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Houston Fertility Journal

    Is a Fertility Specialist Right For You?

    January 18, 2018 / by Center of Reproductive Medicine   

    Center of Reproductive Medicine


    A positive pregnancy test. It’s all you have been wanting, but for some reason it’s not happening. Part of you thinks it’s time to see a doctor, the other part of you thinks you might just need to relax. Is a fertility specialist right for you?

    If you answer yes to any of these questions, it might be time to seek help:

    1. Are you older than 30 and have been trying to achieve pregnancy for six months or longer?
    2. Are you under 30, and of reproductive age and have been trying longer than a year?
    3. Are you overweight, underweight, or living an unhealthy lifestyle?
    4. Do you or your partner have any genetic disorders, hormonal imbalances or other medical issues that could impede your reproductive organs?
    5. Have you had more than three miscarriages in a row, or three or more abortions?

    Age is More Than Just a Number


    No one likes to think of age as a determining factor as to whether or not they can have a baby. However, if you have been dismissing your age as no big deal, you could be risking never having the chance to conceive. Here’s a breakdown of your odds and risks to yourself and your potential baby by the numbers:

    Fertility in your 20s

    In your 20s, if you’re having sex regularly, barring any other conditions, your odds of conception are around 20 or 25 percent. Your less likely to have medical complications once you do achieve pregnancy, and as long as there aren’t any medical factors in the way, your baby is more likely to be born healthy.

    It’s also been found that moms to be in their 20s have been found to have more energy for their pregnancies, have better immune systems, and have better chances of bringing a pregnancy to term.

    On the flip side, it’s been found that moms to be who have a baby in their 20s are at a higher risk of feeling like they missed out on their youth down the road. And, some women have reported that having a child in their 20s sidetracked their professional aspirations.

    If you’re in your 20s and have been trying to get pregnant for more than a year, you might want to see a fertility specialist.

    Fertility in your 30s

    Women in their 30s, that are having sex regularly have a 15 to 20 percent chance of achieving pregnancy each month. Again, this is barring any other conditions. It’s important to note that your fertility chances will decrease drastically as you age, and will get considerably smaller once you hit 35.

    Though women in their 30s can still have the energy, health and vitality it takes to bring a pregnancy to term, in their late 30s they are at higher risk for complications throughout their pregnancies, and more likely to experience miscarriages.

    If you’re in your 30s and have been trying to get pregnant for more than six months, you might want to see a fertility specialist.

    Fertility in your 40s

    We hate to be the bearer of bad news, but once you reach your 40s, your odds of achieving pregnancy dwindle to less than five percent each month. For women over 45, the odds dip as low as one percent.

    You’re also at significantly higher risk for pregnancy complications, and there’s a larger chance of miscarriage. It’s also been found that the fetus has a higher chance of Down Syndrome, chromosomal abnormalities, and other medical conditions when the mom to be is over the age of 40.

    If you’re in your 40s and have been trying to get pregnant for more than three months, it’s a good idea to go ahead and see a fertility specialist. Time is even more critical the older you get.

    Your Weight Can Affect Your Ability to Get Pregnant

    It may seem trivial, but there is in fact an ideal weight for achieving pregnancy. If your BMI is between 18.5 and 24.9 you’re considered a healthy weight. In other words if your BMI falls in that range, you’re at an ideal weight for a healthy pregnancy as long as they are no other factors that could affect you or your baby.

    BMI health by the numbers

    • You’re considered underweight if your BMI is under 18.5
    • A healthy BMI is between 18.5 and 24.9
    • Overweight is 25-29.9
    • Obese people have a BMI of 30 or greater

    Why does being overweight or underweight impact your pregnancy odds? Let’s take a look at what your weight does to your body.

    Weight and Infertility


    Obesity and fertility

    Obesity is associated with a multitude of health problems, up to and including:

    • High leptin levels (Leptin is the hormone that is responsible for regulating the amount of energy expended as well as regulating appetite.)
    • Polycystic Ovary Syndrome (PCOS)
    • Imbalanced hormones that affect fertility
    • Abnormal insulin levels that can cause diabetes and/or pregnancy complications
    • Your risk of pre-eclampsia is doubled when you’re overweight. (Pre-eclampsia symptoms include high blood pressure and potential damage to the liver and kidneys. When it’s not treated it can lead to the death of both mother and baby)

    If you are overweight and trying to conceive, discuss an exercise and nutrition regimen with your primary care physician. It’s also a good idea to discuss a game plan with your fertility specialist to improve your odds of achieving pregnancy and carrying it successfully to term.

    Underweight and fertility

    A woman who is underweight can have difficulties with hormone imbalances, as well as irregular and nonexistent menstrual cycles. When you’re having issues with menstruation, you may also be having difficulty ovulating, and no ovulation means no chance of achieving pregnancy.

    If you are underweight and trying to conceive, you may want to gain weight by consuming additional nutritious foods daily, especially those high in protein. How to go about properly gaining weight should be discussed with your primary care physician as well.

    Men need to be a healthy weight as well

    It takes two to tango as they say. As such, men must also be a healthy BMI to assist in achieving pregnancy. Men who are underweight or overweight can suffer from hormonal complications, as well as issues with their sperm count and sperm motility.

