Understanding Fertility Challenges
Infertility affects an average of 1 in 7 couples, yet it’s a topic that often flies under the radar until couples face challenges trying to conceive. For those planning to start a family now or in the future, understanding the conditions that can impact fertility, fertility risk factors and available options that may help can offer clarity and hope.
The Impact of Age on Fertility
One of the most significant influences on a woman’s fertility is age. “It’s one of the more common issues we see in our field in women over the age of 35,” said Jeris Cox, MD, a fertility specialist and owner of Adore Fertility. “This is due to a decline in egg quantity and quality as a woman ages.”
Common Female Fertility Issues
Several other conditions can affect a woman’s ability to conceive, including ovulation disorders such as polycystic ovarian syndrome, where the woman typically has irregular menstrual cycles or none at all. Endometriosis, which can lead to inflammation and scarring around the reproductive organs, is another common cause and is frequently marked by extremely painful periods. Additionally, structural issues such as blocked fallopian tubes or uterine fibroids – benign growths in the uterus – can interfere with egg fertilization or embryo implantation.
Male Infertility and Testosterone Use
Male infertility also is a significant factor and can result from a range of underlying issues. Low sperm counts or the absence of sperm may be caused by genetic factors, previous illnesses or even childhood surgeries such as hernia repairs for undescended testicles. A rising cause Dr. Cox and her team are seeing is the use of testosterone therapy. “More men are using exogenous testosterone supplementation and are unaware that this can actually halt their natural sperm production,” she explained. “Testosterone use shuts down the brain’s stimulation to the testes and can stop sperm production altogether.”
Lifestyle Factors That Affect Fertility
For women, increasing age, a history of sexually transmitted infections that may have caused scarring and poor overall health can all play a role in fertility. Extremes in body weight – being significantly underweight or overweight – also are concerns, as are long-term habits such as smoking, excessive alcohol consumption and drug use.
Recognizing Warning Signs
Warning signs that may suggest a fertility issue include irregular or absent menstrual periods, abnormal bleeding, hot flashes or trying to conceive for more than a year – or six months for women over 35 – without success. “If you’re not having a regular 25-to-35-day menstrual cycle or can’t detect ovulation with at-home kits, you should see a fertility doctor,” Dr. Cox advised.
Proactive Fertility Planning
Even without symptoms, she advised proactive planning. “Any female over 30 who is not actively pursuing pregnancy but thinks she wants children in the future should consider baseline fertility testing,” she suggested. This can provide valuable information about egg reserve and open the door to options like egg freezing.
Improving Fertility Naturally
There is no one-size-fits-all cure for infertility or way to reverse the effects of age. Still, there are steps that can improve fertility: maintaining a healthy weight, avoiding smoking and drug use, limiting alcohol intake and practicing overall good health habits.
Role of Diet and Supplements
When it comes to diet, Dr. Cox cautioned, “There’s no miracle diet or supplement. A well-balanced diet and prenatal vitamins can ensure you get the iron, folate and zinc needed for healthy cellular turnover.” She emphasized that while the supplement market is flooded with claims, most are not supported by scientific evidence. Prenatal vitamins, however, are widely recommended for any women trying to conceive.
Fertility Treatment Options
Fortunately, fertility treatment has advanced significantly in recent years, and many cases can be addressed with relatively simple and affordable options. For women who are ovulating irregularly and have no major structural issues, oral ovulation induction combined with intrauterine insemination is often the first step. Medications for ovulation induction can increase the chances of ovulating multiple eggs, which may improve the likelihood of conception.
Advanced Fertility Treatments and IVF
When more complex factors are involved, such as age-related egg decline, poor sperm production or blocked fallopian tubes, in vitro fertilization becomes the preferred option. IVF allows doctors to retrieve multiple eggs in one cycle, fertilize them in a lab and select the healthiest embryos for transfer. Pre-implantation genetic testing can improve the chances of a successful pregnancy by ensuring the embryo is genetically normal before implantation.
Encouragement and Hope
Dr. Cox emphasized to people struggling to conceive not to let fear of cost or stigma keep them from seeking help. “Some people avoid coming in because they assume treatments are too expensive. But not all fertility workups or treatments are costly,” she said. “Sometimes we have simple, low-cost methods that can make the difference. You’ll never know unless you take the step to be seen.”
The emotional journey of infertility can be just as challenging as the physical one, but there is hope. “The reason I love what I do is because most of the time we can succeed for our patients,” Dr. Cox smiled. “That doesn’t always mean we can achieve pregnancy with their own eggs or sperm, but it means we can help them become parents. Families are created in many ways.”
Infertility may be a difficult path, but it’s one that increasingly comes with options, support and hope.
By Anne Toole
