If you are having trouble conceiving, you or your partner may have a fertility problem. Of course, the likelihood of conception is affected by a wide range of factors, including how long you’ve been off birth control, how often you have sex, you weight and general health, and much more. If you’ve been trying for a year or more, however, a more serious problem might be the cause. The following are the most common causes of female infertility:
Polycystic Ovarian Syndrome
Polycystic ovarian syndrome (PCOS) is characterized by an imbalance of hormones, which prevents normal ovulation. Of course, without the release of eggs, it’s impossible to become pregnant. A doctor can prescribe medication that will help your body to ovulate regularly in case if you are diagnosed with PCOS.
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Pelvic Inflammatory Disease
Pelvic inflammatory disease (PID) occurs when the reproductive organs are infected. This can be the result of sexually transmitted diseases, abortion, or surgery. The scarred organs can block the fallopian tubes, preventing sperm from reaching the egg. Depending on the severity of PID, it can be treated with antibiotics or surgery.
Uterine Fibroids
Uterine fibroids are noncancerous growths of tissue in the uterus. Most women have them at some point, and when they are small, they are not harmful. However, if they are large and numerous, they may interfere with conception and a healthy pregnancy. Doctors can typically detect uterine fibroids during a normal pelvic exam. If you have fibroids that are causing infertility, you can have them removed through a non-invasive procedure.
Endometriosis
Endometriosis is a disorder in which the endometrium, the lining of the uterus, attaches to places outside the uterus. During menstruation, this lining sheds but cannot exit the body. This can be painful and cause fertility problems. Fortunately, endometriosis can be treated by either medication or surgery.
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How long should I try to conceive before seeing a fertility specialist?
The American Society for Reproductive Medicine (ASRM) recommends that women under 35 who have been trying to conceive for one year, or women 35 and older who have been trying for six months, should consult a fertility specialist. If you have known fertility risk factors or irregular cycles, you may want to seek evaluation sooner. Most US fertility clinics can provide an initial consultation to assess your individual situation.
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Is PCOS treatment covered by insurance?
PCOS treatment coverage varies depending on your individual insurance plan and state requirements. Diagnostic testing, medication like metformin to help with ovulation, and some fertility treatments may be covered, though many plans require documentation of infertility (typically one year of unsuccessful attempts). It's best to contact your insurance provider directly or have your fertility clinic's billing department verify your coverage before beginning treatment.
Can endometriosis be diagnosed without surgery?
While laparoscopy (minimally invasive surgery) is the gold standard for diagnosing endometriosis, doctors can often suspect it based on symptoms, medical history, and imaging studies like ultrasound or MRI. However, imaging cannot definitively rule out endometriosis, and a definitive diagnosis typically requires visual confirmation during a surgical procedure. If you suspect endometriosis, discuss non-surgical diagnostic options with your gynecologist.
What is the success rate for removing uterine fibroids to improve fertility?
The success rate for improving fertility after fibroid removal depends on the fibroid's size, location, and whether it was distorting the uterine cavity. Studies show that removing fibroids that protrude into the uterine cavity can improve pregnancy rates significantly, while removal of fibroids that don't affect the cavity may have less impact. Your fertility specialist can assess whether your specific fibroids are likely affecting conception and recommend the appropriate treatment approach.
Can
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pelvic inflammatory disease cause permanent infertility?
PID can cause permanent infertility if scarring damages the fallopian tubes or other reproductive organs, but prompt treatment with antibiotics can often prevent permanent damage. The risk of infertility increases with each episode of PID and the delay in treatment, which is why early diagnosis and antibiotics are crucial. If you suspect PID or have a history of it, inform your fertility specialist so they can evaluate for any tubal damage.
How is female infertility evaluated in the US?
A standard fertility evaluation typically includes a medical history, pelvic exam, blood work to check hormone levels and ovulation, and imaging such as ultrasound or hysterosalpingography (HSG) to assess the uterus and fallopian tubes. Your doctor may also perform additional testing based on your symptoms and initial results. The ASRM provides guidelines that most US fertility clinics follow to ensure comprehensive evaluation of female infertility.
Are there lifestyle changes that can improve fertility if I have PCOS?
Yes, research shows that weight loss, regular exercise, and a balanced diet can improve ovulation and fertility outcomes in women with PCOS, even without medication. Reducing insulin resistance through diet and lifestyle modifications is particularly important, as PCOS is often linked to insulin-related hormonal imbalances. Discuss with your healthcare provider or a fertility dietitian about specific lifestyle changes that may benefit your situation.
