You and your partner have been trying for months now to get pregnant but with no success. While it was fun in the beginning, you’re starting to get a little stressed about it now. Sex with your partner has changed from being enjoyable to only being done according to your ovulation schedule. And you find yourself thinking “what’s wrong with me?” more often these days.
Unlike on television, where characters seem to get pregnant just by thinking about it, in real life, conception isn’t always so easy. Many women experience fertility problems at some point during their lives and the reasons behind it are endless.
Fertility and Your Age
First, there’s your age. Most women realize that once they hit 35 or 40, there are more problems involved with pregnancy, one of which is conceiving. What many don’t realize, though, is that after 30, a woman’s ability to have a child begins to decline. That’s not to say that all hope of conception is lost if you’re 31. It’s not until you’re 40 that your ability to become pregnant begins to significantly decrease (although it is still certainly possible).
What difference does age make? Well, it’s no big surprise that your body ages. However, you may have been too occupied noticing all the outside changes to remember that your insides are also aging. That includes your eggs. As they get older, they just don’t work as well; this is the main reason behind infertility due to age. Moreover, when the mother is older, there is a higher risk of birth defects due to maternal age. But age is not the only factor causing infertility in women.
Fertility and Your Health
Health problems, whether temporary or chronic, can affect your reproductive capabilities. If you have experienced irregular periods all your life, this could indicate that medical help is necessary for you to get pregnant. If you have diabetes or hypothyroidism, it can affect your fertility in two ways. First, the illness itself can interfere with your ovulation cycle, making it irregular. If the illness itself doesn’t affect your menstrual cycle, then the medication used to treat it can act as an anti-depressant.
If you’ve had any type of abdominal or pelvic surgery in the past, it can cause adhesions in the pelvis. These can prevent conception from taking place or produce an ectopic pregnancy. If you have used an IUD (intrauterine device) for an extended period of time or if you have had a D&C (dilation and curettage), there could be scarring in your uterus, again affecting your ability to successfully become pregnant.
If you have ever had an STI (sexually transmitted infection), this can also inhibit your chances of becoming pregnant. STI’s are especially problematic for women because they can cause serious scarring throughout your reproductive organs.
Fertility and the Environment
If there are no direct medical conditions that could affect your reproductive health, then cast your memory back upon your working environments. Prolonged exposure to dangerous chemicals has been known to cause infertility as well as birth defects. And don’t limit your memory to just your workplace; think of your environment in general. Exposure to radiation and pesticides can be particularly dangerous.
Fertility and Your Lifestyle
If everything still seems to be in your favour, then consider your diet and lifestyle. Smoking has many negative side effects on your health and your ability to become pregnant is one of the things it can affect. Simply cutting back on smoking won’t help; you need to completely quit.
Consuming large quantities of alcohol and caffeine is also bad for your fertility. One glass a day of each is fine, but any more than that and you could be negatively affecting your chances of getting pregnant. Using narcotics, even occasionally, can also hamper your reproductive organs’ ability to function properly. If you are training heavily for an upcoming event (for example, a marathon or biathlon), it may cause your periods to become irregular. If you really want to be in the Boston Marathon this year, then wait until it’s done and over with before you start trying to conceive.
The Next Steps
But how do you know for sure if you’re infertile? Well, if you have been trying to get pregnant for a year with no luck, book yourself and your partner for an appointment with your health care provider (if you’re over 40, then you can make this appointment after trying for 6 months). To help determine whether or not you are infertile, a series of tests will be done. These tests can let you know if your fallopian tubes are open, if your ovaries are producing healthy eggs and, for your partner, if he is able to produce healthy sperm.
To test your fallopian tubes, a hysterosalpingogram (HSG) is performed. This test involves injecting dye into the uterine cavity and seeing where the dye goes. If the fallopian tubes are open, then the dye will eventually end up in the abdominal cavity. If the tubes are not open, then the dye allows your health care provider to see where there may be a blockage. It also allows for the detection of scar tissue, polyps and fibroid tissue.
A different test is done to check the health of your eggs. This test examines your follicle stimulating hormone (FSH), which is released by your pituitary gland. As you get older, your FSH level naturally gets higher. A woman who has gone through menopause will have a very high level of FSH compared with a young woman in her twenties. However, a high level of FSH means that your eggs are no longer in top form. Even if you are in your twenties, if you have a high FSH level, you may need help in trying to conceive a child.
If you are having fertility problems, make sure you have your partner tested, too, before deciding what the best solution is. Refer to our page on Male Fertility Issues for information.
Revision date: June 21, 2011
Last revised: by Janet A. Staessen, MD, PhD