Fertility Overview

Read about what causes fertility problems and ways to improve your chances of becoming pregnant.

Infertility is caused by a disease of the male or female reproductive system, resulting in failure to achieve a successful pregnancy through timed, unprotected sex for twelve months, or after six months if you are age 35 or older.

How common is infertility?

In the United States, about 1 in 8 women younger than age 45 have trouble getting pregnant or carrying a pregnancy to term.

What causes fertility problems?

Female factors cause about a third of fertility problems; with male issues, another third. The other cases are caused by a combination of the two or by unexplained issues.

The most common causes of fertility issues for women involve problems with ovulation (the release of eggs), poor ovarian reserve, blocked fallopian tubes, anatomical abnormalities of the uterus or endometriosis (a condition in which endometrial tissue grows outside the uterine cavity abnormally).  

For men, fertility issues often revolve around the amount or health of the man’s sperm. His sperm count, movement and shape may be evaluated. Depending on the results, other tests may be in order.

Is age a contributing factor?

Age is an important factor in fertility. A healthy woman has around a 20 percent chance of getting pregnant every month. However, as a woman ages, the quality and quantity of her eggs decline. Around age 30, a woman’s fertility starts to decline, especially after age 37.

A woman’s age can also contribute to lower birth rates and increased risk for miscarriage. Also, the older a woman is, the lower the rate of live birth pregnancy when using her own eggs with In Vitro Fertilization (IVF). For women younger than age 35 who use their own eggs with IVF, about 54 percent of cycles will result in a live birth. For women ages 38-40, this success rate declines to almost 27 percent and down to only 3.9 percent for women older than age 40. However, someone who decides to undergo IVF using donor eggs is likely to have the same success as a younger woman, as it is the age of the egg that matters. The current success rate of an IVF cycle using donor eggs is quite high — over 53 percent.

What can I do to improve my chances of becoming pregnant?

Lifestyle changes may help improve your chances of becoming pregnant. Here are a few tips to increase fertility:

• If you smoke, quit. Smoking lowers fertility in women.
• Keep your weight in a healthy range. Being overweight or underweight can affect a woman’s ovulation.
• Avoid alcohol. It can cause menstrual and ovulation problems. If you do get pregnant, it increases the risk of birth q           defects and miscarriage.
• Get the right amount of exercise. Not exercising enough may lead to obesity, and this can be a risk leading to fertility issues. Excessive exercise may also be a contributing factor.

What can men do to protect their fertility?

These actions may help men produce healthy sperm:

• Avoid frequent or heavy use of alcohol.
• Don’t smoke. Talk to your doctor if you need help quitting for good.
• Avoid radiation and chemotherapy, if possible.
• Stay away from toxic substances.

What can I expect at my first appointment with a reproductive endocrinologist?

Before your appointment with your reproductive endocrinologist, make sure your OB/GYN sends your records, including any treatments. During your visit, you’ll likely fill out a health history form and get a physical examination. For women, you may also have tests ordered (coordinated with your next period), such as blood work and an ultrasound. An X-ray procedure, called a hysterosalpingogram, may be ordered, as well. This procedure evaluates the inside of the uterus for defects and examines your fallopian tubes to make sure they are open. For men, a semen analysis may be done during a scheduled visit.

By Kristin Nelson, Contributing Writer

Sources

American Society for Reproductive Medicine. Endometriosis. Accessed July 19, 2017.
American College of Obstetricians and Gynecologists (ACOG). Evaluating infertility. Accessed July 19, 2017.
Society for Assisted Reproductive Technology. National summary report. Accessed July 19, 2017.
Centers for Disease Control and Prevention. What is infertility? Accessed July 19, 2017.

Last Updated: July 5, 2017