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Causes of Infertility + Risk Factors to Know

Causes of Infertility + Risk Factors to Know


Infertility isn’t just a clinical term; it’s a journey filled with hopes, doubts, and a quest for answers. Whether you’ve been TTC (trying to conceive) for several months or even for years, you’re likely looking for answers to the nagging question, Why am I not getting pregnant?

Struggling to start a family can feel like being stuck in a maze with no exit in sight. But we’re here to help you understand common causes of infertility, risk factors for struggling to conceive, as well as signs that your journey to having a baby may be a longer one than you anticipated.

Infertility might feel like a lonely road, but it’s more common than you think. Roughly 15 percent of couples in the United States have trouble conceiving (or about one in every six or seven couples). With the right guidance, support, and sometimes medical intervention, many infertile couples find their way to parenthood.

No matter what’s delaying you getting pregnant, there’s light at the end of the tunnel in the form of various infertility treatment options, including natural ones such as changes in diet and exercise habits. Let’s dive in to uncover the underlying reasons that both women and men may deal with infertility.

What Exactly Is Infertility?

Picture this: A couple decides it’s time to have a baby. They try for a year, expecting to experience the excitement of having a positive pregnancy test within several months, but nothing happens.

This scenario, my friends, is what doctors typically label as “infertility.”

Infertility is defined as “not being able to get pregnant (conceive) after one year (or longer) of unprotected sex,” according to the Centers for Disease Control and Prevention. If you’re over 35, the timeline to being diagnosed with infertility shortens to six months.

In other words, if you’ve been having unprotected sex for between six months to one year without successfully becoming pregnant, for one reason or another, you’re dealing with infertility. About 85 percent of couples will conceive naturally within one year of having unprotected sex; however 15 pecent won’t, due to infertility causes such as lack of ovulation, low sperm count, PCOS, and other relatively common conditions.

Most Common Causes of Infertility

When it comes to the culprits behind infertility, we sometimes forget that with each couple, the journey to becoming parents is a story with two main characters. Infertility affects both females and males, although female infertility often gets more attention.

In fact, it’s estimated that when a couple can’t become pregnant, 50 percent of the time there’s a male infertility issue at play. Among 20 percent of couples who are having trouble getting pregnant, male infertility is the primary cause, while it’s a contributing factor in another 30 percent to 40 percent of all infertility cases.

Causes of Female Infertility:

Because conception and pregnancy are such complex processes—involving various hormones, glands, and systems in the body—there are many potential reasons why a couple might struggle with infertility. Of course, the timing of unprotected sex also plays a big role in whether or not a couple will conceive!

When it comes to female infertility in particular, a large study done by the World Health Organization found that the most common identifiable factors of female infertility are:

  • Ovulatory disorders: 25% of cases (many of which are tied to PCOS)
  • Endometriosis: 5%
  • Pelvic adhesions: 12%
  • Tubal blockage: 11%
  • Other tubal/uterine abnormalities: 11%

Here’s more about some of the common causes of infertility affecting females:

