Some of the most common causes of female infertility include:
- Failure to ovulate. If you’re not ovulating, it could be due to several factors, including natural aging, endocrine disorders, ovarian or gynecological conditions like PCOS or POI, or lifestyle and environmental factors.
- Problems with the menstrual cycle. The menstrual cycle is what prepares the female body for pregnancy, so any issues with your cycle could lead to difficulty getting pregnant.
- Structural problems. This usually includes the presence of abnormal tissue in the uterus or fallopian tubes. This can prevent the egg from moving from the ovaries to the uterus, prevent sperm from being able to fertilize the egg, or interfere with implantation.
- Infections. Chronic infections in the cervix can reduce the amount or quality of cervical mucus. Untreated STIs are also associated with lowered fertility.
- Failure of an egg to properly mature. This can be caused by several factors, including PCOS, obesity, or a lack of specific proteins that help an egg mature.
- Implantation failure. A fertilized egg may fail to implant on the uterine wall due to genetic defects in the embryo, a thin endometrium, scar tissue, or endometriosis.
- Endometriosis. This condition causes scar tissue to form in the reproductive organs and causes structural problems. About 30-40% of women with endometriosis are infertile, and between 25-50% of infertile women have endometriosis.
- Polycystic ovary syndrome (PCOS). This common cause of female infertility is when a woman’s ovaries and adrenal glands produce more androgens than normal. High levels of these hormones interfere with ovulation and the development of ovarian follicles.
- Primary ovary insufficiency (POI). This condition describes when a woman’s ovaries stop producing hormones and eggs at a young age. These women ovulate infrequently, if at all.
- Uterine fibroids. These noncancerous growths form on the inside of the uterus and contribute to infertility.
- Autoimmune disorders. Conditions like lupus, Hashimoto’s, or rheumatoid arthritis may affect fertility.
If you have one of these conditions or suspect underlying health issues are impacting your fertility, talk with your doctor. They can help you understand what’s going on and how you can move forward.
What is involved in fertility testing?
There are several ways to measure fertility. Doctors usually start with two blood tests that measure a woman’s levels of anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH). AMH is released by a woman’s eggs, and these levels go down as her egg count declines. This provides an idea of how many eggs she has left compared to other women of her age. Levels of FSH go up as a woman’s egg count goes down, and it also provides an indication of her ovarian reserve.
A fertility assessment with your OBGYN will also include a comprehensive discussion about your medical history and lifestyle, including medications you’ve used, surgical history, and your work and living conditions. Your doctor will perform a pelvic and physical exam to look at areas including your thyroid, breasts, and hair growth. They may want to perform additional testing to evaluate if ovulation is occurring, ovarian function, and uterine function. Following this initial assessment, your doctor will know the right tests to recommend for your specific situation.
The truth about at-home fertility tests
Today, there are several companies that offer at-home fertility testing. These typically include the AMH and FSH blood tests; the sample is collected at home, then sent into a lab to measure these hormone levels.
However, recent studies have found that the number of eggs a woman has left—what these blood tests measure—is not a definite indication of fertility. More important is the quality of eggs she has remaining, for which tests don’t yet exist. If you’re curious about your fertility, the best option is to visit your OBGYN. They are equipped to perform a comprehensive analysis of your health and fertility, while at-home tests can leave you with potentially misleading information.
The COVID-19 vaccine and fertility
Currently, there is no evidence that getting the COVID-19 vaccine impacts fertility for either women or men. In fact, if you’re trying to conceive, it’s essential to protect yourself from this virus. The CDC recommends everyone who is trying to become pregnant or may become pregnant in the future get vaccinated, as well as their partners.
Many people have become pregnant after receiving a COVID-19 vaccine, including those who were involved with clinical trials for the vaccines. In a study of people undergoing in vitro fertilization (IVF), researchers compared women who had antibodies from a COVID-19 vaccine, those with antibodies from a recent COVID-19 infection, and those with no antibodies from either. There were no differences in pregnancy success rates among these three groups.
If you’re trying to conceive and wondering about your fertility, talk with your OBGYN. They have all the tools to help you understand your health and the best way to move forward. And with virtual visits, starting the conversation is easier than ever. Schedule an appointment today!