Infertility is defined as the attempt to have a child (by having frequent sexual intercourse) for at least one year without success. Female infertility, male infertility, or a combination of the two affects millions of couples in the United States. It is estimated that 10 to 18 percent of couples have trouble having a baby or having a successful delivery.
Infertility is due to female factors about one-third of the time and malefactors about one-third of the time. In all other cases, the cause is unknown or a combination of male and female factors.
The causes of female infertility can be difficult to diagnose. There are many treatments available that will depend on the cause of infertility. Many infertile couples will be able to conceive an untreated child. After trying to have a child for two years, about 95 percent of couples conceive successfully.
The main symptom of infertility is the inability to become pregnant. A menstrual cycle that is too long (35 days or more), too short (less than 21 days), irregular, or absent may mean that you are not ovulating. There may not be any other obvious signs or symptoms.
When to see your doctor
When to seek help depends on your age:
- Until age 35, most doctors will recommend that you try to get pregnant for at least a year before getting tested or treated.
- If you’re between 35 and 40, discuss your concerns with your doctor after six months of trying.
- If you’re over 40, your doctor may want to start testing or treatment right away.
Your doctor may also want to start testing or treatment right away if you or your partner have known fertility problems or if you have a history of irregular or painful periods, pelvic inflammatory disease, miscarriages, previous cancer treatment, or endometriosis.
Each of the following factors is essential to getting pregnant:
- You must ovulate. To become pregnant, your ovaries must produce an egg and release it, a process known as “ovulation. Your doctor can help you evaluate your menstrual cycles and confirm that you are ovulating.
- Your partner should have sperm. This is not a problem for most couples unless your partner has a history of illness or surgery. Your doctor may do some simple tests to check the health of your partner’s sperm.
- You should have regular sex. You should have frequent sex during your fertile time. Your doctor can help you better understand when you are most fertile.
- You should have open fallopian tubes and a normal uterus. The egg and sperm are found in the fallopian tubes, and the embryo needs a healthy uterus to develop.
For pregnancy to occur, every step of the human reproductive process must occur correctly. The steps of that process are:
- One of the two ovaries releases a mature egg.
- The fallopian tube takes it.
- The sperm ascends through the cervix, passes through the uterus, and enters the fallopian tubes to reach the egg and fertilize it.
- The fertilized ovary travels down the fallopian tubes to the uterus.
- It implants and grows in the uterus.
- In women, several factors can alter the process at any stage. One or more of the following factors can cause female infertility.
- Age. Women’s egg quality and quantity begin to decrease as they age. Around age 35, the rate of follicle loss accelerates, resulting in fewer and lower quality eggs. This makes conception more difficult and increases the risk of miscarriage.
- Smoking. In addition to damaging the cervix and fallopian tubes, smoking increases the risk of miscarriage and ectopic pregnancy. It is also thought to age the ovaries and deplete eggs prematurely. Quit smoking before starting fertility treatment.
- Weight. Being overweight or very underweight can affect normal ovulation. Having a healthy body mass index (BMI) can increase the frequency of ovulation and the likelihood that you will get pregnant.
- Sexual history. Sexually transmitted infections, such as chlamydia infection and gonorrhea, can damage the fallopian tubes. Having unprotected sex with multiple partners increases the risk of getting a sexually transmitted disease that can later cause fertility problems.
- Alcohol. Maintain a moderate alcohol intake of no more than one alcoholic beverage per day.
If you are thinking about getting pregnant soon or in the future, you can increase your chances of having normal fertility if:
- You maintain a normal weight. Women who are overweight and underweight are at greater risk for ovulation disorders. If you need to lose weight, exercise moderately. Intense strenuous exercise for more than five hours a week has been associated with decreased ovulation.
- Stop smoking. Tobacco has several negative effects on fertility, not to mention negative effects on overall health and the health of the fetus. If you smoke and are thinking about becoming pregnant, quit smoking now.
- Avoid alcohol. Excessive alcohol consumption can lead to decreased fertility. Drinking alcohol can affect the health of a developing fetus. If you are planning to become pregnant, avoid alcohol and do not drink alcohol while you are pregnant.
- Reduce stress. Some studies have shown that couples who suffer psychological stress have less effective results in sterility treatments. If you can, find ways to reduce the stress in your life before you try to get pregnant.
- Limit caffeine. Research suggests that limiting caffeine intake to less than 200 milligrams per day should not affect your ability to get pregnant. That’s 1 to 2 6 to 8-ounce cups of coffee per day.