Understanding the causes of infertility can help women take preventative measures. For example, certain medications can cause infertility, and that is one of the causes of infertility we’ll be discussing in this article.
1 in 8 couples of “reproductive age” experience infertility. Approximately 7.4 million women have received professional help for the various causes of infertility in women during their lifetime.
Furthermore, approximately 12% of married women currently state that they have had trouble getting pregnant or sustaining their pregnancy. Statistics such as these demonstrate fertility issues in women are more common than many people realize.
“Infertility” in women is a term used to refer to ongoing difficulties trying to get pregnant or maintain a successful pregnancy. The condition of infertility is often diagnosed after a woman attempts to get pregnant for 12 months without results.
While all women can potentially struggle with fertility issues, the risk of these problems increases according to certain factors. Everything from your age to your genetics may have a part to play when it comes to possible causes of infertility.
What is Infertility in Women?
Female infertility is a condition in which a person’s ability to get pregnant, carry a pregnancy to full term, and give birth is somehow impaired or limited. Studies suggest after 1 year of having unprotected sex, up to 15% of couples are unable to conceive. After 2 years, 10% of these couples will still not have successfully had a baby.
Female infertility is common, but the causes have yet to be fully identified. Most experts and researchers agree a number of factors can influence the fertility of a woman.
During an examination, a doctor will often ask a number of questions and conduct various tests to diagnose female infertility. You may need to answer questions such as:
- Have you ever had any previous miscarriages or pregnancies?
- Is your menstrual cycle normal and regular, or irregular or painful?
- Do you experience abnormal discharge or heavy bleeding regularly?
- Do you have pain in your pelvis, and is this pain worse at certain times (such as during sex?)
- Have you had abdominal or genital surgeries in the past?
How Does Age Impact Female Fertility?
The biggest factor in infertility is age. While fertility declines with age in both men and women, the effects of age can be more significant in women. In their thirties, women are half as fertile as they are during their early 20s. A woman’s chance of conception also declines significantly the further she progresses into her 30s.
Female fertility starts to decrease from the age of 32 for most women, but the chances of a successful pregnancy reduce significantly after the age of 37. Age is becoming a more common actor in female infertility issues as more couples are waiting to have children until their 30s and 40s.
As a woman gets older, her production of certain hormones crucial to pregnancy begins to diminish, and problems with the uterus become increasingly common.
Problems with egg number and quality are common, as women are born with all the eggs they’ll ever have. This supply can “run out” before menopause occurs. What’s more, some eggs will not be able to fertilize or grow a healthy fetus, due to chromosomal issues.
Causes of Infertility: Issues with Ovulation
Infertility can be caused by a range of factors. In one in four cases where couples are unable to maintain a pregnancy, a reason cannot be found. In other cases, defining an exact cause can be complicated, as various factors may be contributing to an inappropriate biological environment for a child.
Most causes of infertility in women are issues that influence ovulation, the process in which an egg is released by the ovaries.
Ovulation problems can emerge as a result of pre-existing conditions, such as polycystic ovary syndrome, underactive or overactive thyroid glands, and premature ovarian failure. Pelvic injuries or conditions which require surgery may also lead to scarring in the fallopian tubes, which prevent eggs from being released regularly.
Other issues which influence both ovulation and fertility include:
- Cervical mucus problems: When a woman is ovulating, the mucus in her cervix becomes thinner, allowing for the movement of sperm to the egg. If there’s a problem with your mucus, this could make it harder to conceive. In some cases, doctors can conduct tests to determine “mucus hostility” in the cervix.
- Fibroids: Women can experience a number of growths (often non-cancerous) called “fibroids” throughout their body. Approximately 26 million women are currently estimated to have uterine fibroids. Some fibroids around the womb and uterus can cause issues with fertility, by preventing a fertilized egg from attaching itself to the womb or blocking fallopian tubes.
- Pelvic Inflammatory disease: PID, or Pelvic Inflammatory disease is an infection of the upper female genital tract, which contains the fallopian tubes, womb and ovaries. This is often caused by a sexually transmitted infection which causes scars and damage to the fallopian tubes. Common causes of PID include chlamydia and gonorrhea.