  • Irregular Menstrual Cycles: If your monthly cycle and periods seem like an unpredictable rollercoaster, this can definitely affect your chances of getting pregnant. Irregular cycles can come in the form of absent or late ovulation, short or long cycles, very heavy periods that indicate an underlying health issue, or absent periods altogether. It’s generally easier to become pregnant when your cycle is regular and predictable, this way, you know when you’re ovulating so you can time sex to boost your chances of conceiving.
  • Hormonal Havoc: Hormones, including estrogen and progesterone, are like the body’s messengers, but sometimes they don’t deliver the messages correctly. Issues with hormone levels (including thyroid hormones) can disrupt ovulation and make cycles irregular, causing it to be tough to predict the best time for baby-making. Think of abnormal hormone levels, whether too high or too low, like trying to catch a train when the timetable is always changing.
  • Uterine Fibroids: Fibroids are like unwanted guests that reside in the womb, potentially disrupting a cozy environment for a baby. They’re made up of tissue that grows in the wrong place, and they’re not always noticeable or painful, although they can cause discomfort and heavy periods in some cases. Because fibroids can affect hormone levels, they can make it harder to get and remain pregnant.
  • Polycystic Ovary Syndrome (PCOS): It’s estimated that 70 percent of women with anovulation (no ovulation) have PCOS. Picture your ovaries deciding to throw an unwelcome party, complete with multiple cysts (small, fluid-filled sacs which are one criterion for PCOS). These uninvited guests can disrupt the regular ovulation process, making the menstrual cycle unpredictable and in some cases, leading to ovulation being totally absent. PCOS often marches in with a band of symptoms like irregular periods, excess hair growth, acne, and sometimes difficulties with weight management. It’s a common but manageable condition, often playing a sneaky role in fertility challenges.
  • Endometriosis: Endometriosis is when tissue similar to the lining inside the uterus starts growing outside of it. It’s an uncomfortable condition to deal with, and in addition to causing pain and heavy periods, it can lead to various symptoms affecting the reproductive system and fertility.
  • Pelvic Inflammatory Disease (PID): Often stemming from infections like chlamydia or gonorrhea, PID can lead to scarring and blockages in the reproductive system. It’s like having roadblocks on the path where the egg and sperm need to travel and meet. PID has been found to be more common among people with poor access to healthcare, which can explain why it can stem from untreated infections.
  • Fallopian Tube Troubles: These tubes are where eggs travel to meet sperm, so if there’s a blockage, such as due to scarring, the egg and sperm simply can’t meet.
  • Early Menopause: Sometimes, the ovaries decide to retire early, and when they clock out, so does fertility. Unfortunately, this can start occurring in some women’s late 30s, and without treatment, it can disrupt fertility indefinitely.
  • Certain Medical Treatments and Conditions: Treatments like chemotherapy or Cystic Fibrosis (an autoimmune disease) can interfere with fertility because they affect the body’s natural processes, including menstruation and ovulation.

Causes of Male Infertility:

Now that you know the reasons that some women deal with infertility let’s explore how men play a role in fertility struggles:

  • Sperm Count Concerns: The number of healthy “swimmers” that a man produces has a big impact on whether or not a couple can conceive. Sperm production is a complex process, and if anything goes awry, it’s like a factory shutdown. Men can have low sperm counts for various reasons, such as an unhealthy lifestyle, toxin exposure (including smoking), or a varicocele, which is an abnormal vein in the testicles that disrupts sperm’s ability to survive.
  • Varicocele: Never heard of a varicocele? It’s surprisingly common. It’s a swelling of the veins that drain the testicles, which puts a stop in the sperm’s journey. The good news is that it’s the most common reversible cause of male infertility (varicoceles can be corrected with surgery).
  • Sperm Duct Issues (Including Infections): Infections can interfere with sperm production or sperm health or can cause scarring that blocks the passage of sperm. Similar to fallopian tube issues in women, infections in the tubes in the testicles are like having a roadblock on the sperm highway. If the ducts that carry sperm are damaged or blocked, sperm can’t make it out during ejaculation.
  • Ejaculation Issues: Various conditions can prevent the proper release of sperm, including certain genetic diseases like Cystic Fibrosis or autoimmune disorders. The immune system can mistakenly consider sperm as harmful invaders and try to eliminate them, resulting in low sperm count.
  • Tumors: Cancers and nonmalignant tumors can affect the male reproductive organs directly through glands that release hormones related to reproduction, like the thyroid or pituitary gland, or through unknown causes.
  • Hormone Imbalances: Disorders of the testicles, pituitary gland, and thyroid can cause hormone imbalances, such as low testosterone, that affect fertility. For example, low T can contribute to issues such as erectile dysfunction.
  • Lifestyle and Environmental Factors: Overexposure to certain environmental elements like heat, toxins, and chemicals can affect sperm production or function. Even things like heavy drinking, smoking, and drug use can take a toll. It’s like living in a house where the environment is constantly messing with the thermostat and air quality.

