You and your partner are ready to become parents and you start thinking about trying for a baby, or maybe you have already been trying for some time without any luck. It is very important to know that even for healthy couples there are some risk factors for infertility which should be avoided before planning pregnancy.
There are risk factors for female infertility, some risk factors for male infertility and some factors which could damage fertility of both partners.
RISK FACTORS for FEMALE INFERTILITY
General factors that can affect the ability to ovulate, conceive, or deliver a child successfully include the following:
Age - Risk factor for Infertility
In general, women in their late 30s are less fertile than women in their early 20s. Nowadays women postpone pregnancy as they are busy with their career - many women are waiting until their 30s and 40s to have children. So age is a growing cause of fertility problems. About one-third of couples in which the woman is over 35 have fertility problems.
It is well known that aging decreases women’s chances of having a baby in the following ways:
- ovaries become less able to release eggs;
- number of eggs left is decreasing;
- eggs are not as healthy as they were before 30;
- with age health conditions and health problems could create unexpected causes for fertility;
- women after 35 have higher chances for miscarriage.
Maternal age is probably the most significant factor for women ability to conceive. While some women are waiting to become pregnant after 35, their ovary's ability to produce normal, healthy eggs declines with age, increasing the risk of chromosomal abnormalities and unsuccessful fertilization, implantation and pregnancy development. Dramatic fertility changes were noted after 40.
Endometriosis - Risk factor for Infertility
According to medical statistics it is estimated that infertility can affect around 40% of women with Endometriosis. Infertility can be one of the consequences of Endometriosis. Women are not only dealing with a debilitating disease but they are also in fear of not being able to have children.
It has been found that between 30-40% of women undergoing laparoscopy as part of an infertility evaluation are found to have Endometriosis.
There appears to be a number of mechanisms by which Endometriosis impacts on fertility. Scarring or adhesions in the pelvis, for example, may cause infertility. The fallopian tubes and ovaries may adhere to the lining of the pelvis or to each other, restricting their movement. The scarring and adhesions that takes place with Endometriosis may mean that the ovaries and fallopian tubes are not in the right position, so the transfer of the egg to the fallopian tubes cannot take place. Endometriosis can cause damage and/or blockage to the inside of the fallopian tube, impeding the journey of the egg down the fallopian tube to the uterus.
Another factor which could cause infertility for women with Endometriosis, may be the over-production of prostaglandins. These are hormones which play and important role in the fertilization and implantation of the embryo. An excess of prostaglandins may interfere with these processes.
Because Endometriosis often causes painful intercourse, couples may fail to have intercourse during the woman’s most fertile time, which will obviously impede the possibility of conception.
Polycystic Ovarian Syndrome (PCOS)- Risk factor for Infertility
Women with PCOS are at high risk of infertility and infertility rate with PCOS is very high. During PCOS women are producing increased levels of androgens (male hormones) which is caused by the enormous production of insulin in their bodies. Another problem caused by PCOS is being resistant to insulin which makes women more prone to diabetes.
Polycystic Ovarian Syndrome (PCOS) also known as Stein-Leventhal syndrome is a complicated endocrine disorder associated with a long-term lack of ovulation (anovulation) and an excess of androgens (male hormones, e.g., testosterone). PCOS affects an estimated 6-10% of all women and most don't even know they have it.
Formation of eight or more follicular cysts of 10 mm or smaller in the ovaries is very typical for PCOS. The process related to the anovulation - ovary's failure to release an egg (ovum). The many cysts in a polycystic ovary are follicles that have matured but, due to abnormal hormone levels, were never released. In a normal ovary, a single egg develops and is released each month.
PCOS is one of the most frequent causes of infertility. About 5-10% of all women of reproductive age suffer from PCOS. However, only about 25% of women who actually have PCOS are diagnosed as having it. Some PCOS women get lucky and are able to become pregnant even during irregular menstrual cycle (oligomenorrhea).
