Fertility problems in women is unfortunately too common of an issue that many people struggle with. However, it may not always be clear whether your experience is just a natural part of the process, or whether it is time to seek treatment from a fertility specialist.
How to know when to seek treatment from a fertility specialist?
Typically women are believed to be the most fertile within the first 3 months of trying to conceive. This does not mean that after 3 months you should be running to a fertility doctor. In fact, for women under the age of 35, infertility is typically not considered an issue until after 12+ months of trying to conceive without getting pregnant. However, for women over the age of 35, fertility treatment may be necessary after just 6+ months of trying. This discrepancy is due to the general decline in fertility that women experience with age. Men also experience a decline in their fertility but it is not believed to be significant before the age of 50.
Reasons for female fertility problems
Age is the most important determinant of fertility
Ferility and the Menstrual Cycle
Fertility and Lifestyle
Fertility and Stress
Age is the most important determinant of female fertility. The odds of conception slowly start to fall from the age of 27 and women over the age of 35 in general experience a longer time to conception, have an increased chance of first trimester miscarriages, and have an increased risk of having a child with Down syndrome. This is essentially due to the fact that age largely defines the quality of eggs. The reproductive system is particularly sensitive to mutations and those that occur naturally over time can reduce egg quality. By age 40, it is estimated that up to 90% of eggs have a genetic abnormality. Most of these abnormal embryos resolve spontaneously but if they persist, they can result in spontaneous abortion in later stages of pregnancy or may result in the birth of a child with a genetic disorder. However, 80% of children with Down syndrome are born to women under the age of 35, indicating that even young women may have genetically abnormal eggs and women that are concerned may consider pre-implantation genetic screening. If you are not having trouble conceiving but have experienced two or more miscarriages, then you should consult with a fertility specialist.
Another indicator of egg quality is your menstrual cycle. A woman can conceive in the 6 days leading up to ovulation and is the most fertile 2 days before ovulation. Every cycle is orchestrated by the growth of a single egg and defects in either the egg or the follicle can disrupt a healthy menstrual cycle. If you experience early ovulation, have premenstrual spotting or have a short cycle length, it may suggest that something is wrong. In addition to a history of irregular menstrual periods, fertility treatment may also be advisable for those with previous abdominal or gynecological surgery, pelvic inflammatory disease, a sexually transmitted disease, known structural abnormalities of the uterus or other reproductive organs, as well as endocrine disorders like thyroid disease.
Another important determinant of your fertility that should not be underestimated is your lifestyle. Improving your health by minimizing caffeine, quitting smoking, exercising and getting an adequate amount of sleep can have a tremendous impact on improving fertility. Also keep in mind your body mass index (BMI), as women that are either obese or too thin will have trouble conceiving. A healthy diet rich in antioxidant vitamins is also important but in addition to that, various supplements including coenzymeQ10 may be helpful. Many of these lifestyle guidelines apply to men as well since they can have a significant impact on the quality of sperm. A fertility specialist can work with you and your partner to determine which particular supplements will be of benefit. It is also advised that women that are planning to conceive should take folic acid since it decreases the risk of neural tube defects in children.
Many men and women put substantial pressure on themselves when they are trying to conceive, not realizing that the stress this causes may be the reason they are not successful. It is therefore important to reduce stress, a task sometimes easier said than done. Making a conscious effort to relax will have a positive impact on your healthy and fertility. How you achieve this varies from person to person but many people have found that acupuncture can help.
Seeking fertility treatment
Ultimately when to seek fertility treatment is a personal decision and will vary based on many factors including age. Before you commit, make sure you do your research so that you choose the treatment that will best improve your chances of conceiving.
1. Optimizing natural fertility: a committee opinion. Fertil Steril, 2013. 100(3): p. 631-7.
If you would like to learn more about female fertility, continue reading this related blog post: “How to Prepare for Pregnancy”.