Potential Signs You May Have Fertility Problems (& How To Move Forward Confidently)
Deciding that you are ready for a child is a huge change in life — and as with any change, it comes with a plethora of difficulties and obstacles. Attempting to get pregnant can be emotionally and physically challenging, especially if you haven't had much luck thus far. Often, getting pregnant takes a lot of time and patience, even when you're following all the tips, tricks, and rules in every mommy book on the planet. The American Pregnancy Association says that couples usually have success conceiving "within one year," which is a lot longer than many people may think.
However, if your attempts at conception have lasted much longer or proved more difficult than typical, more complex fertility issues may be involved. Fertility issues sound scary and hopeless at first, but finding out the root cause for your difficulty carrying a baby means finding possible solutions, too. In fact, many women who believe that they cannot get pregnant due to fertility issues often find themselves surprised by a positive pregnancy test. Figuring out if you do have fertility problems can alleviate some of the stress that comes with conception, as well as provide much-needed answers and solutions going forward.
Your medical history
You're healthy, young, and so far as you know, there's just no reason for you to be having difficulty conceiving. What gives? The answer may lay in the medical history you've written off as unimportant. Ex-smokers, for example, may continue to have fertility issues long after giving up the habit.
"Current cigarette smokers take longer to get pregnant, have increased complications, and have lower pregnancy rates after fertility treatments,' Dr. Sheeva Talebian, an NYC-based fertility specialist, tells Women's Health. "It's also known that smoking accelerates the rate of egg loss." Drinking alcohol while trying to conceive can also decrease your chances of getting pregnant (via WebMD).
A history of cancer may also affect your fertility, or rather, cancer treatment. The American Cancer Society says that especially goes for any radiation therapy "that's aimed at or around a woman's reproductive organs." Cancer itself (depending on the type) can also pose risks and complications to both pregnancy and conception. Asking your doctor about another seemingly innocuous medical history may reveal hidden ties to fertility issues and solutions for increasing your chances of becoming pregnant.
An irregular menstrual cycle
Having an irregular period can be a pain in day-to-day life, so it may not come as a surprise that it would affect your attempts to get pregnant as well. "A 'normal' cycle is anywhere between 21 to 35 days with consistently not more than a two to three-day variance from cycle to cycle," OBGYN Emilee Sandsmark, MD, tells Banner Health. "Any cycle that occurs more or less frequently than this is considered abnormal ..."
With a cycle that doesn't vary, it's much easier to track things like ovulation, though even today, there are things about the menstrual cycle that many women don't know. There are plenty of period myths you need to stop believing, but the fertility window isn't one of them. Tracking that can be hard enough with a regularly occurring cycle, and an irregular period can make finding your windows of fertility more difficult.
Banner Health also reports that irregular periods are caused by a few different things — and "irregular ovulation" is often the culprit. Those with "irregular ovulation" can still get pregnant; they may just have a more difficult time doing so. Your doctor or OBGYN should be able to help you figure out the exact cause of your irregular cycle and whether medical intervention is your best bet.
You're over 35 years old
Passing 35 years old may not feel like a huge milestone, especially when you may have the big five-oh to look forward to in the future. You're not old, so why should 35 matter? After all, plenty of people are now waiting until their 30s or 40s to start having children. The American College of Obstetricians and Gynecologists says that fertility will "decline" in your 30s, and by the time you hit 35, that decline becomes more rapid. There are many things women should know about their biological clock, one of them is that as you age, your ovaries and eggs age right alongside you, becoming less viable for pregnancy.
Health problems become more likely after 35 as well. Things like high blood pressure or pregnancy-related complications, such as preeclampsia, are more likely to occur after 35. Luckily, there are plenty of ways to treat age-related infertility, starting with infertility evaluations. Those who have passed 40 should talk to an OBGYN about infertility testing prior to attempting to conceive. If you are in your 30s, you should look into it if you have been having difficulty conceiving after six months of actively trying.