Environmental factors - Risk factors for Infertility
Smoking. Women who smoke are at higher risk of female infertility. Besides damaging your cervix and fallopian tubes, smoking increases your risk of miscarriage and ectopic pregnancy. It's also thought to age your ovaries and deplete your eggs prematurely, reducing your ability to get pregnant.
Alcohol. Heavy drinking is associated with an increased risk of ovulation disorders and endometriosis - intake of excessive alcohol on a regular basis instigates and increases chances of contracting endometriosis and ovulation disorders leading to female infertility.
Caffeine. Consuming more than the equivalent of six cups of coffee a day (900 milligrams of caffeine) may decrease your fertility.
Excessive or very low body fat - Risk factor for Infertility
Weight is another important risk factor for women. Normal body weight and normal body fat are important for normal ovulation. Although most of a woman's estrogen is manufactured in her ovaries, 30% is produced by fat cells, which transform male hormones produced by the adrenal glands into estrogen. Because a normal hormonal balance is essential for the process of conception, extreme weight levels (either high or low) can contribute to infertility.
If you are overweight or significantly underweight, it may inhibit normal ovulation. Women who are overweight have decreased fertility and an increased risk for miscarriage. Additionally, very low body weight may be associated with infertility and miscarriage.
Healthy lifestyle and normal body mass index (BMI) could increase your fertility. In general normal BMI is 20-25. Getting to a healthy body mass index (BMI) has been shown to increase the frequency of ovulation and the frequency of pregnancy chances.
Extremes in weight, fat, diet and exercises should be avoided because any extreme body situation can decrease your fertility.
Abnormal Pap test - Risk factor for Infertility
Pap test is a regular test that every adult woman should have around every two or three years. In some specific cases your doctor could recommend Pap test every year or even more often. During a pap smear, a group of cells from the cervix are collected and examined microscopically to help determine if a woman has cervical cancer or if she is at risk of developing cervical cancer. A pap smear is a fast test, and is, for the most part, painless. The accuracy of the pap smear is relatively high, which means that very few women who have a regular pap smear will have cervical cancer. Pap test that indicates no abnormalities is called a “normal” or “negative” pap smear. A pap smear that indicates cancerous or pre-cancerous cells is called “positive” or “abnormal.”
During pregnancy Pap test is recommended. Pap test does not create any risks to you or to your fetus. If your pap test comes back with an abnormal result during pregnancy, your doctor will discuss possible treatment options that are safe for you during pregnancy, or discuss the possibility of delaying any treatments until after you have your baby. In many cases, just delivering your baby will wash away the abnormal cells.
If there are serious problems, additional testing and/or treatment would be needed.
Doctor can recommend colposcopy or a cervical biopsy. If so, these procedures may cause some bleeding of the outside of the cervix, but do not pose any threat to your baby. If your doctor would be forced to do an internal biopsy, there may be some risk of pregnancy complications.
Diethylstilbestrol (DES) - Risk factor for Infertility
DES (diethylstilbestrol) is a synthetic form of estrogen, a female hormone. It was prescribed between 1938 and 1971 to help women with certain complications of pregnancy. Use of DES declined following studies in the 1950s that showed it was not effective in preventing pregnancy complications. When given during the first 5 months of a pregnancy, DES can interfere with the development of the reproductive system in a fetus. For this reason, although DES and other estrogens may be prescribed for some medical problems, they are no longer used during pregnancy.
Women, who were pregnant between 1938 and 1971 and took DES, regardless of whether a live birth resulted, are considered DES exposed. Women who took DES have a 35% greater risk for breast cancer than women who never took DES, and should be particularly cautious about breast care and self-exam.
If you think you were exposed to DES during pregnancy, it's important that you discuss this with your physician so that he can be alert for any changes that could be related to your exposure. It's important for DES mothers to discuss this with the adult children who were born so that they can inform their physicians to look for possible consequences caused by prenatal exposure to DES. Your children could need special exams and care from a medical
Sexually transmitted diseases (STDs) - Risk factor for Infertility
Sexually transmitted diseases like chlamydia and gonorrhea can cause fallopian tube damage. Having unprotected intercourse with multiple partners increases your chances of contracting a sexually transmitted disease (STD) that may cause fertility problems later.
