Female Infertility
The body and mind are integrated parts of a whole. Thus, infertility is a complicated web that requires delicate examination and “untangling” by an expert, who isolates which of the strands make it difficult for a woman to conceive and carry a healthy, full-term baby.
When we evaluate statistics from the 12% of the American population struggling with infertility, infertility factors are shared equally between men and women, and – in some cases – couples are diagnosed with multiple factor infertility, meaning both partners have an infertility factor. Accurate diagnosis of these factors is integral to selecting the appropriate medical treatment or fertility treatment.
When to consult with a Fertility Specialist
Experts recommend seeking consultation with a fertility specialist when a woman 34-years or younger tries unsuccessfully to get pregnant for 12-consecutive months; when a woman is 35-years or older and tries unsuccessfully for six-consecutive months; or when a woman 38-years or older tries for three-consecutive months.
If you fall into one of the above categories, contact the Fertility Center of Dallas to schedule a consultation. We’ve provided innovative and successful fertility treatments for more than two decades, and are leading fertility treatment experts in the Dallas and Fort Worth metropolitan areas. Our experience and success rates draw patients from all around the nation and we look very forward to being a part of your solution.
Female Infertility Factors
Accurate diagnosis is the key to selecting the “just-right” fertility treatment(s) for your particular infertility factor(s) and medical history. Some of the most common causes of infertility for women, called female infertility factors include:
Age-Related Infertility
There is no mystery that women in their 20s are significantly more fertile than women in their 30s, who are significantly more fertile than women in their 40s. Fertility rates dip drastically for women 35-years of age and older, and even more dramatically after the age of 40, as the result of reduced egg quality and quantity.
For example, the chances of you getting pregnant in any given month in your:
- 20s – 20% to 25%
- 30s – 15% to 20%, with a notable decline after age 35
- 40s – 5%, with a dramatic decline after 45, at which point it drops to 1%
The largest reason for this decline is due to egg quantity (egg reserves diminish as you age) and egg quality, which also diminish with age. Success rates for IVF and other fertility treatments also diminish with age, which is why you’ll notice IVF success rates are higher for women in their 20s, and decline with each successive age bracket.
Women who are 35-years and older also experience elevated miscarriage rates, as well as higher risk of conceiving a child with chromosomal abnormalities and/or genetic defects, which is why older women often consider PGS/PGD screening for embryos prior to IVF transfer. Using a donor egg is also a smart option, yielding IVF success rates equal to that of the donor’s age.
Women aren’t the only ones prone to age-related infertility. Diminishing sperm quality in men 45-years and older also affects fertility rates, miscarriage rates and the risk of having a baby born with chromosomal/genetic defects.
Unexplained Infertility
Roughly 20% of couples (one in five) who can’t conceive will be diagnosed with unexplained infertility. This is an incredibly frustrating diagnosis, and occurs when all the tests reveal, “everything seems to be in order.”
Firstly, any diagnosis of unexplained infertility deserves a second opinion. In addition to an inaccurate diagnosis, unexplained infertility may signal there is some sort of immune system response in the works, which can be identified via very specific tests. If it doesn’t seem to be an immunological response causing the problem, the most successful treatments for unexplained infertility include the use of fertility medications that stimulate egg production and/or IVF.
Recurrent pregnancy loss (recurrent miscarriage)
By and large, the most common reason for recurrent miscarriages (three or more miscarriages in succession) are chromosomal and/or genetic defects. Both of these can be identified if the fetal tissue is able to be saved and tested by your fertility specialist, better targeting the fertility treatment plan.
Other causes include:
- Uterine abnormalities (fibroids, a uterine septum or other deformities) that make it difficult for a fertilized egg to implant and/or for a fetus to develop to full size.
- Incompetent cervix (the cervix dilates when the fetus reaches a certain size/weight) causing the baby to slip out of the uterus before it’s reached full-term.
- Immunological causes, including clotting issues, partners with similar or incompatible genetic material, the recognition of the sperm and/or fetus as a “foreign invader,” etc.
