Are you trying to get pregnant and it’s taking longer than you thought it would? If so, you probably have some growing concerns about infertility. Could there be something preventing you from getting pregnant, perhaps in your physiology or your lifestyle? The only real way to find out for sure is to have a complete fertility evaluation performed. There are several common factors of infertility that couples should not ignore…
A Woman’s Age
The age of a woman definitely impacts the quality of her eggs. As a woman gets older, the quality of her eggs declines and thus, her chances for pregnancy decrease. At the same time, the chances of miscarriage and of genetic abnormalities begin to increase.
Many women think that at the age of 35, their fertility just falls off a cliff, but the reality is that it actually begins to decline early in their 30s. The decline, however, does accelerate more rapidly over the age of 35. There isn’t much difference between being 25 and being 27 in terms of getting pregnant; unfortunately, research shows that there is a big difference between being 35 and being 36, and chances are better at 36 than they are at 37, and so on.
One typical misconception is that fertility treatment can reverse this decline, allowing older women the same chances to get pregnant as younger women. Sadly, for women using their own eggs, this is not the case. Age is the one problem that cannot be fixed; the effectiveness of fertility treatments also goes down as a woman’s age goes up.
What this means for women over the age of 35 is that treatment recommendations are often more aggressive. Reproductive specialists may decide to move to IVF sooner because they want a treatment that will work faster. Sometimes, reproductive specialists will even suggest moving from IVF to donor eggs sooner or, in some cases, going directly to donor eggs.
The great thing about using donor eggs is that the chances of success depend on the age of the donor, not on the age of the recipient. Egg donors go through a screening process and they typically are healthy women between the ages of 21 and 32, thus the success rates are very high.
Nonexistent or Irregular Periods
Women who have irregular periods, or those who do not get a period at all, may already have a feeling that their ability to get pregnant is impacted. Menstruation is tied to ovulation, the process whereby the ovary releases a mature egg every month to be fertilized. When a woman doesn’t ovulate or only ovulates periodically, it is very difficult or even impossible to get pregnant.
An irregular or nonexistent period almost always means there is an underlying ovulation issue. This is a really common cause of infertility in women, and the good news is that in most cases, with the help of a reproductive specialist, this is an issue that can be resolved. The process of getting the woman’s body to start ovulating again is called ovulation induction and can be as simple as taking an oral medication. Once ovulation is occurring regularly, the chances for achieving pregnancy are quite good.
Painful Periods
Pain, above and beyond the normal cramps associated with a monthly period, can be a sign of a condition called endometriosis. With this condition, the uterine lining, called endometrium attaches and grows outside the uterus in the abdominal cavity. This endometrial tissue bleeds, causing inflammation and scarring. Sometimes the scar tissue can block the fallopian tubes or even cause cysts in the ovaries that affect their ability to release eggs.
How much endometriosis affects a woman’s ability to get pregnant depends on the health of her fallopian tubes and ovaries. With an infertility workup, a reproductive specialist can assess the situation and decide whether treatment is necessary and what type of treatment might be best. With the right treatment, women with endometriosis have a good chance of getting pregnant.
You Haven’t Been Really Trying
Many women have heard the guidelines for seeking help from a fertility specialist. It is often suggested that women under the age of 35 try on their own for a year while women over 35 should try naturally for just six months. The catch with these time frames is that they only consider the time you have been having unprotected intercourse, not the amount of time you have been “actively” trying to conceive.
The definition of infertility is one year of unprotected intercourse without a pregnancy, and it does not take into consideration whether you’ve been actively trying at the right time of the month. Typically, after a year, 85% of couples will be pregnant. The remaining couples should seek an infertility evaluation. That doesn’t necessarily mean fertility treatment will be needed; it just means that a complete fertility workup should be done to find out what is going on.
There Is a History of STDs
Sexually Transmitted Diseases (STDs), even those that are successfully treated, can affect a woman’s fertility. STDs, especially chlamydia and gonorrhea, can cause inflammation and scar tissue that damage the fallopian tubes. Any damage to the fallopian tubes can prevent pregnancy or certainly make it much more difficult to conceive. STDs can also increase the risk of ectopic pregnancy, which is a pregnancy where a fertilized egg is stuck in the fallopian tube and must be removed.
A history of STDs doesn’t necessarily mean that you will have infertility, but it’s worth getting checked out. There are simple tests available that can evaluate the health of the fallopian tubes. Once the results are in hand, a reproductive specialist will know whether the patient needs treatment.
Smoking
Everyone knows that a woman is not supposed to smoke when pregnant, but it turns out that smoking, and even regular exposure to second-hand smoke, also makes it much harder to get pregnant. Many women don’t realize that smoking affects the quality of their eggs. It also affects the ability of the fallopian tubes to transport the egg and sperm, which makes getting pregnant harder and increases the risk of an ectopic pregnancy. Smoking by men affects their production of sperm and can cause erectile dysfunction. Even with fertility treatment, pregnancy rates decrease dramatically if the patient smokes.
Research studies of patients undergoing IVF treatment have noted some very dramatic findings. These studies have shown that female smokers need higher doses of hormones to stimulate their ovaries, have fewer eggs obtained, more canceled cycles, lower implantation rates, and they undergo more cycles with failed fertilization than nonsmokers. For this reason, many fertility clinics will not even start treatment with a patient who smokes.
Quitting smoking is difficult, but it does make a difference. Experts believe that if you stop smoking, even just 2 months before you start fertility treatment, it significantly improves your chances of getting pregnant.
If you recognize one of these symptoms in yourself, be sure to talk to your doctor about it right away. Take control of your fertility and make an appointment with one of our compassionate and highly trained reproductive specialists. The Center of Reproductive Medicine serves the greater Houston area with full-service fertility clinics in Webster and Beaumont.