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Houston Fertility Journal

5 Signs it's Time to See an Infertility Specialist

[fa icon="calendar"] Mar 7, 2018 3:25:47 PM / by Center of Reproductive Medicine   

Center of Reproductive Medicine

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Have you ever uttered the phrase, “Oh I wish I had a sign?” or “If only something would send me a sign?” If so, you’re not alone. When people are struggling with things in life, they seek signs to guide them, and tell them that they are on the right path.

One of the many things people struggle with is getting pregnant. The worries and confusion that can arise with something as emotional as this can be mentally and physically taxing. If this sounds like you, and you’ve been searching for a sign that may help you fulfill your dream of getting pregnant, here are 5 signs it’s time to see an infertility specialist:

  • You’ve been trying for a while to get pregnant to no avail
  • You have a genetic disorder/hormonal imbalance
  • You just turned 40
  • You’re leading an unhealthy lifestyle
  • You have a disease or other medical issue

Like many of the signs we seek, they often need further interpretation once we find them. With that in mind, let’s break these signs down even further to help you figure out if it’s time to discuss your situation with an infertility specialist.

Sign #1 - After many attempts to achieve pregnancy, you’re still not pregnant.

First off, what does many attempts to achieve pregnancy really mean? It means you and your partner have been regularly having intercourse for many months or even a year, and it has not yet resulted in getting pregnant. How long should you be trying before it’s time to chat with an infertility specialist?

  • If you’re under 35 and relatively healthy - seek help if you have been trying for a year or longer.
  • If you’re between 35 and 40 - you should seek help if you have been trying for six months.
  • What about if you’re over 40? Skip ahead and scroll down to sign #3.

Sign #2 - People with genetic disorders or hormonal imbalances may need help from an infertility specialist to get pregnant.

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Genetic disorders that could lead to fertility complications in males include Klinefelter’s syndrome, Y chromosome microdeletions and Gene Polymorphisms. The most common genetic cause of infertility in men is Klinefelter’s syndrome.

Klinefelter Syndrome is a chromosome disorder that is not inherited. A male with this syndrome has an additional X chromosome, which causes infertility, low testosterone and other characteristics such as the development of breast tissue. Unfortunately, the chromosomes are present in every cell of the body, and the extra X chromosome cannot simply be removed.

However, for males dealing with Klinefelter Syndrome, there is the option of lifelong testosterone therapy that could aid them in being more fertile. The good news is, with every medical advancement, options are becoming more widely available to males with Klinefelter Syndrome and other genetic disorders.

A genetic disorder that could lead to fertility complications in females is Turner Syndrome. According to the U.S. National Library of Medicine, “Turner syndrome is a chromosomal condition that affects development in females. The most common feature of Turner syndrome is short stature, which becomes evident by about age 5. An early loss of ovarian function (ovarian hypofunction or premature ovarian failure) is also very common. The ovaries develop normally at first, but egg cells (oocytes) usually die prematurely and most ovarian tissue degenerates before birth. Many affected girls do not undergo puberty unless they receive hormone therapy, and most are unable to conceive (infertile). A small percentage of females with Turner syndrome retain normal ovarian function through young adulthood.”

Hormonal imbalances can also be to blame for infertility in both men and women. Anything that disrupts the normal function of the adrenal glands, hypothalamus, thyroid and/or the pituitary gland can cause complications with fertility.

In women, an abnormal thyroid and/or abnormalities in any other hormones can lead to:

  • the inability to ovulate or even have a menstrual cycle
  • birth defects in the baby, and risk of miscarriage if conception does occur

One of the most common hormone related health problems that causes infertility in women is polycystic ovary syndrome (PCOS). It’s exact cause is unknown. PCOS results in an imbalance of reproductive hormones, and it creates problems in the ovaries. The ovaries make the egg that is released each month as part of a healthy menstrual cycle. With PCOS, the egg may not develop as it should or it may not be released during ovulation at all.

In men, an abnormal thyroid and/or abnormalities in any other hormones can lead to:

  • poor semen quality
  • poor testicular function
  • lowered or nonexistent libido
  • low sperm motility

Sign #3 - There could be a chance you’re too old to have a baby.

In the interest of full disclosure, we’re not going to sugar coat it. If you are older than 40, achieving pregnancy and bringing it to term will be a much more difficult road. It’s a hard concept to grasp, but couples who wait too long could have a significantly smaller chance of starting or expanding their families because of the way the human body changes with age.

When a woman is well into her 30s, the quality and quantity of her eggs significantly drops. This reduction only continues as she continues to age. That is perhaps the biggest factor in why an otherwise healthy older woman has a hard time conceiving. Unfortunately, an older woman has higher risks of miscarriage as well.

This is not a fully female problem, however. An older man may contribute to the inability to achieve pregnancy as well. Though a man will continue to produce sperm all his life, the volume will decrease as well as its motility.

It’s also important to note that the risk of miscarriage is nearly double that for women with a male partner older than 45 compared with those with a male partner in their twenties. Another thing to consider is that according to the Fertility Coalition, “Children with fathers aged 40 or older are more than five times as likely to have an autism spectrum disorder than children fathered by men aged under 30.”

If both the hopeful mom and dad to be are older than 40 it only exacerbates the complications, and the risks to both the mother and the unborn child. All hope might not be lost, however. It just means that seeking the help of an infertility specialist is that much more critical if you are over 40 and have been trying to achieve pregnancy longer than three to six months.