- Endocrine/hormonal imbalances.
- Blood disorders.
Your fertility specialist will identify the cause so you proceed with the right fertility treatment.
Secondary Infertility
Secondary infertility takes couples by surprise because they’ve already been pregnancy and had a healthy child in the past. However, secondary infertility is actually twice as common as primary infertility, and can be caused by a range of factors, including:
- Advanced maternal age ( see Age-related Infertility above)
- Side-effects of medications
- Latent infections
- Scarring or pelvic damage from previous pregnancy, C-section or surgery
- Lifestyle changes (see Infertility Risk Factors below)
- Immunological causes
- Undiagnosed infertility factors such as endometriosis, PCOS, fibroids, etc., that didn’t affect conception the first time but are complicating infertility now
If you’ve been pregnant and given birth before, we recommend checking in with a fertility specialist sooner than you would have the first-time around – particularly if you have any of the following symptoms:
- Irregular periods
- Heavy or painful periods
- Pelvic pain and/or discomfort
- Pelvic discomfort during intercourse
- Abdominal swelling or discomfort
All of these are symptoms of potential female infertility factors requiring treatment.
Diminished ovarian reserve
Diminished ovarian reserve means you don’t have as many eggs left, and fewer or the eggs you have left are viable for a healthy pregnancy. Age is the most typical reason for women to experience diminished ovarian reserve (see above). However, women may also experience diminished ovarian reserve as the result of genetics, premature menopause or even environmental factors.
Usually, diminished ovarian reserve is treated via IVF to preserve as many viable eggs as possible.
Endometriosis
Endometriosis is one of the leading causes of female infertility. It occurs when the endometrial tissue lining the uterus winds up outside of the uterus where it isn’t supposed to be, most often in and around the fallopian tubes, outside the uterus, and/or on ovarian tissue. Endometrial blockages, inflammation and resulting scar tissue affects everything from healthy ovulation and the ability for the sperm to meet the egg, and for successful implantation and fetal development to occur.
If you’ve been diagnosed with endometriosis in the past or have typical symptoms of endometriosis (heavy and/or really painful periods, intense pelvic pain during menstruation, etc.), and you’re not getting pregnant as planned, endometriosis could be the culprit.
Treatment could be as simple as regulating endometriosis for a few months via birth control pills before trying again. It may also require laparoscopic surgery to remove excess endometrial tissue and scarring and/or or other assisted reproductive technology (ART) options.
Tubal factor infertility
Tubal factor infertility is diagnosed when all or a portion of the fallopian tubes is blocked. The most common causes are scar tissue from pelvic inflammatory disease, historical STDs, endometriosis or from previous pelvic surgeries. Anatomical abnormalities may also be a cause.
If surgery isn’t able to remove scarring enough to improve unassisted fertility rates, IVF is the standard treatment for tubal factor infertility diagnosis.
Cancer and/or cancer treatments
Although not everyone ends up having children, many people at least want to have the option. Cancer — and treatment for cancer — can sometimes take that option away or raise doubts about whether having children is even the right thing to do. The good news for people facing cancer is that, in most cases, you can become a parent if you wish. It may not happen in the way you expected before you learned you had cancer, but if you can be flexible, you’ll find there are options to help.
Infertility Risk Factors
Aside from age-related infertility or the factors listed above, other lifestyle choices, genetics, and/or environmental factors increase your chances of infertility. The good news is that making immediate changes can markedly increase fertility rates, and/or enhance your chances of fertility treatment success.
Simple changes such as focusing on anti-inflammatory or Mediterranean diets, getting regular exercise, ceasing unhealthy habits like smoking, excessive drinking, etc., weight management and stress reduction all go a long way towards boosting fertility rates.
Some of the most important infertility risk factors worth noting are:
Smoking & Infertility
Smoking not only increases infertility rates, it also increases your chances of having a premature baby, a baby with low-birth weight or a baby born with existing medical conditions and/or birth defects. Smoking also increases your chances of having a miscarriage. Men who smoke have higher rates of poor sperm quality and low-sperm count.
