What you need to know about infertility in women

August 21, 2022

Did you know that 1 in 6 couples experience difficulty conceiving? [1]

Turns out getting pregnant is not as straightforward as your high school sex education teacher made it seem.

There are a lot of factors that need to line up in order for an egg to fertilize, and intentionally conceiving takes calculation and strategy for most couples.

Unfortunately, the lack of common knowledge about conception has created a stigma around infertility that makes people feel ashamed and insecure.

What is the definition of infertility?

Infertility is defined as the inability to become pregnant after 12 months of regular unprotected sex. [2]

This is due to the concept of cumulative pregnancy rate, meaning that the chances of a woman getting pregnant increase over the first twelve months of trying before they statistically plateau.

The truth is, difficulty conceiving is common and there are lots of ways to check and improve your fertility status.

*Please note that both male and female fertility are important for conception, but we will be focusing on female infertility in this article.

What are the signs of potential infertility in women?

Infertility is not always obvious, apart from the main symptom being inability to get pregnant.

However, there are many signs that can be signs of a medical condition that is linked to infertility which should be explored further if you are experiencing them. [3]

These include:

Pelvic pain
Irregular or missed periods
Extremely heavy periods
Extremely painful periods
Spotting between cycles
Pain during sex
Loss of sex drive
Hair loss or thinning
Increased growth of body hair
Sudden and severe adult acne

What are the risk factors for infertility?

Age

Women over 35 are more likely to experience infertility.

This is because women do not produce new eggs over the course of their lifetime. Women are born with all their eggs and they become less viable with age.

Weight

Women that are underweight or overweight produce lower levels of estrogen, making them more likely to experience infertility.

Lifestyle

There are many lifestyle factors that can affect fertility, including alcohol consumption, cigarette smoking, drug use, excessive exercise, lack of exercise, and nutrition.

Genetics

Unfortunately, genetic abnormalities and defects can play a role in infertility.

What are the medical conditions that can cause infertility in women?

Endocrine Disorders

The endocrine system is a complex network that is responsible for hormone production. When the hormones responsible for a woman's reproduction are disrupted, it can lead to infertility. Some common examples include pituitary disorder, thyroid dysfunction. [1]

Disorders of ovaries

Ovarian disorders such as polycystic ovarian syndrome (PCOS) or primary ovarian insufficiency (early menopause) can affect the ovulation process, which can lead to difficulty conceiving. [4,5]

Structural problems of reproductive system

Abnormalities in the structure or growth of abnormal tissues within the reproductive organs can sometimes impact a woman’s fertility. Common causes can include blockage in the fallopian tube, multiple and/or large fibroids that grow towards the inside of the uterus, or scar tissues from previous injuries, infections, or procedures. Sometimes an unusually shaped uterus can affect implantation as well. These structural issues can become hindrance for movement of the egg or implantation. [6]

Uterine Disorders

Endometriosis is a common gynecological condition where the inner lining of the uterus migrates to nearby organs, commonly found on ovaries, bowel, or pelvic walls. While it is not fully understood how this is linked to infertility, it may be due to its inflammatory nature and/or obstructions caused by growth of scar tissues and adhesions. [6]

Other medical conditions

Some other medical conditions that can affect fertility include autoimmune disease, sexually transmitted disease, cancer, and pelvic inflammatory disease. [6]

How is infertility in women diagnosed?

There are a range of tests that doctors and specialists may order to diagnose any medical conditions listed above, and eventually give a good picture of your fertility status.

