Infertility affects 1 in 8 couples. One third of the time it is due to a female problem, one third of the time it is due to a male problem, and one third of the time it is a result of both a male and female problem.
Most all women are concerned about having a potential fertility problem.
Here are some warning signs that could make it more difficulty for you to get pregnant.
A normal menstrual cycle ranges from 21 to 35 days, and is on average about 28 days for most women. Cycles should be overall consistent from month to month. If not, this demonstrates a problem with ovulation. Ovulation is critical when trying to get pregnant. When ovulation is not regular, it makes it hard to know when the egg is being released, and when to have intercourse.
Women can have problems ovulating due to various conditions, such as Polycystic ovary syndrome (PCOS), thyroid dysfunction, and extremes of weight (too high or too low). Ovulation problems can also happen as women get older and are nearing menopause.
Tracking your menstrual cycles from month to month helps you understand your body. You can look back at your last 3 to 4 months of cycles to see if your cycles are regular. If there is any concern, do not hesitate to reach out to your doctor to get a hormonal evaluation. Some ovulation disorders can be treated easily with medications.
If you have started to skip menstrual cycles, this indicates a lack of ovulation. This is even more of a problem if you used to have regular cycles, and now they are no longer present. This could be an early sign of menopause, or a different hormonal problem and requires prompt evaluation.
Very painful periods could be a sign of endometriosis, which is a very common condition, affecting about 10-11% of women. Endometriosis can cause scarring in the pelvis and a blockage in the fallopian tubes leading to fertility problems. Additionally, endometriosis can reduce egg quality making it harder to get pregnant. Lastly, women with endometriosis may have pain during intercourse that can make it difficult when trying to conceive.
Spotting in between periods
Spotting in the middle of your menstrual cycle could be due an abnormality within the uterus. Some women may have fibroids or an endometrial polyp (or overgrowth of tissue) in their uterus. These lesions in the uterus, while rarely associated with cancer, can reduce the chances of being able to get pregnant. Therefore, any spotting in between periods should be addressed by your doctor.
Heavy menstrual bleeding
Its hard to know exactly what heavy periods mean, as this can vary from woman to woman. However, if you have noticed your periods are heavier than they used to be or that you are soaking through pads or tampons, this could be due to uterine fibroids. Fibroids are benign tumors in the uterus, which can impact fertility, depending on their size and location.
History of abdominal surgery
Any type of abdominal surgery can put you at risk of scar tissue around the fallopian tubes and ovaries. The scar tissue is also known as pelvic adhesions. Adhesions can result in scarring or a blockage within the fallopian tubes. If the fallopian tubes are blocked, sperm and egg cannot meet and conception cannot take place. Your doctor can talk to you about tests that can be done to see if your fallopian tubes are open.
History of STIs or pelvic inflammatory disease
Some sexually transmitted infections (STIs) can cause scarring of the fallopian tubes. These include infections with gonorrhea or chlamydia.
If you have previously been diagnosed with one of these, or have been diagnosed with pelvic inflammatory disease (PID), then you are at risk of having a problem with your fallopian tubes and should consider having a test to check your fallopian tubes.
Being over the age of 35
We were all meant to have children in our 20’s.
As we get older, the chances of having a fertility issue increase. Most of this is a result in a decline in egg quantity, but also egg quality. Therefore, the chances of getting pregnant in any given month is lower in women who are over the age of 35.
What are these chances?
If you have never been pregnant before, the chances of conceiving per month are as follows:
- 30 – 33 years: 17-19%
- 34 – 37 years: 11-12%
- 38 – 39 years: 5%
- 40 – 44 years: 3%
If you have any of these warning signs, do not hesitate to ask your OB/GYN for an evaluation.
Also, it is never inappropriate to seek an evaluation from a fertility specialist, even if you just started trying or are thinking of trying to get pregnant.
I am a board-certified Reproductive Endocrinology and Infertility physician and Ob/Gyn who has been treating infertility patients since 2014. I have a boutique private practice in Orange County, and focus on providing patients with the most personalized approach to fertility care.
After graduating cum laude and Phi Beta Kappa from the University of California, Irvine, I received my medical degree from University of South Alabama, College of Medicine where I graduated in the top of her class.
I then completed my residency training in Obstetrics and Gynecology at the University of Southern California. There I received tremendous experience in all facets of Obstetrics and Gynecology, but specifically had an interest in Reproductive Endocrinology and Infertility. I continued my medical training and pursued a subspecialty in Reproductive Endocrinology and Infertility at Rutgers, New Jersey Medical School.
After my fellowship, I moved back to my hometown in Orange County and practiced at Kaiser Permanente in Orange County, as well as Eden Centers for Advanced Fertility in Newport Beach.
But I was passionate about providing my patients with the most personalized approach to fertility services and treatments, and therefore I opened up my own practice in 2020. My practice mission is to ensure patients feel comfortable and cared for, since infertility treatments can be overwhelming.