Sign #4 - Lifestyle choices can impede the ability to get pregnant.

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You may not want to hear this, but the choices you are making in your daily life, or that you have made previously in your life can have an impact on whether or not you can have a child. Just a few of the lifestyle choices that can negatively affect your odds of achieving pregnancy include, but aren’t limited to:

  • Smoking (even secondhand smoke) can reduce your chances getting pregnant by as much as 50%.
  • Drinking more than two alcoholic beverages in a week.
    • In females excessive drinking can disrupt the menstrual cycle, and in the worst cases can cause anovulation - a menstruation cycle where ovulation never occurs.
    • Alcohol use can also negatively impact the lining of the uterus which could hurt a fertilized egg if conception does occur.
    • Alcohol can reduce the mobility, quantity, and quality of sperm in males.
  • Using illicit drugs
    • In men, drugs such as marijuana, heroin, cocaine and other “hard” or illegal substances can lower sperm count, and even stop the ability to ejaculate altogether.
    • In women illicit drug use can stop ovulation, deplete egg count and/or damage your eggs permanently. Remember, women are born with all the eggs that they will ever have. Damaging them therefore could mean no second chances.
  • Too many trips to Starbucks - Though studies are not completely conclusive on this, too much caffeine has been shown to decrease the chance of pregnancy in some women, and increase the chance of miscarriage in some pregnant women.
  • Prolonged exposure to environmental toxins or chemicals can also lead to infertility issues over time.  
  • Excessive stress - There are some who argue that being overly stressed can hurt your ability to conceive. While studies on this are also inconclusive, engaging in activities to lower your stress levels couldn’t hurt. Meditation, getting a good night’s sleep, and eating a well-balanced diet could help you to reduce stress.
  • Eating junk food could be the culprit of your infertility. Many nutritionists and physicians believe that the foods we eat determine whether or not our bodies are healthy enough to conceive, or bring a pregnancy to term.
    • As a standard, for a healthier diet you should be regularly consuming leafy green vegetables, lean proteins, fruits and whole grains.
    • You should reduce your intake of sodium, unhealthy fats, excessive oils and preservatives.
  • Over or under exercising - Overexertion can disrupt normal ovulation and menstruation cycles in women, and can lower sperm motility in men. Under exercising can lead to obesity.

Being overweight can hurt your chances of becoming pregnant, and increase your odds of complications while pregnant.

Maintaining a healthy weight is imperative when a woman is trying to conceive, and it provides a healthier environment for a baby to grow once conception occurs. A woman is considered obese when her body mass index (BMI) is 30 or higher.

Regardless of what lead to your obesity, your unhealthy weight can make it harder to get pregnant, and puts you and your baby at risk if you do get pregnant. Obese people often have higher than normal leptin levels, decreased insulin resistance, and lower libidos. Chemicals and hormones often get imbalanced in overweight individuals. This imbalance can cause impaired ovulatory function, and damage reproductive health overall.  

Risks associated with obesity during pregnancy include gestational diabetes, preeclampsia, hypertension, blood clotting, infection, the need to induce labor, risk of Caesarean birth, and in the worst cases miscarriage and stillbirth.

Again, being overweight is not strictly a female issue. Men who are overweight can also contribute to the infertility equation. A man who is obese may suffer from decreased sperm count, as well as lower libido and reduced sperm motility and quality.

What should you do if you are under/overweight?

The first best step may be to meet with your primary care provider just to ensure that no other medical factors are the cause for your weight issues. Then, after all other factors are ruled out, they can work with you on developing a nutrition and exercise regimen that is right for you. You may need the assistance of a nutritionist as well.

Once you can get to a healthy weight level, if you are still struggling to conceive, it may be time to work with an infertility specialist to rule out other factors that could be contributing to your situation.

Sign #5 - Diseases and other medical issues can cause fertility complications.

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Patients with a complicated medical history will often have a harder time achieving pregnancy. For example, the odds of getting pregnant can be drastically reduced in patients with a history of medical conditions like hypertension, diabetes, heart or kidney disease, sexually transmitted diseases or infections, pelvic inflammatory disease, endometriosis, reproductive cancer and many others.

Other conditions that may be cause for concern include but aren’t limited to:

  • Recurrent miscarriages - i.e. having three or more miscarriages
  • Having three or more abortions
  • If you have scarring in the uterus related to any previous medical condition or surgeries
  • Any disorders or diseases that resulted in damage to the uterus or fallopian tubes
  • If you’ve ever had or currently have ovarian cysts
  • A history of very late periods, or going long periods without having a menstrual cycle
  • Erectile dysfunction that impedes your ability to have intercourse.
  • The inability to ejaculate, or a reduction in your discharge
  • An allergy to sperm
  • Use of anabolic steroids and/or corticosteroids
  • Endocrine system disorders
  • A history of organ transplants
  • Signs of premature menopause, or a sudden change in your menstruation cycle

Your signs may be pointing to the need for an infertility specialist.

Although articles like this are educational, it’s important to note that taking action is the only real path to change. Though we hope this post has put your mind at ease, and reassured you that you’re not alone, it doesn’t alter the fact that it may be time to see an infertility specialist. We know how frustrating it can be to struggle with starting or expanding your family, and we would like to help you navigate the waters on your journey.

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