- Endometriosis: A condition called endometriosis involves small pieces of the womb lining starting to grow in various places, such as the ovaries. This can lead to damage in the fallopian tubes, causing infertility issues.
Can Medication Influence Fertility?
Certain medicines can influence fertility. The long-term use of NSAIDs such as ibuprofen and aspirin may make it more difficult to conceive.
Chemotherapy medications can sometimes cause ovarian failure, which means the ovaries cannot function as normal. Neuroleptic medicines (antipsychotics) can also cause missed periods. Illegal drugs such as cocaine can also seriously influence fertility.
Often when taking medication or acute and chronic conditions, it’s best to ask your doctor whether the use of these substances will have any impact on your attempts to become pregnant.
How Do Doctors Test for Female Infertility?
Some tests can also be done, such as an examination of the breasts for unusual milk production, a pelvic exam, and a pap smear test, to further evaluate potential issues which may be causing infertility. Some doctors recommend:
- Blood tests: Lab tests conducted with blood will depend on your health history and diagnoses considered by your doctor. Doctors may test ovarian reserve and progesterone (a hormone critical to the menstrual cycle which signals ovulation).
- X-ray Hysterosalpingogram: A “HSG” test involves injecting dye into the cervix so the caregiver can watch the dye move through the fallopian tube with an X-ray, testing for blockages and potential fibroids.
- Laparoscopy: Small monitoring instruments called laparoscopes can be inserted into the abdomen to examine the organs.
- Transvaginal ultrasound: In this test, an ultrasound wand can be inserted into the vagina to allow for a better view of organs like the ovaries and uterus.
- Hysteroscopy: A hysteroscope (a small, thin device with a camera attached to it), can be inserted into the cervix to view the inside of the organ.
- Saline sonohysterogram: This test looks at the lining of the uterus to examine for structural abnormalities during a transvaginal ultrasound.
Are Some Women at Greater Risk of Infertility?
Some people are less likely to successfully carry a pregnancy than others. Your DNA test from CircleDNA could show you if you have genetic factors which influence your fertility levels. Lower amounts of fertility hormones can be passed down through generations. Genetic studies have also identified mutations in genes that can contribute to reproductive disorders.
Inherited traits can also increase your risk of other conditions which may harm fertility rates. For instance, eating disorders can significantly lower your chances of a successful pregnancy, and research indicates your likelihood of having these conditions may be higher if other people in your family have also suffered from eating issues.
Issues with abnormal menstrual cycles and endometriosis can be passed through genetics. Some people also have a higher risk of obesity or being underweight. Both of these conditions can negatively influence fertility. Other factors linked to genetics include:
- Uterine fibroids and cysts
- Autoimmune disorders such thyroid gland conditions and lupus
- PCOS (Polycystic ovary syndrome)
Certain lifestyle changes can increase your risks as well. Excessive substance use including heavy drinking and smoking can cause infertility by creating an imbalance in your hormones and reducing the natural progress of the menstrual cycle. If you’re concerned you may have a higher risk of infertility than most, speaking to a doctor and getting a DNA test can give you a better insight into the genetic elements which may influence your family planning.
Can Women Overcome Infertility Issues?
If your healthcare provider diagnoses a case of female infertility, tests will be conducted to determine the cause. There are a variety of treatment options depending on the reason for infertility. Structural problems can be treated via surgery, while hormonal medications may be useful for ovulation issues and thyroid conditions.
Some patients require artificial insemination, or in vitro fertilization to improve their chances of a successful pregnancy, while others will simply need to make lifestyle changes, such as reducing alcohol consumption, quitting smoking, or changing medications that harm fertility.
While most forms of female infertility cannot be prevented or predicted, you can take steps to reduce your risk, such as maintaining a healthy weight, developing good dietary habits, and going for regular examinations at your doctor’s surgery to ensure your reproductive health.
If you have a problem with female infertility, your doctor will be able to suggest a potential treatment course based on your case. The faster treatment begins, the better your chances of success will be, as the older you get, the more problems you may encounter. Any issues with fertility need to be addressed as soon as possible.