Risk Factors for Infertility

Among both men and women, certain factors can raise the risk of infertility, including those related to age, lifestyle habits, weight, diet, and health history. Unfortunately, age is a big one for both males and females—considering fertility isn’t timeless in either sex.

Lifestyle choices like smoking or heavy drinking are like putting roadblocks on your fertility journey. And let’s not forget weight—both extremes, under or overweight, can decrease the chances of becoming pregnant since body weight affects hormone levels.

Here’s more about risk factors for infertility in both sexes:

  • Age: Just like fine wine, we get better with age, but unfortunately, our fertility does not. The biological clock is real, and it ticks even louder as we age, especially once we reach our 40s and beyond. For example, among women aged 35 to 39 years old, infertility rates are as high as 25 percent, while about 30 percent of women between 40 and 44 experience infertility. Men’s fertility also starts to decline around age 40 to 45 years, due to changes in testosterone and sperm count.
  • Weight: Being over or underweight can affect hormone production, thus affecting fertility. Healthy fertility is usually about finding that sweet spot in the middle.
  • Stress: High stress can interfere with the HPA axis and therefore, the production of certain hormones needed to produce sperm in men and to ovulate in women. Stress messes with just about every bodily system, and our body’s natural fertility rhythms are no exception.
  • Poor Diet: A lousy diet is equivalent to trying to run a car without the right kind of fuel. A diet lacking in essential nutrients, such as healthy fats and fiber, can negatively affect fertility. For instance, research suggests that a diet based on the Mediterranean diet, such as one high in omega-3 fatty acids, plant-based protein, and vitamins and minerals, has a positive impact on fertility.
  • Exercise Extremes: Too much or too little exercise can throw your hormones off balance. It’s all about moderation – not too much, not too little.

Spotting Symptoms and Signs of Infertility: When Should You Be Concerned?

What are the signs that you can’t get pregnant? The most glaring sign of infertility is the absence of a positive pregnancy test despite regular, unprotected romps in the bedroom for six or more months.

For women, if your menstrual cycle is unpredictable or your periods are missing completely, that could be a major clue. Men, on the other hand, might notice some hormonal changes – maybe less facial hair or problems in the bedroom department.

These signs and symptoms can indicate that a couple might be dealing with infertility:

  • Inconsistencies in cycle length, heavy or light periods, or complete absence of periods.
  • Experiencing severe pain and very heavy bleeding during menstruation.
  • Experiencing two or more consecutive miscarriages.
  • Difficulty with erection, ejaculation, or a decrease in sexual desire, which can be linked to hormonal issues among males.
  • Swelling or pain in the testicles, which can be signs of varicocele or other issues that might impact sperm production.
  • Facial hair growth in women, or changes in voice and reduced muscle mass in men (signs of hormone imbalances).

Treating Infertility: Where to Start

Feeling overwhelmed? Don’t worry because there’s a whole toolbox of infertility treatments available, which are always determined based on the underlying causes of a couple’s struggles. And if you’re feeling like you’re the only couple you know struggling to have a baby, know that about 1 in 8 women aged 15 to 49 years receive infertility services before successfully conceiving.

Treatments for infertility range from medications that assist with hormone levels and ovulation to more advanced techniques, such as surgery to remove scar tissue and fibroids or IVF. And for those scratching their heads over ‘unexplained infertility,’ there’s still hope with tailored treatment approaches.

How can you boost your fertility naturally? Tackling infertility requires a careful balance of lifestyle, diet, and exercise changes, and sometimes, medical management is still needed in addition to natural treatments to address underlying conditions. With modern medicine and holistic approaches, many fertility issues can be successfully overcome.

Key Takeaways on Causes of Infertility

Understanding the causes of infertility—whether hormone-related, diet or bodyweight-related or due to issues like PCOS or endometriosis—is like putting together a complex puzzle. Addressing each piece, whether it’s a medical condition, lifestyle factor, or environmental influence, plays a crucial role in overcoming infertility. For many couples, the road to parenthood is somewhat bumpy to navigate. However, a significant number of fertility issues are treatable, so there’s always a glimmer of hope.





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