Common Causes of Infertility

Being unable to reproduce is a truly difficult condition for a lot of women who dream of starting a family. Perhaps you and your partner have made the decision to have a baby, but no matter how much you try you are not able to conceive the child. It can be disappointing, frustrating and devastating to struggle with these issues.

But why do women have trouble conceiving? The truth is that there is no one specific reason, there are many different reasons that could have an influence. Sometimes infertility is due to a disease, or a condition, or simply the natural aging process. There are many reasons that could come into play. If you have been trying to conceive with no success, it is important to talk to your doctor so that you can figure out what the problem might be and what your options are. However, your doctor or gynaecologist usually would not start any fertility investigations unless you’ve been trying for at least 12 months ¹.

Here are some of the reasons why some women are not able to reproduce:

PCOS

One of the issues that can be preventing women from being able to reproduce is a disease called PCOS. If you suspect that you are suffering from this syndrome it is important to see your doctor as soon as possible, so that you can receive a diagnosis and a treatment plan.

PCOS stands for polycystic ovary syndrome and it is caused be a hormone imbalance that disrupts ovulation. The ovaries can develop several small cysts and they will not mature one egg every cycle. Some of the symptoms of this condition include excessive hair growth, weight gain, acne and irregular menstrual periods.

This condition is more prevalent in women who are overweight. Obesity is a risk factor that can damage your long term health, decrease your chances of conceiving and cause more issues in your pregnancy. If you are overweight or obese, take steps to manage your diet and increase your activity

Some of the possible ways of dealing with this condition include changing diet and lifestyle if you are overweight. Also, there are ovulation stimulating drugs such as gonadotropins and clomiphene as well as IVF. A weight loss of only 5% can re-start regular ovulation in obese women².

Endometrosis

This is a condition in which endometrial tissue, which is the uterine lining that usually sheds with each monthly period, starts to grow outside of the uterus. This can cause all sorts of problems, including ovulation problems and tubal blockages. When the pieces of the womb lining grow in the wrong places, they will block and distort the pelvis and make it very difficult for an egg to be released and become implanted in the womb.

The symptoms of this issue include pain during penetrative intercourse, painful periods, chronic pelvic pain, painful bowel movements during menstruation and painful urination. However, there can also be no symptoms at all other than a difficulty conceiving. The pain is described as a stabbing pain or severe cramping that occurs within the pelvis, in the lower back and even down the legs. The amount of pain that a woman with endometriosis feels does not necessarily correlate with the extent or severity of the condition. Some will have little or no pain while having extensive endometriosis while others will have severe pain yet are only slightly affected by the disease.

There is no cure for the condition, but there are a number of treatments that might help with the symptoms. The possible solution for endometriosis can be laparoscopic surgery in order to remove the abnormal tissue or unblock the tubes. There are also some drugs available for more severe cases, or in vitro fertilisation. After the surgery, 81-84% of patients are able to conceive in most of the mild cases and 36-66% in severe cases³.

The cause of endometriosis is not entirely clear, but you are more at risk if you have a family history of the condition. Sisters or daughters of women with the condition are at a higher risk of developing it themselves. There is tentative evidence that seems to suggest that the use of combined oral contraceptives will reduce the risk of endometriosis. Also, cutting down your alcohol consumption and exercising more will help to prevent against this issue.

Fibroids

Another issue that can cause infertility is fibroids. These are non-cancerous tumors of muscle tissue that grow within the uterus. They happen when a single muscle cell in the uterine wall starts to multiply and grows to form a tumor. They are not life threatening, but they can change the size and shape of the uterus which will decrease fertility. Fibroids are usually found within the body of the uterus, but something they are also found in the cervix or attached to nearby organs such as the bowel or bladder.

Fibroids are a relatively common problem; they are found in 20% of women of reproductive age. They are more common in women of African origin. The exact cause of these growth is unclear but they are thought to be a combination of hormonal, genetic and environmental factors. They can be small or large and they can affect women in different ways.

Fibroids affect fertility in many ways. They will affect whether or not the egg and the sperm meet, whether the embryo is able to implant, the positioning and growth of the baby and whether the pregnancy can continue. Fibroids that are located within the uterine cavity or that change the shape of the cavity will decrease fertility by approximately 70%. Fortunately, when those fibroids are removed fertility will return to normal. If you suffer from fibroids, talk to your doctor about the best strategy for removing them so that you can increase your chances for conceiving a child.

Biological Clock

Many women are waiting until they are in their 30s or even 40s to have children. In the USA, around 20% of women are now having the first child after the age of 35. There are a lot of advantages to waiting until you are slightly older to have a baby. You will likely be more financially stable, you can enjoy things like travel while you are in your 20s before settling down and you will have more wisdom and experience to impart to your child. However, waiting too long means that you are running the risk of your biological clock running out.

