“What do you mean you don’t know, even after all of those tests?” If that’s something you have thought or said, after spending a lot of time and money at a fertility clinic, trying to find out why you can’t get pregnant – then you’ve probably been diagnosed with Unexplained Infertility. And you are not alone. About one in five couples, and 20-30% of fertility patients have been told there is no definitive explanation for why they can’t conceive.
The fact is, the diagnostic testing available can only identify the major reasons a couple might be struggling to conceive, but the tests can’t detect more subtle infertility factors.
Even though you don’t know exactly the cause of your infertility, it doesn’t mean you don’t have any options.
Let’s talk about the most common causes for infertility – the risk factors and medical issues that can impact your fertility.
Fertility Risk Factors
If you’re a smoker, consider quitting before you start trying to conceive. Besides improving your overall health, stopping nicotine consumption can also improve your fertility. That’s because smoking can potentially damage a person's fallopian tubes and cervix. It can also impact sperm health and motility. Some experts also believe that smoking causes your eggs and ovaries to age more quickly.
A person’s weight may also impact fertility. Sometimes being overweight, or underweight can alter the frequency of ovulation. If you don’t ovulate, you can’t get pregnant. Watching what you eat and drink (especially alcoholic drinks) is important while you’re trying to conceive. For some people, it may not take much to get your ovulation back on track. Studies have shown that for people who are at an unhealthy body weight - gaining or losing just 5 percent of their body weight – may help regulate your ovulation.
Your age ranks at the top of the list of risk factors that impact fertility. That’s because the quantity and quality of eggs starts to decline after age 35. Which means the risk of miscarriage goes up, making it more challenging to get and stay pregnant the older you are. In fact, about one-third of people with ovaries over the age of 30 have fertility problems. The problem is that even though people with ovaries are in their prime stage of fertility in their 20’s – for a lot of people, that’s not the right time in their life to start a family.
So now you know what lifestyle factors can impact your fertility. Now let’s talk about medical issues that can also complicate your chances of getting pregnant.
To conceive you basically need three things:
You need to ovulate.
You need access to healthy sperm and viable eggs.
You need open fallopian tubes for the egg and sperm to meet and a healthy uterus where the embryo can grow.
Common Medical Issues
Here are the most common medical conditions people with ovaries deal with that you should rule out if you’re having trouble getting pregnant:
Polycystic Ovarian syndrome, or PCOS is the most common cause of infertility in people with ovaries. PCOS is a hormonal imbalance that causes ovulation to become irregular or could prevent ovulation from happening altogether.
Endometriosis is another leading cause for infertility. Endometriosis happens when the lining of a person’s uterus grows in other places like the fallopian tubes, abdomen or ovaries. This extra tissue growth can cause irritation and scar tissue. Endometriosis can cause the fallopian tubes to be blocked, create inflammation and may even impact egg quality. Some people don’t have any symptoms – while others may have pain during sex, heavy periods or pelvic pain.
Premature Ovarian Failure is when a person's ovaries stop producing an adequate number of quality eggs well before the age 40.
Thyroid issuescan cause your period to become irregular. This happens when your body creates too much (hyperthyroidism) or too little (hypothyroidism) of the hormone. This is a condition that is easy to treat.
Cervical mucus issues may also prevent pregnancy from occurring. That fluid in your vagina comes from your cervix – and is stimulated by the estrogen hormone. The amount and “quality” of that fluid, or mucus, varies depending on what point you are in your menstrual cycle. When you get close ovulating – estrogen surges. This surge should cause the cervix to produce more mucus and change its quality - so it’s the perfect texture to protect sperm on its journey to the fallopian tubes. But, not everyone produces a lot of cervical mucus around time of ovulation. Some vaginas even create a “hostile” or acidic environment for sperm – where the mucus never thins out – and stays thick and sticky. Having abnormal cervical mucus can prevent sperm from ever reaching the egg.
Damaged or blocked fallopian tubes can cause infertility because the sperm can’t get to the egg for fertilization – and then the fertilized egg can’t get to the uterus to implant and grow. Pelvic inflammatory disease (PID), can cause scarring and blockage of the tubes – which is commonly caused by sexually transmitted diseases - like chlamydia or gonorrhea. Previous surgery could also cause blocked tubes – including surgery to remove an ectopic pregnancy.
Uterine fibroids are typically non-cancerous masses of tissue that develop. When fibroids grow inside the uterus, and near the endometrial lining – fertility can be impacted. The issues will depend on the size, amount and location of the fibroids. Symptoms may include heavy periods, infertility and miscarriages.
Some put the burden of infertility solely on themselves, and never think to ask their partner to get checked out. Male infertility is very common – more than you might ever hear about. So, that if your male partner isn’t tested, then you won’t be able to rule out issues with the other half of the fertility equation – sperm.
The bottom line here is – you will find a way to your forever family. And we are here to help and support you on this journey as best we can. Please don’t hesitate to reach out if we can answer any specific questions.