“How do I know if I’m infertile?”
“Should I be worried about my fertility?”
These are common questions people of childbearing age ask. We spend years preventing pregnancy while we are in school or building a career – and when it’s time to start a family, fertility concerns come into play.
What is infertility?
Infertility is defined as one year of intercourse without pregnancy for someone under age 35, and six months of trying for someone 35 years and older.
Around 17.5% of the adult population – roughly 1 in 6 people worldwide – experience infertility. But if you haven’t tried to conceive yet, how can you determine if you are at risk for fertility problems? The good news is most adults do not have challenges getting pregnant provided they do not have factors that put them at risk.
What are infertility risk factors?
It’s important to note that infertility affects genders equally.
For biological women – several risk factors are well known.
- Those who have had a sexually transmitted disease in the past may have had damage to their fallopian tubes leading to a blockage.
- Irregular periods which are often due to a lack of ovulation may indicate a problem.
- Fertility difficulties may be due to polycystic ovaries or other hormonal problems.
- Those who have had surgery in their abdomen, a tubal pregnancy, or a history of endometriosis may have reduced fertility.
- They may have chronic pain in the lower abdomen or severe menstrual cramps which could mean there is a problem with the uterus or tubes.
- Some may have very heavy periods or a history of fibroids leading to decreased fertility.
For biological males, the following can result in lower sperm counts and infertility:
- Injuries to the testes
- Chemotherapy
- Radiation
- Certain medications (such as testosterone supplements)
- Marijuana
How does age impact fertility?
We know delaying childbearing too long can make it much more challenging to conceive. Those over the age of 35 years often have difficulty conceiving, but each person is different in how quickly their ovaries age.
Those over the age of 40 may have a significant decrease in fertility, so individuals in this age group should seek an evaluation as soon as possible.
How can you maintain fertility?
A healthy lifestyle is key to maintaining your fertility - including a healthy diet and normal weight. Avoiding reproductive toxins such as cigarette smoking, and marijuana may also have a positive impact.
Individuals on long-term medication or with diseases such as diabetes or high blood pressure should speak with their healthcare provider to make sure they are as healthy as possible and that the medications they are taking are safe when trying to conceive.
If you have concerns about your future fertility, some basic testing can be done by your healthcare provider. This may include a semen analysis, blood tests, and ultrasound.
Should I consider freezing my eggs?
Certainly, we are hearing more and more about egg freezing. However, it is a complicated and expensive process that is not without risk.
Those who choose to freeze their eggs may never need them. Nevertheless, it offers peace of mind to those in their mid-30s who do not have a partner or who are not ready to begin their family.
If that is something you are contemplating doing, you should see a reproductive endocrinologist (fertility specialist) for a consultation. You will have an opportunity to learn about your fertility potential whether you choose to pursue any treatment.
Finding a fertility specialist
If you are concerned about infertility, speak with your healthcare provider. The good news is there are many treatments available should you have difficulty conceiving. To learn more about fertility or to make an appointment with a specialist, visit: https://fertility.womenandinfants.org/
Disclaimer: While I am a doctor, I am not your doctor. The content in this blog is for informational and educational purposes only and should not serve as medical advice, consultation, or diagnosis. If you have a medical concern, please consult your healthcare provider, or seek immediate medical treatment.
Carol Wheeler, M.D.
Women & Infants Fertility Center
Professor, Department of Obstetrics and Gynecology (Clinician-Educator)