Blood tests

A full blood test that includes testing your kidney, liver, full blood count, thyroid, and essential vitamins and mineral levels are usually the starting point for most doctors. It is a good guide to check that all your organs are functioning properly, and the levels are within range. Hormone levels are commonly checked and some doctor may request blood tests including immunity against certain infections, sexually transmitted diseases, and genetic testing. [7]

Ultrasound

To check your reproductive organs, having an ultrasound is one of the most important scans to check your fertility. This can be done from the outside on your belly, or inside the vagina, which is called a transvaginal ultrasound. This allows the technician or doctor to see the structures of your uterus, ovaries, cervix, tubes, and pelvic area, and may be able to pick up some structural abnormalities. [7]

Pap smear

Doctors may perform a pap smear to check for or signs of infections, which can detect cervical cancer. [7]

Hystero-Salpingo contrast Sonography

A HyCoSy is an ultrasound performed to check if the fallopian tubes are blocked. This is usually referred to by a fertility doctor or gynecologist when women get to deeper investigations in their fertility. [8]

Anti-Mullerian Hormone test (AMH test)

Anti-Mullerian hormone is a hormone secreted by cells in the follicles. This is a blood test that can indicate a woman’s ovarian reserve. The test result is usually shown relative to a woman’s age as the amount of eggs and how many fertile years you have can differ. [9]

Cycle tracking

Cycle tracking can be a starting point when a woman starts seeing a fertility doctor. Multiple blood tests and ultrasounds are conducted throughout the cycle to check that all the reproductive hormones are at the right levels at the right time, and scans are done on very specific days of your cycle to see if ovulation is happening as expected. For some women this is a good way to find out exactly what days they ovulate, and can plan around this much more efficiently. [10]

When should I see a doctor?

The guidelines recommend women seeking medical help if they are unsuccessful after trying for 12 months, or 6 months if you are over 35 years old.

Having said that, you can see your GP as soon as you start planning for a pregnancy. You don’t always have to wait until there is a problem to reach out to health care professionals.

The good thing about seeing a doctor as early as you can, is that the doctor can run some simple tests to check your baseline health, which he/she can give you a guidance on what prenatal supplements to take, what sort of diet to go on, and any other health advice you may need for you and your partner.

Is there anything I can do to improve fertility?

While many causes of infertility require clinical treatment, there is no harm in making sure that you are as healthy as possible while trying to conceive.

It is important to remember that even if we are at a healthy weight, regular and consistent exercise is a critical part of a healthy lifestyle. Our bodies are designed to move, and there are so many benefits to regular exercise other than weight management.

Of course, eat a well-rounded diet and avoid processed foods. Consume organic produce when possible, as agricultural chemicals are known endocrine disruptors. [11]

If you have been drinking alcohol or smoking cigarettes, now can be a good time to make some lifestyle adjustments. While stopping everything cold turkey can be difficult, make little steps by educating yourself and making little conscious changes, even gradual reductions can be significant for your health and your future baby.

You don’t have to start taking prenatal supplements only when you fall pregnant, a lot of times it can be beneficial to start taking them when you start family planning. On top of having a well balanced diet, supplements can give you that boost for the essential vitamins and minerals needed for you and your baby’s health.

There are also numerous herbal allies that can help support your reproductive system. Again these are all things you can do in addition to a healthy diet and lifestyle. You can explore some options here.

You’ll also want to minimize the amount of household and environmental toxins that you are exposed to. Always opt for natural products, make sure your lube is sperm-safe, and avoid using plastics with BPA.

Lastly, make sure that you are getting enough rest and taking good care of your mental health. The body heals and repairs itself during sleep, so quality rest is a fundamental pillar of good health.

Struggling with infertility is also taxing emotionally, so make sure that you are leaning on your loved ones. You have nothing to be ashamed of, and you don’t have to go through it alone.

Above all else, don’t lose hope.

Remember, there are tons of variables and conditions that can affect fertility, but this doesn’t necessarily mean that they will.

Symptoms associated with infertility can also be associated with other issues, and pre-existing medical conditions don’t eliminate all odds of conceiving a child. As long as you have an ovary, and a uterus, it is a good starting point to have a baby.

Always consult with a medical professional if you’re having concerns, don’t be afraid to get a second or third opinion, and remember that your body is hard-wired for healing.

Infertility is a difficult challenge to face, but you are capable of amazing things!

References:

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What you need to know about infertility in women

Did you know that 1 in 6 couples experience difficulty conceiving? [1]

What is the definition of infertility?

What are the signs of potential infertility in women?

What are the risk factors for infertility?