Causes of Infertility

Infertility is defined as the inability to become pregnant after one year of unprotected sex. Affecting 1 in 8 couples nationwide, infertility is one of the most emotionally devastating diseases affecting modern day families. Some causes of infertility are attributed to the male while other causes are related to the female. Sometimes no cause of infertility is found, and the official diagnosis given to an individual or couple is “unexplained infertility.”

Women and Infertility

Female infertility affects women from all age groups and racial and ethnic groups and there are many causes of female infertility, including:

  • Reproductive system problems (uterus, fallopian tubes, ovaries)
  • Ovulation problems
  • Endometriosis
  • Polycystic ovary syndrome (PCOS)
  • Adenomyosis
  • Age (women over 35)
  • STDs
  • Hormonal issues

Other causes of female infertility may include:

  • Tumors/cysts
  • Weight problems (being overweight or underweight)
  • Alcohol, smoking or drug use
  • DES exposure in the womb
  • Surgeries
  • Clotting disorders

Endometriosis and PCOS
Many women are affected by two common female infertility problems: endometriosis and polycystic ovarian syndrome (PCOS). We explain these conditions below.

Endometriosis. Endometriosis is a common cause of female infertility that may leave up to 30 to 40 percent of affected women infertile. Symptoms of endometriosis include pelvic pain, abnormal menstrual cycles and bleeding, and pain during bowel movements or intercourse.

Polycystic ovary syndrome. Women with PCOS often do not ovulate, making it difficult to conceive. Symptoms of PCOS include excessive facial and body hair, hair loss, acne and obesity.

STDs and Fertility
Did you know that STDs cause up to 50 percent of preventable female infertility cases in the U.S.? STDs can lead to pelvic inflammatory disease (PID). PID is a common cause of female infertility that can be prevented. Common symptoms of PID include:

  • Pelvic pain
  • Abnormal bleeding
  • Discharge with odor
  • Painful urination
  • Fever/chills

Often women do not have symptoms of STDs. Or a woman’s STD symptoms may be mild, not seeming to be a cause for concern. Because of the lack of clearcut symptoms, it is important to be screened regularly for STDs.

Symptoms of Female Infertility
If you and your partner have been having unprotected sex for a year and have not yet conceived, talk to your a reproductive endocrinologist (RE). An RE is able to diagnose and treat fertility problems. If you have one or more of the following symptoms, seek help sooner, rather than later:

  • Unexpected bleeding
  • Pelvic pain or pain during intercourse
  • Unexplained fever
  • Abnormal discharge
  • Pain and itching in the vagina
  • Irregular or absent periods
  • Increased hair growth
  • Breast secretion
  • A history of miscarriage

Men and Infertility

Causes of male infertility generally relate to issues with the following:

  • Sperm quality
  • Sperm count
  • Physical abnormalities

There are also other problems that may prevent a man’s sperm from reaching and fertilizing a woman’s egg.

Secondary Infertility

Anxiety often occurs when couples have problems getting pregnant after having given birth to a healthy child. The term “secondary infertility” is used when a couple is unable to get pregnant, or unable to carry a pregnancy to term, after giving birth at least once before.

Causes of Secondary Infertility
Female factor infertility is to blame for about 40 percent of the cases of secondary infertility. Male factor infertility accounts for the other 40 percent of cases. The remaining 20 percent of cases are due to unexplained factors or caused when both partners possess fertility problems.

The causes of secondary infertility vary. Oftentimes, secondary infertility is the result of one or more of the following factors:

  • Female pelvic and tubal problems
  • Problems with ovulation
  • Sperm abnormalities, like low sperm count

According to the CDC, African American women in the U.S. have the highest rates of secondary infertility. The reason for this may be higher rates of sexually transmitted diseases and resulting pelvic inflammatory disease (PID), which can lead to infertility. It is extremely important that you get tested for STDs before you try to get pregnant.

Age can sometimes be a factor with secondary infertility. Because of increasing maternal age, secondary infertility is more common in women as they approach age 40 and beyond.

When to Seek Help
On a positive note, according to CDC data, couples with secondary infertility are more likely to achieve pregnancy than couples with primary infertility. Primary infertility is the term for infertile couples who have never given birth before.

Fertility specialists recommend that couples under the age of 35 try to conceive for at least one year before seeking treatment for secondary infertility. For those older than 35, doctors recommend seeking fertility treatment when pregnancy does not occur after trying to conceive for six months. One exception to these guidelines is that couples of any age with known fertility problems should seek help right away.

Miscarriage and Secondary Infertility
A recurrent miscarriage is characterized by three or more pregnancy losses in a row. Often, miscarriage is caused by chromosomal defects of the embryo or fetus, and other conditions that can’t be treated.

However, if you experience recurrent miscarriages after a previous childbirth, talk to your doctor about ways to reduce your chances of subsequent miscarriage. Your doctor may recommend healthy lifestyle modifications like quitting smoking and drinking, starting an exercise regimen and healthy eating program, managing stress, and maintaining a healthy weight. Avoiding physical harm and exposure to toxins or environmental hazards may also reduce your risk of miscarriage.

We’re Here to Help

If you are concerned about not getting pregnant, make an appointment to see a reproductive endocrinologist (RE). An RE is an OB/GYN who has additional training in the specialty of reproductive endocrinology.