    Genetic Disorders, Hormonal Imbalances and Other Medical Issues Can All Impact Your Ability to Achieve Pregnancy

    Both men and women can suffer from a wide variety of issues that can impair their reproductive organs and cause infertility.

    Common causes of male infertility

    Hormonal Imbalance - Any disorder of the testicles, low testosterone or abnormality which negatively affects things like the adrenal glands, hypothalamus, thyroid and pituitary can impede fertility.

    Retrograde Ejaculation - Spinal injuries, diabetes, certain medications and surgery of prostate or bladder, can cause men to suffer from retrograde ejaculation. In basic terms, retrograde ejaculation is what happens when semen enters the bladder rather than emerging from the tip of the penis during orgasm.

    Vasectomy, prostate surgery and many other surgeries -  Any surgery that is done on the testicals or scrotum, rectal area, abominal area and even hernias can in some cases impact sperm motility and sperm count leading to infertility.

    Tumors - Non-malignant and cancerous tumors many times can negatively affect the male reproductive organs.

    Undescended testicle(s) - During fetal development, some male babies face the problem of one or both testicles not descending to the sac from the abdomen.

    Certain Infections - In many cases, sexually transmitted infections like HIV and gonorrhea, and inflammation of testicles or epididymis can negatively affect sperm production and/or health. These types of infections can even result in scarring that is known for blocking the passage of sperm.

    Anti-sperm antibodies - These are immune system cells that try to eliminate sperm because they think they are harmful to the body.

    Chromosome defects - Some chromosome defects lead to abnormal development of reproductive organs in males. A few common genetic syndromes that cause infertility are Klinefelter's syndrome, cystic fibrosis, Kallmann's syndrome and Kartagener's syndrome.

    Sperm blockage - Any injury or condition that causes sperm to be blocked in the tubes that carry it can lead to infertility. Common blockage causes are infections, trauma, surgery, and abnormal development.

    Medications, drugs, tobacco use, and even diet choice - Some medications and lifestyle choices impair sperm production. In some men, changing their diet can be the key to solving their infertility problems. Those who have celiac disease for example, often have positive results simply by opting for a gluten free diet.

    Varicocele - A varicocele is what happens when there is swelling of the veins that are responsible for draining the testicle. Varicocele leads to low sperm quality.

    Other causes for male infertility are:

    • Environmental causes such as prolonged exposure to heavy metals or toxic chemicals at work or home
    • Clothing that restricts or raises the temperature of the scrotum
    • Higher than normal levels of radiation

    Common causes of female infertility


    Ovulation problems - Ovulation problems occur when an egg doesn’t mature in the ovaries, or when the ovaries don’t release a mature egg.

    One known ovulation problem is premature ovarian failure, also known as premature menopause. This occurs when prior to the age of 40, you stop ovulating regularly. In some cases, you stop ovulating at all. You’re technically not in menopause until after going a full year without having a period, however.

    Another known ovulation disorder is Polycystic Ovary Syndrome (PCOS). PCOS is a clinical condition in females where their hormones are not in balance. It can lead to irregular and nonexistent menstrual cycles.

    Blockage or other problems in the uterus and/or fallopian tube(s) - Problems in the fallopian tubes can prevent sperm from reaching the egg. It can also block the passage through which the fertilized egg enters the uterus. Pelvic inflammatory diseases and sexually transmitted infections are just two of the known causes that can lead to blockage or damage of the uterus and/or fallopian tubes.

    Poor egg quality, or low egg count - As a woman ages the quality and number of eggs produced by the ovaries declines.

    Endometriosis - When the tissues that should be in the lining of the uterus are growing outside of the uterus, that’s known as endometriosis. Typically, when a woman has endometriosis, they will need to undergo surgery to remove this endometrial tissue from where it’s growing abnormally (usually the pelvis or abdomen). Other options are to surgically open the blocked fallopian tubes, or to administer fertility drugs. As with all of the conditions listed here, you’ll need to discuss your best options with a fertility specialist.

    Other causes for female infertility are:

    • Lifestyle factors such as prolonged drug and alcohol use, smoking, bad diet
    • Sexually transmitted diseases and infections
    • Other cervical and uterine problems
    • Cancers, other hormonal imbalances, or genetic disorders not listed above

    Seek Help if You’ve Had Multiple Miscarriages or Abortions

    When it comes to achieving pregnancy, there are sadly no guarantees for bringing that pregnancy to term. As many as 30 perfect of pregnancies end in a miscarriage. If you have had more than three miscarriages in a row, it’s called a recurrent miscarriage, and it suggests a chronic health problem that may actually be treatable.

    If you have had more than three abortions, you may also want to seek the guidance of a fertility specialist. In some cases of having a surgical abortion, there can be damage to the cervix or uterus. In fact, any procedure that can cause scarring to the reproductive organs could result in difficulties achieving pregnancy in the future.

    Is it Time to Seek the Help of a Fertility Specialist?

    Remember those questions we posed at the beginning of this article? Though we explored those questions in greater detail throughout this post, you may find you have even more questions now than you did before. If this sounds like you, then it is probably time to seek the help of a fertility specialist.

    The journey of trying to start or expand your family can be a scary and difficult one, but it doesn’t have to be a path you walk alone. It’s also better not to wait to get the answers you seek, and have peace of mind about your fertility. We want to help you maximize your odds of making your dreams come true. To learn more about becoming a patient with us, click here.


    Topics: Fertility Specialist

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