Some women want children but either cannot conceive or keep miscarrying. This is called infertility. Lots of couples have infertility problems. About one-third of the time, it is a female problem. In another one-third of cases, it is the man with the fertility problem. For the remaining one-third, both partners have fertility challenges or no cause is found.
Causes of Infertility
Some common reasons for infertility in women include:
Women generally have some decrease in fertility starting in their early 30s. And while many women in their 30s and 40s have no problems getting pregnant, fertility especially declines after age 35. As a woman ages, normal changes that occur in her ovaries and eggs make it harder to become pregnant. Even though menstrual cycles continue to be regular in a woman's 30s and 40s, the eggs that ovulate each month are of poorer quality than those from her 20s. It is harder to get pregnant when the eggs are poorer in quality. Also, as a woman approaches menopause, her body does not respond as well to hormones that stimulate ovulation. In time, the ovaries may not release an egg each month. Also, as a woman and her eggs age, if she becomes pregnant, there is a greater chance of having genetic problems, such as having a baby with Down syndrome.
Some women have diseases or conditions that affect their hormone levels, which can cause infertility.
- Women with polycystic ovarian syndrome (PCOS) rarely or never ovulate. Failure to ovulate is the most common cause of infertility in women.
- With primary ovarian insufficiency (POI), a woman's ovaries stop working normally before she is 40. It is not the same as early menopause. Some women with POI get a period now and then. But getting pregnant is hard for women with POI.
- A condition called luteal phase defect (LPD) is a failure of the uterine lining to be fully prepared for pregnancy. This can keep a fertilized egg from implanting or result in miscarriage.
Common problems with a woman's reproductive organs, like uterine fibroids, endometriosis, and pelvic inflammatory disease can worsen with age and also affect fertility. These conditions might cause the fallopian tubes to be blocked, so the egg can't travel through the tubes into the uterus.
Certain lifestyle factors also can have a negative effect on a woman's fertility. Examples include smoking, alcohol use, weighing much more or much less than an ideal body weight, a lot of strenuous exercise, and having an eating disorder. Stress also can affect fertility.
Unlike women, some men remain fertile into their 60s and 70s. But as men age, they might begin to have problems with the shape and movement of their sperm. They also have a slightly higher risk of sperm gene defects. Or they might produce no sperm, or too few sperm. Lifestyle choices also can affect the number and quality of a man's sperm. Alcohol and drugs can temporarily reduce sperm quality. And researchers are looking at whether environmental toxins, such as pesticides and lead, also may be to blame for some cases of infertility. Men also can have health problems that affect their sexual and reproductive function. These can include sexually transmitted infections (STIs), diabetes, surgery on the prostate gland, or a severe testicle injury or problem.
When to See Your Doctor
You should talk to your doctor about your fertility if you:
- are under age 35 and have not been able to conceive after 1 year of frequent sex without birth control
- are age 35 or older and have not been able to conceive after 6 months of frequent sex without birth control
- believe you or your partner might have fertility problems in the future (even before you begin trying to get pregnant)
- or your partner has a problem with sexual function or libido
Happily, doctors are able to help many infertile couples go on to have babies.