents may reduce fertility.
  • Mental stress: This may affect female ovulation and male sperm production and can lead to reduced sexual activity.