As a woman grows older her ovaries become less able to release eggs. Also, she has a smaller number of eggs left and they are not as healthy. Also, she is more likely to have health conditions that will cause fertility problems and she is more likely to have a miscarriage. Don’t wait too long to have a child, unless you are happy with the possibility that you might not be able to conceive your own.

Options for older women include surrogacy, adoption or egg or embryo donation. Approximately 33% of women who use donor eggs or embryos in IVF treatment have a successful pregnancy.

Obesity

Being overweight or obese will negatively affect your chances of conceiving and of having a healthy baby. If you are planning to get pregnant, it is important to get regular exercise, eat a healthy diet and commit to losing weight. If your BMI is higher than 40 your doctor might recommend that you have gastric band surgery as a way to help you lose the weight. If your BMI is in the 25-40 range you will likely be able to lose the weight through a combination of diet and exercise. It’s difficult to change your lifestyle at first, but after a while you will get used to your new healthy habits and your overall health will change for the better.

Obesity can affect fertility because it causes hormonal imbalances and problems with ovulation, especially for obese women who are having their first baby. It is not exactly clear how this works, but the theory is that obesity causes disruptions in the hormone leptin which regulates appetite and energy expenditure and might prevent fertilization. Also, obesity will increase your risk of Polycystic Ovary Syndrome which is a common cause of infertility.

Not only does being obese make it more difficult to conceive, it will also increase the risk of complications in the pregnancy and health issues for the baby. This includes miscarriage, pre-eclampsia, hypertension, infection, blood clotting, gestational diabetes and much more.

On the other side of things, being underweight to an unhealthy level can also reduce a woman’s fertility. It will cause an imbalance in hormones that will affect ovulation and decrease her chances of getting pregnant. It can also cause irregular periods which make it difficult to predict the day to ‘try’.

The ideal BMI you should try to attain is between 20-25⁴.

STDs

There are a few different types of sexually transmitted diseases that can cause infertility, which is why it is important to be checked for these diseases on a regular basis. Some STDs have no symptoms, so they should be screened for regularly.

Gonorrhea and Chlamydia are preventable causes of pelvic inflammatory disease (PID) which can lead to infertility. If it is left untreated, approximately 10-15% of women with chlamydia will develop PID. Also, chlamydia can cause an infection of the fallopian tubes without any symptoms.

These “silent” infections of the upper genital tract can cause permanent damage to the uterus, fallopian tubes and the surrounding tissues – which will lead to infertility. Chlamydia and gonorrhea can cause inflammation of the cervix and the urethra, which can cause vaginal spotting, vaginal discharge and a burning sensation during urination.

If it is left untreated, this can cause serious damage to the fallopian tubes or the uterus. Pelvic Inflammatory Disease can also cause nausea and fever can can cause permanent damage to the reproductive organs. Always practice safe sex and make sure that you have a routine check up and a test for STDs.

Smoking

Most people know that smoking is terrible for your health, but you might not be aware of the link between smoking and fertility problems. Smokers will take much longer to conceive than non-smokers and they are much more likely to have fertility problems.

Women who smoke are at least 1.5 times more likely than non-smokers to take longer than a year to get pregnant⁵. Also, if the male partner is a heavy smoker this will significantly contribute to a delayed conception. Second hand smoke is not much better. If you live in a household with someone who smokes and you are exposed to the secondhand smoke, it is more likely that you will take more than a year to get pregnant.

The good news is that most of the negative effects that smoking has on fertility are reversed a year after stopping smoking. Quitting smoking can be difficult because of how incredibly addictive the nicotine can be, but it is possible.

If you need a bit of help and support, there are many groups and services that can help you to quit smoking. There are also apps that you can download on your phone that will keep track of how many days you haven’t smoked and how much money you have saved by not buying cigarettes. Also, some smokers find that nicotine gum or nicotine patches help to wean themselves off when the cravings for a cigarette strike.

Common Reasons for Infertility in Women

These are just a few of the common reasons why women might struggle to conceive. Sometimes it can be a combination of these factors, or the reason can be difficult to determine without extensive testing. If you have been trying to conceive for more than a year you should visit your doctor to ask them about what the problem might be.

Some issues might not be solvable, so you might need to consider alternative options such as adoption or surrogacy. However, in many cases where the problem is identified you will be able to figure out the best possible treatment for the issue. The best thing to do is to deal with it as soon as possible, so that you have the best chance of successfully recovering your fertility.