Avoid sexually transmitted diseases. It would be wise to limit sex partners and use condoms to reduce the risk of getting sexually transmitted disease (STD) including HIV/AIDS, gonorrhea, chlamydia, syphilis, herpes, trichomoniasis, etc. Some STDs (especially undetected and untreated) can damage your reproductive system and cause infertility. If you think you may have an STD, get treatment promptly to reduce the risk of damage to your reproductive system.
Condoms can prevent sexually transmitted infections. Be sure you know how to choose the right condom, how to use a male condom correctly and/or how to use a female condom.
Pelvic Inflammatory Diseases and Fallopian tubes - Risk factor for Infertility
Pelvic inflammatory disease (PID) is a serious infection in the upper genital tract which called female reproductive organs (uterus, fallopian tubes and ovaries). PID can be sexually transmitted or naturally occurring. In most cases PID is caused by a type of bacteria, often the same type that is responsible for several sexually transmitted diseases, such as gonorrhea and chlamydia. In some cases, PID develops from bacteria that have traveled through the vagina and the cervix by way of an intrauterine device (IUD).
PID can affect the uterus, fallopian tubes, and/or the ovaries. It can lead to pelvic adhesions and scar tissue that develops between internal organs, causing ongoing pelvic pain and the possibility of an ectopic pregnancy. PID could be a reason of infertility (untreated cases). In fact, PID is currently the leading cause of female infertility. If left untreated, PID can also lead to chronic infection. In addition, if PID is not diagnosed early enough, peritonitis and inflammation of the walls of the abdominal and pelvic cavity may develop.
Sexually active women between the ages of 20 and 31 are at the greatest risk of acquiring the PID through sexually transmitted bacteria. Women under 25 are more likely to develop PID than those older than 25. This is because the cervix of teenage girls and young women is not fully matured, increasing their susceptibility to the STDs that are linked to PID. Women who use intrauterine devices (IUDs) are at higher risk.
Early treatment of PID is strongly recommended.
Stress - Risk factor for Infertility
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How many time we are facing stress! - Love, danger, fear, abuse, exams, conflicts, work, personal relations, misunderstandings, fight, sadness, diseases, death, etc. Eating disorders, dieting, drug use, and reliance on stimulants like caffeine and alcohol are also interpreted by the body as kinds of stress. Poor nutrition seems to physically change the proteins in the brain so they can no longer send the proper signals for normal ovulation. When we are under stress, our adrenal glands are designed to produce the hormone called stress hormones (cortisol, adrenaline and noradrenaline) which have direct impact on the sex hormones (mainly estrogens and progesterone). Sex hormones are responsible for normal regular menstrual cycles. Neurotransmitters (chemical messengers) act in the hypothalamus gland, which controls both reproductive and stress hormones. Severely elevated levels of stress hormone can, in fact, shut down menstruation.
It was hypothesized that women with higher stress levels would be more likely to experience abnormal cycles and that within women higher stress levels would positively relate to follicular phase length and inversely relate to luteal phase length.
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Many women have irregular periods after stress. So, if you have stress, better take care of it as soon as possible!
Multiple miscarriages - Risk factor for Infertility
A miscarriage is always devastating to parents who have been trying to conceive. While experiencing one miscarriage can be distressing, having to go through two or more can be overwhelmingly traumatic for a couple. Suffering multiple miscarriages is a good indication that you need to see a fertility specialist. Recurrent pregnancy loss is often a sign of an underlying fertility problem that requires treatment before a successful pregnancy can occur.
Multiple miscarriages is a prove of serious fertility problem.
Genetic conditions - Risk factor for Infertility
Infertility could be a result of some genetic diseases which are inherited and could be discovered in family tree. Common example is pathology with X chromosomes - as being a carrier of Fragile X syndrome.
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