Top causes of female sub-fertility
12th August 2018
Perhaps you’ve been trying to fall pregnant for a while, or it’s something you are hoping to get going with soon. But everything you hear in the news and on social media is all doom and gloom about female fertility. This article aims to shed some light on the causes behind female infertility to help you take control of your fertility by arming you with the facts.
It’s important to remember that age is a vital factor when trying to conceive. Fertility does decline as women get older, and after the age of 35 this decline is sharper. However, this knowledge, along with the information in this article should help empower you to get the help you need, when you need it.
You may have heard that couples should seek help from their GP if they have been trying to get pregnant for a year, but did you know that if you are 35 and older, you should actually be referred to a specialist sooner than that.
It’s only natural for a woman who is struggling to conceive to convince herself that it is all her fault. If this is how you feel, then you’re not alone. In reality though, female factors account for approximately 40%, so less than half. Read on to see if any of the following could apply to you.
You could fall into this category if you have irregular periods, or no periods at all. Problems with ovulation fall into three broad categories, and it’s important to distinguish which category you fall into, as the treatment will differ.
1. Polycystic ovary syndrome (PCOS)
Women with PCOS vary in the symptoms they exhibit, but could have a combination of irregular periods (maybe even only a couple a year), acne, hair loss and obesity. There is also a subgroup with a normal or low BMI, so assumptions about this condition cannot be made. When it comes to fertility, management options include exercise and diet to lower BMI, and drugs to stimulate the ovaries to release an egg.
2. Hypothalamic/pituitary disorders
This could be you if you have never had periods, or if they have stopped but you aren’t taking contraception. Common causes are excessive exercise or a low BMI.
3. Premature Ovarian Insufficiency
This occurs in 1% of women and is when the ovaries stop working properly and stop producing eggs years before they should. It is important to know that the ovaries don’t always completely fail, and 5-10% of women can still conceive.
You may already know you have endometriosis, particularly if you suffer from painful periods, but in many cases it goes undiagnosed. This is because it could be mistaken for other conditions such as irritable bowel syndrome. It can account for up to 15-20% of cases of infertility, although on a more positive note, not all women with this condition have problems getting pregnant.
But what exactly is it? It’s when the tissue of the lining of the womb (the endometrium) is found in other parts of the pelvis, and in the most severe cases can cause scarring and blockages of your tubes.
The important thing to remember is that if you are trying to get pregnant and you already know you have endometriosis, please don’t wait too long before you see a doctor. Also, if your mum or sister have been diagnosed with it, there’s a chance you may have it too as it does tend to run in families.
The symptoms to be aware of are:
- Tummy or back pain which may be worse during your periods
- Painful periods
- Pain during/after sex
- Pain when opening your bowels during a period
- The good news is that keyhole surgery to treat endometriosis can improve the chances of getting pregnant naturally
Your fallopian tubes play an incredibly important role. We all know that the egg has to travel down the tubes from the ovary to the womb, but did you know that it is actually where the sperm and egg first meet to create that all important embryo? And it is also where the developing embryo spends its first 3 or 4 days! But scarring, damage or blockages of the tube or tubes can lead to infertility.
The most common causes are:
- Sexually transmitted diseases such as chlamydia
- Pelvic infections (PID)
- Previous abdominal surgery (can cause scarring affecting the tubes)
- Previous surgery to remove the tube eg. because of an ectopic pregnancy
Again, if you know that any of these apply to you, or worried that they might, please see your doctor sooner rather than later if you are trying to get pregnant.
There is some evidence that fibroids can have an impact on your ability to get pregnant. But it is important to remember that many women get pregnant and have babies with fibroids. A lot of those women wouldn’t even have known that they had a fibroid until their first scan! So don’t be too disheartened if you fall into this camp.
If you do see a fertility specialist they will make a decision with you about whether the fibroids would be best removed surgically, or left well alone. Some tell-tale signs that you may have fibroids are if you have heavy periods, or feel that your tummy is really bloated all the time.
A couple may face difficulties conceiving because of issues with the male partner, and some studies have even shown that this could in fact affect up to 50% of couples with infertility. It is therefore so important that a couple are investigated together at the same time. And male factor could be the main culprit even if he has children from a previous relationship.
The problems can range from no sperm at all, to small numbers of sperm that don’t swim very well or that don’t look completely normal. There can also be psychosexual problems complicating matters, such as erectile dysfunction. The good news is that testing for semen and sperm problems is pretty easy and non-invasive, especially when compared to women who may need internal scans and examinations!
This is a often a frustrating situation to find yourself in as there is no specific answer as to why you aren’t getting pregnant, and it can affect up to 25% of couples struggling to fall pregnant The positive side of this is that perhaps over time this may correct itself. But, if you have been trying for a long time, don’t delay getting help or treatment.
In the meantime, the following ways may help improve your fertility:
- Stop smoking. See your GP for strategies to help you achieve this.
- Limit your caffeine intake to 200mg a day. This equates to one or two cups of coffee per day.
- Maintain a normal weight. Don’t overdo it on the exercise or diet though!
- Avoid excess alcohol or binge drinking
- Reduce stress. Easy to say, hard to do. Exercise, meditation, yoga and spending quality time with family and friends can all help reduce your stress levels. Also, sleep is a major factor in your general health and well-being, and so it is worth trying to get at least 7 hours sleep a night.
To understand more about your reproductive health, Adia offers whole body fertility check through easy finger-prick blood tests and short questionnaires. Find out more about our Fertility Tests here.