You've miscarried before
According to the Mayo Clinic, only about 1% of women experience "repeated miscarriages." However, after a second miscarriage, the odds tend to increase. While most miscarriages are due to a problem with the fetus, such as "problems with the baby's chromosomes," they may be an indication of another problem. "Poorly controlled diabetes or a uterine problem" can lead to miscarriages, so if you have already experienced one, it could be that one of these issues may still be present. The added emotional and physical strain of having experienced a miscarriage may also affect your ability to conceive.
If you have had multiple miscarriages, be certain to see a health provider, as tests can be run to identify the main issue. In the meantime, however, there are steps you can take to increase your likelihood of a healthy pregnancy. Maintaining a healthy lifestyle is key; managing your vitamin intake, exercising, and eating leafy greens can boost your health. Taking prenatal vitamins or folic acid supplements can also help, especially if you begin a few months before you attempt to get pregnant. As with any change to your health regime, make sure to do careful research and get a consultation from your healthcare provider.
You've had STIs
There are several things every sexually active person should know about preventing STDs, and the most important is that you get screened annually. While it is likely that you may have just one partner if you are attempting to get pregnant, if you have not been tested since you began seeing one another, it is important to get tested in case either of you are unaware of a pre-existing infection.
Some sexually transmitted diseases — chlamydia and gonorrhea — can cause permanent damage if left untreated and may not always be recognizable without testing. In fact, most women have no symptoms. For this reason, even if you are reasonably sure you don't have any STDs, getting checked out is still a good idea. And if you know you've had one, you should talk to your doctor about how to proceed.
Chlamydia and gonorrhea can also cause pelvic inflammatory disease. The CDC reports that "about 10-15% of women with chlamydia will develop PID." Sexually transmitted infections can severely damage your reproductive system, including "the fallopian tubes, uterus, and surrounding tissues." Damage of this kind is frequently linked to infertility. So, if you have had an STI or STD, talk to your doctor about it, as there may be lasting damage you were unaware of.
You may have endometriosis
Even though about 10% of women experience endometriosis (via the World Health Organization), it still seems shrouded in mystery. It can be difficult to receive a diagnosis, so many women with endometriosis may not know they have it. If your irregular menstrual cycle isn't due to an irregular ovulation cycle, it may be the work of endometriosis. Endometriosis' most prevalent symptom is pelvic pain, so many simply think they have bad cramps and fail to realize they may have the condition. If you think you may be affected by endometriosis, stick to your guns and make sure you're being heard by your doctor.
The condition is unfortunately also linked to infertility and "increased risk of having difficulty becoming pregnant," according to Brigham and Women's Hospital. There are treatments for endometriosis-related fertility issues, so if you think you may have the condition, seek out a medical professional's opinion. Aside from increased period pain or an irregular cycle, you can look for signs like pain during intercourse, pain while using the bathroom, and fatigue. While it may be discouraging to receive a diagnosis initially, knowing that there is something you can do to alleviate your pain may ultimately lead to feeling more optimistic and in control of your situation.
You may have PCOS
Much like endometriosis, PCOS (or polycystic ovarian syndrome) sometimes gets swept under the rug. However, the CDC says that this condition is "one of the most common causes of female infertility." PCOS causes the ovary not to release an egg at the end of the menstrual cycle every time it's supposed to (or they don't release at all). Obviously, this can be a huge concern regarding pregnancy, as you cannot conceive without the egg being where it's supposed to be. Like endometriosis, one of the most telling symptoms of PCOS is an irregular period, but other symptoms include things like more obvious facial hair, acne, weight problems, and, of course, difficulty becoming pregnant.
Luckily, there are a number of different treatments specifically for becoming pregnant when you have PCOS. While there are some other risks you may have during your pregnancy in relation to PCOS, it has largely been seen that the condition can be overcome in regard to conception, especially for women under the age of 35. Talking to your doctor or OBGYN can help you decide if you need to be tested for PCOS and what your next steps will look like. This is another condition that can be tricky to get a diagnosis, so be firm with your doctor when it comes to testing, and don't allow them to brush off your concerns.
