The average age of first-time mothers has been on the rise since the 1970s, with many women now choosing to wait until their thirties to enter motherhood. As more and more women wait to become mothers or want to continue having children well into their forties, fears of infertility have also been on the rise. Over 10% of American women experience infertility, meaning they have attempted to conceive for more than a year without success. For women over 35, infertility can come into question after only six months of unsuccessful attempts at conception. Ovulatory problems can stem from both medical and behavioral factors, many of which are treatable. We have listed the most common causes of female infertility below.
PCOS is a hormonal disorder that is usually identified by irregular periods, elevated levels of male hormones that cause facial hair or hair loss, and enlarged ovaries. PCOS currently ranks as the number one cause of infertility in females, as it prevents proper ovulation. The exact cause is not yet known, but doctors believe high insulin levels, inflammation, the existence of excess male hormones, and hereditary factors could all be relevant causes. Obese women, in particular, are at risk, due to the high insulin levels and inflammation often experienced. Several treatments exist for those with PCOS, ranging from weight loss programs to fertility drugs.
Endometriosis has become a hot topic in the medical world, as it is becoming more common amongst American females and often does not get diagnosed until adulthood. Endometriosis affects infertility as it causes excess tissue growth outside the womb. This can cause severe pain before and during menstruation, exhaustion, and digestive problems. There is not yet a cure for endometriosis, but treatment does exist to help ease pain and the intensity of menstrual periods.
Many women who struggle with infertility become diagnosed with ovarian failure or insufficiency. These conditions are often related to premature menopause, but they are crucially different in that women with POI or POF still have a chance to conceive, while premature menopausal women cannot. Symptoms may often seem pre-menopausal, such as the loss or fluctuation of a period, hot flashes, irritability, and decreased sexual desire. Chromosomal defects, toxins from chemotherapy and radiation, and autoimmune diseases are all risk factors and causes of ovarian insufficiency or failure. Doctors typically recommend estrogen therapy as well as calcium and Vitamin D supplements, due to the increased risk of osteoporosis if diagnosed with POI or POF.
Uterine fibroids are most commonly benign tumors that grow inside the womb and grow more common as women age. These fibroids can cause heavy bleeding, pregnancy complications, lower back pain, and frequent urination. Doctors are unsure of the exact cause of fibroids but believe they are related to irregular female hormone levels and genetics. Experimental treatments are available for fibroids but may not be covered by insurance.
Besides the social stigmas and intense symptoms associated with STDs and STIs, they can also cause infertility and impact about 15% of infertile women in the U.S. Not all sexually transmitted diseases and infections can cause infertility, but chlamydia, gonorrhea, and trichomoniasis are several of the major culprits.
Although technology has helped many women start the reproduction process later and later, age is still one of the largest risk factors for infertility. Atresia is the follicle degeneration process causing egg-containing follicles to decrease as age increases and occurs in every woman regardless of their cycle or use of fertility intervention. As eggs are lost in the body over time, the chances of conception grow slimmer, averaging at 20% each month of trying at age 30, versus just 5% by age 40. Women over 35 are suggested to search for treatment in assisted reproductive technologies such as intrauterine insemination or in vitro fertilization. Women over 42 are suggested to consider an egg donor if other treatments have not worked.
Underweight women, those who have a BMI of 18 or lower, are at risk due to a lack of fat to produce enough hormones, ovulation, or an entire menstrual cycle. Women with eating disorders, nutrient deficiencies, extreme exercise regimens, and too little body fat are at risk for infertility because the body is running low on energy and support; thus needing to shut down anything that is not vital, such as ovulation, to keep other crucial systems running. Gaining weight through eating nutritionally-dense foods and adopting a low to moderate exercise plan is the most recommended option. Reproductive technology can often lead to conception, but without enough fat and other nutrients in the body, the woman will likely lose the baby in utero.
Overweight women, those who have a BMI between 25 and 29.9 are also at risk for infertility. Obese women, those with a BMI at or above 30, are at an even higher risk. Fat cells produce estrogen throughout the body, and too many fat cells can cause hormonal imbalances and lead to the loss of ovulation. By adopting a healthy eating plan and incorporating low to moderate exercise into one’s daily routine, an overweight or obese woman can not only increase her chances of conception but also at having a healthier pregnancy and child overall, as higher BMI’s are linked to gestational diabetes, miscarriage, pre-eclampsia, among other issues.
Poor nutrition is not just for the under and overweight populations. Many women with considerably healthy body masses make poor eating choices due to comfort, familiarity, a busy schedule, and a variety of other reasons. Research has shown that the recommended amount of both macronutrients (carbohydrates, fats, proteins) and micronutrients (vitamins and minerals) are essential for a fetus to develop properly. Most of the fast food and packaged items we eat are void of any micronutrients, keeping us from filling our bodies with what we need to create and carry a healthy baby. If you incorporate whole grains, lean meats, fruits, and vegetables into your diet, it will be much easier to obtain the recommended daily allowance (RDA) of nutrients provided by doctors and dieticians. Taking a prenatal vitamin is recommended as soon as one begins to attempt conception, and a healthy diet to create a healthy baby should as well.
As mentioned earlier, excessive exercise can lead to the absence of ovulation or a period, but it is not just for those with unhealthy body weights. Too much physical or emotional stress on any woman can be shown to affect her ability to conceive. Exercise should be a part of every woman’s daily routine when possible, as it has many health benefits, but those trying to lose weight to become more fertile should seek the majority of it in the kitchen instead of the treadmill. While emotional stress has not been proven to cause infertility, studies have shown correlations to stress and its ability to impair the body from fully functioning due to cortisol, our biggest stress hormone. It can create a loss of sex hormones as well as cause inflammation, impair the immune system, and prevent detoxification. Assessing your exercise regimen and reducing stress are recommended for those wanting to conceive.
While we all know not to consume these substances during pregnancy, research links all three of these to infertility. The U.S. Surgeon General discourages women planning on becoming pregnant from consuming alcohol in any amount but drinking two or more alcoholic beverages per day has especially shown to cause higher rates of menstruation problems in women.
Smoking more than doubles a woman’s chance of infertility by increasing the rate of follicular degeneration, reducing the amount of estrogen in the body, and impairing a healthy menstrual cycle. Illegal drugs, including marijuana, have serious risks for infertility, as they can prevent implantation, impair ovulation, and increase the rate of miscarriage.
A few lifestyle changes could make all the difference such as reducing alcohol and processed food intake, eliminating cigarettes and stress, as well as scheduling a moderate amount of exercise throughout the week. All of these behavioral risk factors affect male infertility as well, so keep your partner in check too! Talk to your doctor if you have concerns pertaining one of the medical risk factors, want to be tested for infertility, or are planning to make serious lifestyle changes when it comes to your health.
If you are planning on becoming pregnant, doctors advise you to take care of your body as if you are already pregnant. For example, start taking a prenatal vitamin, reducing caffeine intake, and adhering to a healthy diet.
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