Fertility problems in women and men : Symptoms, causes and support
For hopeful parents, infertility is a word that often sparks fear, anxiety and concern over dreams of having a family. If you’re facing infertility, you’re not alone; one in eight couples (in which the woman is younger than 30) in the U.S. experience problems conceiving their first child.1 Whether you’re struggling with infertility, supporting a partner or friend going through it, or just looking for more information on the subject, here we review the causes, symptoms and how to seek support.
What causes infertility in women
Getting pregnant and carrying a pregnancy to term are complicated processes, and problems with any step along the way can result in infertility. For women, some common causes include failure to ovulate, problems in her menstrual cycle, structural problems of the reproductive system, infection, failure of an egg to mature properly, endometriosis or autoimmune disorders.2 Because fertility problems can stem from any of these (or other) factors, consulting with a doctor is crucial to narrow down the potential issue(s) and pursue treatment accordingly.
What about infertility in men
There’s often a misconception that infertility happens mostly in women, but that isn’t the case. According to the Office on Women’s Health, men account for one-third of fertility problems, women account for another one- third and the remaining cases may be due to a mix of issues or simply unknown.1 As with women, infertility in men can stem from a range of factors. Most often, it’s caused by varicocele (when the veins on a man’s testicle(s) are too large), too few sperm (or none at all) or the movement of sperm.1
Because fertility problems can stem from many factors, consulting with a doctor is crucial to narrow down the potential issue(s) and pursue treatment accordingly.
How do I know if I have fertility problems?
Certain conditions, which you may have already been diagnosed with, may make it difficult to conceive. If after a certain timeframe you notice additional concerns, you’ll need an official diagnosis before moving forward.
Talk to your doctor if you have any of these conditions
Often, infertility may not show up with an obvious symptom or issue, but certain health issues and family history can both play a role. According to the CDC, infertility signs in women may include:
- Irregular periods
- No menstrual periods
- A history of pelvic inflammatory disease
- A history of Polycystic Ovary Syndrome (PCOS)
- Known or suspected uterine or tubal disease
- A history of more than one miscarriage
- Acquired conditions that predispose to diminished ovarian reserve (a condition in which fewer eggs remain in the ovaries than expected for a given age)3
For women, age is also an important consideration when investigating potential fertility issues. See your doctor if you’re under 35 and have been trying to conceive for 12 months. If you’re over 35 and have been trying to conceive for six months, please reach out to your doctor. And if you’re over 40, contact your doctor right as you start trying to conceive.
In men, the CDC lists the following factors that may increase a risk of infertility:
- A history of testicular trauma
- Prior hernia surgery
- Prior chemotherapy
- Sexual dysfunction3
If you have concerns about any of these factors before trying to conceive, it’s worth a preemptive conversation with your doctor.
Several lifestyle factors can also affect fertility in both men and women, such as being overweight or underweight, excessive alcohol use, smoking, or excessive physical or emotional stress.1 Getting your body and mind as healthy as possible is a great step toward planning a family, whether or not infertility ends up being a factor.
When to see a doctor
Most experts suggest waiting at least one year before seeing your doctor for fertility issues, though as mentioned above, this recommendation for women is very dependent on age.1 This may seem like forever when you’re trying to conceive, but if you have any unusual symptoms or specific concerns — like the ones listed above — reach out to your doctor before the year mark, especially if you’re a woman over the age of 35. You might also consider methods to boost your fertility health at home.
Doctors will typically start with a physical exam and evaluation for both partners’ health and sexual histories. If this doesn’t pinpoint the problem, your doctor will conduct tests — semen tests for men, ovulation tracking for women — to start. Women may also undergo blood tests, ultrasound of the ovaries, or other fertility tests, especially if they are over the age of 35.1 Even finding the cause of infertility can be strenuous. It’s OK to feel discouraged or frustrated by the amount of time it takes.
What do I do once I have an infertility diagnosis?
Infertility can be treated with medicine, surgery, artificial insemination, assisted reproductive technology (ART), surrogacy or a combination of methods.1 Finding which options are right for you and your partner will depend on what you and your doctor think is best. They’ll run through the benefits, risks and side effects of each. You should consider which treatments will be best for your lifestyle, body and finances.
Fertility treatments can be taxing — emotionally, physically and financially. As you work through your diagnosis, take the time to find a community that will support you in your journey, such as trusted family members, a group of friends or a support group. Search the database for the National Infertility Association to find support groups in your area or online. Finding a safe and compassionate group of people is essential to feeling understood and uplifted through this challenging time.
As you pursue your dreams of a family, remember that many women, hopeful parents and families have also experienced infertility, and that many specialists and doctors are available to help find solutions to the issues you’re facing. Take things one day at a time, focus on what you can control and be gentle with yourself in the process.
“Infertility”, (2019), Office on Women’s Health, https://www.womenshealth.gov/a-z- topics/infertility#:~:text=Most%20cases%20of%20female%20infertility,polycystic%20ovarian %20syndrome%20(PCOS)
“What are some possible causes of female infertility?”, (2017), Eunice Kennedy Shriver National Institute of Child Health and Human Development, https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/causes/causes-female
“Infertility FAQs”, (March 2022), Centers for Disease Control and Prevention, https://www.cdc.gov/reproductivehealth/infertility/index.htm