Your weight
Better Health states that being underweight or overweight can significantly impact fertility in women, with the latter affecting men's fertility as well. Most often, this is because being outside of your ideal BMI can cause hormone imbalances. Those who are underweight are especially likely not to consider this, so be sure to find your ideal BMI before passing this over as an answer to your fertility issues.
In either case, you can consult with a dietitian to start a plan to get your body to an ideal weight for pregnancy. In general, eating healthy food and drinking plenty of water are good tips. Your exercise routine can affect your fertility as well, so putting together a fitness plan can benefit you in the long run.
Having your partner engage in these lifestyle changes can also benefit you, both in reaching your weight goal and helping with their side of the puzzle. Be sure to do your research and consult with a healthcare professional, especially if you may become pregnant during the change to your usual health regimen.
Exposure to environmental toxins
It can be easy to scoff at the idea of being exposed to a toxin — you'd probably remember if you had an accident while touring a nuclear power plant, right? However, there are plenty of toxins you may be exposed to in everyday life that can cause your fertility problems. The most concerning toxins you may have been exposed to are "endocrine disrupting chemicals (EDCs)," according to a study conducted by StatPearls. EDCs can come from things you never would have considered: soy products, teas, lubricants, and lavender oils.
More obvious are things like industrial chemicals, including flame retardants and pesticides. There is also the possibility of heavy metal exposure — there's a reason that we've become so careful about lead paint, after all. Aside from lead, there's also the chance of "exposure" to arsenic or mercury, both of which can sometimes contaminate food or water supplies.
While it may be hard to think of an incident where you could have been exposed to an environmental toxin, testing can further help you determine if this may be a possibility factoring into your difficulty conceiving. Talk to your doctor or OBGYN about the possibility, and if you think you have recently been exposed, call Poison Control or your local health department immediately.
Non-reproductive diseases
If you have an illness not directly related to reproduction, you may not have taken it into account when thinking about fertility issues. However, many conditions can have an effect on fertility. The Cleveland Clinic says celiac disease, kidney disease, pituitary gland disorders, sickle cell anemia, and thyroid disease are all factors in female infertility. Countless other health conditions can be tied to fertility and reproductive health, even if they may seem unrelated at first glance.
There's no one list that can encompass all illnesses and disorders that can impact your fertility, so if you or your partner have any health issues, they're worth bringing up at your next health appointment. If you have not been diagnosed with anything, it's also worth looking into your family history, as many disorders are genetic. Poor health, in general, can affect your ability to conceive, so if it's been a tough year of bouncing from one bug to the next, you may need a little time for your body to recuperate before it's ready for pregnancy.
You've been trying for over a year
You may not have any obvious symptoms, which can be frustrating, especially after trying for so long! However, the Mayo Clinic says that simply "not getting pregnant" is the "main sign" of infertility and that after a year of trying, it's time to talk to your healthcare provider. They also report that "most couples will eventually conceive," so don't lose hope! As always, there are plenty of treatments and plans your healthcare provider can recommend to overcome infertility and start you down the road to a healthy conception.
Even if it hasn't been a year, visiting your doctor when you begin trying to conceive is a good idea. Your healthcare provider can tell you how often you should be seeing your gynecologist, the risk factors you may be facing, and give you tips on safely carrying to term. Making sure you're up to date on other healthcare procedures can also be beneficial for your pregnancy, and having prenatal care either suggested or prescribed to you can help your pregnancy as well.
Your partner may be infertile
As with women, there are a host of other causes for male infertility that can be investigated. "... 50 percent of infertility cases are in part caused by men," urologist and reproductive specialist Martin Kathrins, MD, tells Brigham and Women's Hospital. "Infertile men don't typically have symptoms. The most reliable way to diagnose male infertility is if they haven't been able to conceive for a year," she says.
Seeing a healthcare professional can help determine if infertility may be on your partner's side and can help you and your partner combat the issue. No matter where the issue lies, be sure to treat yourself and your partner with respect, love, patience, and understanding.
Infertility is no one's fault and can often be extremely distressing for the party with the complication. Take each step in your journey toward pregnancy gently, leaving you and your partner room to communicate and love one another as a team. There are always ways to move forward and address infertility, so don't lose hope!