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Houston Fertility Journal

    Female Infertility: Common Signs and Red Flags to Pay Attention To

    January 14, 2019 / by Center of Reproductive Medicine   

    Center of Reproductive Medicine


    When you were in school, you were likely taught about the birds and the bees. The facts as they were presented to you were that if a man and a woman engage in sexual intercourse, the woman would get pregnant.

    Now, as an adult, if you’re trying to get pregnant and failing to do so, it doesn’t feel as simple as those grade school lessons indicated. It can be downright frustrating, and heartbreaking to keep trying for that positive pregnancy test, and not having it happen.

    Thoughts of “What’s wrong with me?” or “Did I do something wrong?” or even “Am I not able to get pregnant?” all come to mind. It can be a very scary time for a woman, but it might not be time to worry just yet.

    Though it’s important to note that fertility is not strictly a female issue, in this post we will cover the common signs and red flags to pay attention to in terms of female infertility.

    Common Signs and Red Flags that Could Indicate Female Infertility

    Just a few things you should be on the lookout for that might be a sign that you need the aid of a fertility specialist are:

    • You’ve reached or are over the age of 35
    • You have irregular or nonexistent menstrual cycles
    • Your menstrual cycles consist of significant cramping, and/or heavy bleeding
    • Your lifestyle choices aren’t healthy ones
    • You currently have, or there is a family history of disease, cancer or illness
    • You have acne and/or sudden hair growth in odd places
    • You’ve been trying for six months to a year to get pregnant, but haven’t yet
    • You’ve had more than three miscarriages

    Now that you know the common signs and red flags related to female infertility, let’s break them down even further so you have a better idea of whether or not it’s time to seek help.

    Spoiler alert: It's probably time.

    If you are 35 or older, you may want to Visit with a Fertility Specialist


    The idea of a biological clock ticking is unfortunately not just a thing your family teases you about at holidays. It is a reality that should not be ignored because the longer you wait, the less likely you are to be able to achieve conception.

    Women who are 25 and younger, and who are otherwise healthy have as much as a 96% chance of conceiving over the span of a year if they are trying every month while the female is ovulating. Your odds of miscarrying if you get pregnant are on average about 10%.

    From age 25 to about 34 this number goes down by about 10%, meaning you only have up to an 86% chance of conceiving. Your chances of miscarriage increase as well to about 20%.

    Then, when you get to your mid 30s, things start going downhill fast. At 35, women have a 15 to 20% chance of getting pregnant each month, and up to 78% chance within one year of trying every month. By age 40, a woman’s change is less than 5% per cycle.

    The average age of menopause may not be until age 51, but this doesn’t mean you will be fertile until that time. Keep in mind that as a woman ages, her ovarian reserve goes down, as does the quality of her eggs. It is this decrease of eggs that makes it so much harder for a woman to conceive, and the decrease of the quality of the eggs that remains that increases the chance of miscarriage and birth abnormalities.

    Irregular and Nonexistent Menstrual Cycles

    Here’s the thing -- you have to be menstruating to conceive. If you are having abnormal menstrual cycles or not having them at all, it can be that much more difficult.

    The bottom line is that to get pregnant, you have to ovulate. If your body isn’t producing and releasing eggs, increasing the amount of intercourse you engage in may not have any impact on your ability to get pregnant. Everything has to be moving along smoothly in your reproductive system for the best environment to conceive.

    One of your two ovaries has to release a mature egg. Then, that egg must get picked up by the fallopian tube. At this point, your male partner’s sperm must come up through the cervix, through your uterus and into your fallopian tube in order to reach the egg for fertilization to take place. But, we’re not done yet. Then, the fertilized egg has to travel back down the fallopian tube to the uterus, implant and begin to grow.

    If anything has a hiccup along the way, the egg might not ever get fertilized, and if it does get fertilized, it still might not yield a baby. Therefore, if you’re having difficulties with your menstrual cycle, it’s critical that you seek the aid of a fertility specialist, or at least your primary care physician to begin the process of getting that aspect of fertility under control.

    Significant Cramping and Heavy Bleeding during your Menstrual Cycle


    Pain during your menstrual cycle and excess bleeding can sometimes be a sign that you have a condition like endometriosis, polycystic ovarian syndrome (PCOS), or some other medical issue.  

    Endometriosis is a condition that results from endometrial tissue or uterine lining forming outside of the uterus. It is typically found in the pelvis or lower abdomen, but it can actually appear in other parts of the body as well. This can cause slight discomfort, pain with periods and intercourse, or even extreme pelvic pain. Then again, some women who have endometriosis never feel any symptoms at all.