Also worth noting is that studies show exposure second-hand and even third-hand smoke make it more difficult for women to conceive, so enlist those around you to quit smoking as well, and minimize the cigarette smoke exposure in public spaces.
Stress and infertility
The anecdotal evidence showed us that stress affected fertility, but science had a difficult time proving it. Now, as our ability to statistically measure hormone levels and stress factors have improved, empirical evidence does show a correlation between elevated stress levels and difficulty conceiving. This includes women trying to conceive, as well as those undergoing fertility treatments.
Reduce unnecessary stress as much as possible, work to cultivate stress-reduction methods (deep breathing, meditation, yoga, Tai Chi, etc.) and consider using acupuncture treatments in conjunction with your fertility treatments to optimize fertility rates.
Weight and infertility
Women have the highest success rates when they have a BMI between 20 and 25. Being both under- and overweight compromise fertility. Women who are underweight, particularly extreme athletes or women with eating disorders can cease ovulating or experience irregular ovulation cycles (noted via skipped, excessively light or a complete absence of periods). On the flipside, being overweight or obese leads to insulin resistance and other health factors, and is consistently linked with higher infertility rates.
Men are not immune to this either, and men who are overweight or obese are more prone to sperm-related infertility factors, including low sperm count, poor sperm shape or poor sperm motility (the ability to move or swim effectively). If weight management is a struggle for you, work with your physician, a certified nutritionist or personal trainer to increase your chances of fertility success.
Other lifestyle or environmental factors
Unfortunately, we live in a chemical-rich world and many of those chemicals increasingly correlate to hormone imbalances and/or infertility factors. Examples include:
- BPAs and other chemicals used in plastics
- Pesticides and herbicides
- Lead and other industrial chemicals
- Paints, finishes, sealants, etc.
- Phthalates, parabens and other chemicals used in most health and beauty products
- Fragrance (an industry word for “fake scent made using lots of chemicals in a lab”
- Food preservatives
Do your best to source foods, drinks, household cleaners, health and beauty products, food storage containers, etc., from sources/companies that promote earth-friendly practices. If you or your partner work in an industry rich in chemicals or toxins known to affect fertility, it may be worth considering a change in positions or jobs in the name of fertility preservation.
The importance of folic acid and pregnancy
Ultimate fertility success means the conception and birth of a live, healthy baby – free of chromosomal or genetic birth defects. Study after study links healthy folic acid intake and reduced risks of birth defects, particularly those affecting the baby’s brain and spinal cord, as its essential for healthy neural tissue development.
For this reason, doctors recommend women take at least 400 mcg of folic acid per day, before getting pregnant and while trying to conceive, 400 mcg during the first three months of pregnancy, 600 mcg from months four through nine, and then 500 mcg while you’re breastfeeding.
Folic acid is found in a range of foods, including lentils and legumes, spinach and leafy greens, fortified grains and cereals, beef liver, eggs and enriched egg noodles. However, you’re guaranteed to receive adequate folic acid by adhering to your doctor’s recommended prenatal vitamin intake.
Testing & Diagnosis
Making an accurate fertility factor diagnosis requires a consultation, including a complete physical and review of your medical history. We’ll also perform a series of tests, often referred to as “a complete infertility workup” for the doctor’s assessment.
Your first consultation with Fertility Center of Dallas triggers all of the above, and our caring, diligent and downright tenacious doctors will persist until they’re able to determine the exact causes of your infertility, so we can create a personalized fertility treatment plan.
Visit our Diagnostic Testing page for more information about the standard fertility test and treatment options.
Fertility FAQs
Still have questions or concerns? Here are some of the most frequently asked questions we receive here at FCD. Also, please feel free to contact us online or give us a call directly at 214-823-2692. Clear communication and informed patients are the foundation of successful fertility specialist-patient relationships, not to mention fertility treatment success.