    Polycystic ovarian syndrome or PCOS is a hormonal condition that causes your reproductive hormones to get out of balance. This imbalance is what can disrupt or even prevent your menstrual cycle from occurring.

    Other things that can cause heavy bleeding and painful cramps include pelvic inflammatory disease, tumors, and sexually transmitted diseases or infections. If you are struggling with heavy bleeding and painful cramps, it’s definitely a good idea to discuss these concerns with your doctor.

    And, if you are trying to conceive, it’s that much more imperative you bring up these issues because it could be the difference between finding a treatment and having a baby, or missing your window of opportunity to start or expand your family.

    Is this all as serious as we’re making it seem? Maybe I don’t have an issue with female infertility. Perhaps I just need to have more intercourse, or get more sleep, or (insert your old-wives tale here).

    Before we continue we feel we should take a moment and address a common misconception about fertility treatments. A lot of people believe that the need for a fertility doctor is hogwash, and that the practice of fertility treatments was created simply to pad the wallets of the doctors in the business. This couldn’t be further from the truth.

    We recognize just how harsh some of these realities we’re discussing in this post can seem. Unfortunately though, female and male infertility issues usually don’t just go away on their own. By bringing to light the possibilities that many couples are facing, our hope is not just to remove the stigma and shame about the inability to conceive, but also to educate and inform so that the problems that can be solved can be given resolutions.

    Our goal more than anything else, is to help as many people as possible achieve their dream of starting or expanding their families. It’s not always easy, but that’s what we’re here for -- to make navigating these sometimes difficult waters a little less painful. Now, back to the common signs and red flags.

    Make Healthy Lifestyle Choices

    No one likes to think that the things they are doing can have a negative impact on their health or their ability to conceive, but the truth is the things we put into and do to our bodies, can make it harder to get pregnant. Just a few of the things that can cause a female to be infertile, or have difficulty getting pregnant, include but aren’t limited to:

    • Smoking
    • Excessive alcohol and drug use
    • Taking certain prescriptions
    • Working or living in a heavily polluted or toxic environment
    • Working out too much or too little
    • Excessive eating, or under eating
    • Weighing too much or too little (Click here to check out our eBook on this exact topic!)

    You might wonder how these things can impact your fertility. Think of it like a well oiled machine. When you are putting the right things in your machine, everything moves the way it’s supposed to. But, if you start putting the wrong things in your machine, things can start shutting down.

    Believe it or not, weighing too much or too little can disrupt your menstrual cycle, as can working out too much and putting undue stress on the body. You can read more about weight and fertility here.

    If you are hoping to have an easier time getting pregnant, you want to make sure you are eating a healthy diet, getting plenty of rest and exercise, avoiding alcohol and smoking, not taking drugs that can hurt your chances of conceiving, etc…

    Family History and Medical History


    There are several things that can cause female infertility, and some women are more prone to them based on their family history. Chromosome abnormalities and inherited genetic diseases are just two of them.

    Other medical issues that could cause difficulty achieving pregnancy include sexually transmitted diseases or infections, diabetes, heart disease, hormonal imbalances and disorders, and several types of cancer.

    These and many other medical issues is why it’s so important that you get regular physicals, and keep your primary care physician informed of any family history of disease, disorders, defects, etc… You never know how much your medical history could be impacting your ability to get pregnant.

    Do you suddenly have an onset of acne or hair growth in odd places? Yes, it matters.

    Though acne and weird hair growth might be embarrassing, it’s important to mention it if you are randomly or suddenly afflicted with it. As a female, it could be a sign that you have excess testosterone in your body. When you have too much testosterone in your system, it can cause issues with your menstruation and ovulation. Simple tweaks might be all that you need to get your body back on track. That’s why you can’t keep this to yourself. Your doctor needs to know it all so they can help you.

    If you’ve been trying for six months to a year to get pregnant, or have had more than three miscarriages, don’t wait.

    Make an appointment to see a fertility specialist right away.

    Remember that ticking biological clock we mentioned at the beginning of this article? Well, it’s a very real thing, and the longer you wait to seek help, the less likely you are to achieve your dreams of starting or expanding your family.

    We couldn’t share every single cause of female infertility here. Every case is unique, and yours might be something that wasn’t listed in this post. If you are over 35 and have been trying for more than six months, or if you’re under 35 and have been trying for a year or longer, it’s better to be safe than sorry.

    The sooner you can start working with a fertility specialist, the sooner you can find out the cause of your infertility and hopefully find a solution. We would be honored if you choose us to work with in your journey. Click here to learn about getting started with the Center of Reproductive Medicine.

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    Topics: Fertility Specialist, Fertility Journey, Signs of Infertility

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