Infertility can be an emotional and frustrating experience for women who are trying to become pregnant. While it is normal for conception to take some time, certain situations may indicate that it is appropriate to seek a fertility evaluation.
Female infertility can have many different causes, including problems with ovulation, hormonal imbalances, blocked fallopian tubes, endometriosis, uterine conditions, age-related changes, and other reproductive health factors.
Understanding when to seek medical evaluation can help identify potential fertility problems and determine which treatment options may be available.
What Is Infertility?
Infertility is generally defined as the inability to become pregnant after 12 months of regular, unprotected sexual intercourse.
For women who are 35 or older, a fertility evaluation is generally recommended after 6 months of trying without becoming pregnant.
Women over 40 may benefit from seeking an evaluation sooner rather than waiting several months.
Infertility does not necessarily mean that pregnancy is impossible. Many women with fertility challenges are able to become pregnant with appropriate medical evaluation and treatment.
When Should a Woman Seek an Infertility Evaluation?
The appropriate time to seek an evaluation depends largely on age and medical history.
If You Are Under 35
If you are younger than 35 and have regular menstrual cycles, an evaluation is generally recommended after 12 months of trying to conceive without success.
However, you do not necessarily need to wait a full year if you already have symptoms or medical conditions that could affect fertility.
If You Are 35 to 39
Women between 35 and 39 are generally encouraged to seek an infertility evaluation after 6 months of trying to become pregnant without success.
Fertility gradually declines with age, particularly because the number and quality of eggs decrease over time.
If You Are 40 or Older
Women who are 40 or older may benefit from discussing fertility with a healthcare professional as soon as they begin trying to conceive.
An earlier evaluation can provide important information about ovarian reserve and other factors that may affect the chances of pregnancy.
What Are the Signs That You May Need a Fertility Evaluation?
Difficulty becoming pregnant is not the only reason to seek an evaluation.
You may benefit from an earlier assessment if you experience:
- Irregular or absent menstrual periods
- Very painful periods
- A history of endometriosis
- Previous pelvic infections
- Previous pelvic or abdominal surgery
- A history of ectopic pregnancy
- Recurrent miscarriages
- Known uterine or ovarian conditions
- Symptoms associated with hormonal problems
- Previous cancer treatment involving chemotherapy or radiation
- Concerns about declining fertility because of age
An evaluation can help determine whether one or more of these factors may be affecting conception.
What Causes Infertility in Women?
Female infertility can result from problems involving different parts of the reproductive system.
Ovulation Problems
Ovulation is the release of an egg from the ovary. If ovulation does not occur regularly, it can make pregnancy more difficult.
Conditions associated with irregular ovulation include:
- Polycystic ovary syndrome (PCOS)
- Thyroid disorders
- Hormonal imbalances
- Significant weight changes
- Certain medications
- Primary ovarian insufficiency
Irregular or absent periods can sometimes be an important clue that ovulation is not occurring consistently.
Age-Related Fertility Changes
Female fertility naturally decreases with age.
As women get older, both the number and quality of available eggs decline. The risk of miscarriage and chromosomal abnormalities also increases with age.
This is one reason fertility evaluation may be recommended sooner for women in their mid-to-late 30s and particularly for women over 40.
Fallopian Tube Problems
The fallopian tubes provide the pathway through which an egg and sperm meet.
Blocked or damaged fallopian tubes can interfere with fertilization or prevent the embryo from reaching the uterus.
Tubal problems can be associated with previous pelvic infections, sexually transmitted infections, endometriosis, or abdominal and pelvic surgery.
Endometriosis
Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus.
It can cause inflammation, scar tissue, and adhesions that may affect the ovaries, fallopian tubes, or other pelvic structures.
Some women with endometriosis experience infertility even when their menstrual cycles are regular.
Uterine Fibroids
Uterine fibroids are noncancerous growths that develop in or around the uterus.
Many women with fibroids become pregnant without difficulty. However, certain fibroids, particularly those that distort the uterine cavity, may interfere with fertility or increase the risk of certain pregnancy complications.
Uterine Polyps and Other Structural Conditions
Polyps, uterine abnormalities, scar tissue, and other structural conditions can sometimes interfere with implantation or pregnancy.
Imaging and other diagnostic procedures can help identify these conditions.
How Is Female Infertility Evaluated?
A fertility evaluation usually begins with a detailed medical and reproductive history.
Your healthcare provider may ask about:
- Menstrual cycle patterns
- Frequency and timing of intercourse
- Previous pregnancies
- Previous miscarriages
- Pelvic infections
- Previous surgeries
- Medications
- Medical conditions
- Family reproductive history
- Previous fertility treatments
The evaluation may then include laboratory testing, imaging, and other reproductive assessments.
What Tests Are Used to Evaluate Infertility?
The tests recommended depend on the woman’s age, symptoms, medical history, and previous pregnancy history.
Ovulation Testing
Blood tests and menstrual-cycle tracking can sometimes help determine whether ovulation is occurring regularly.
Hormone Testing
Hormonal testing may evaluate thyroid function, reproductive hormones, or other factors associated with ovulation and ovarian function.
Ovarian Reserve Testing
Certain blood tests and ultrasound findings can provide information about ovarian reserve, which refers to the quantity of eggs remaining in the ovaries.
Ovarian reserve testing can provide useful information, but it does not by itself predict whether a woman will become pregnant naturally.
Pelvic Ultrasound
A pelvic ultrasound can evaluate the uterus and ovaries and may identify conditions such as:
- Fibroids
- Ovarian cysts
- Endometriomas
- Certain uterine abnormalities
- Other pelvic findings
Fallopian Tube Evaluation
A test called hysterosalpingography (HSG) can be used to determine whether the fallopian tubes are open and to evaluate the shape of the uterine cavity.
Depending on the circumstances, other imaging or procedures may also be considered.
Should Both Partners Be Evaluated?
Yes. Fertility problems can involve either partner or both partners.
Although this article focuses on female infertility, a comprehensive fertility evaluation may also include an assessment of the male partner.
A semen analysis is commonly used to evaluate sperm count, movement, and morphology.
Evaluating both partners can help identify potential factors affecting conception and avoid unnecessary delays in treatment.
What Treatments Are Available for Female Infertility?
Treatment depends on the underlying cause of infertility, age, ovarian reserve, reproductive history, and the fertility goals of the patient.
Potential treatments may include:
Medications to Stimulate Ovulation
Women who do not ovulate regularly may benefit from medications designed to stimulate ovulation.
Treatment depends on the specific cause of the ovulation problem.
Treatment for Endometriosis
When endometriosis is affecting fertility, treatment may involve medication, surgery, fertility treatment, or a combination of approaches depending on the patient’s symptoms and reproductive goals.
Treatment for Fibroids or Polyps
If a uterine fibroid or polyp is interfering with fertility, a procedure to remove it may sometimes improve the reproductive environment.
Intrauterine Insemination
Intrauterine insemination (IUI) involves placing prepared sperm directly into the uterus around the time of ovulation.
IUI may be appropriate in certain fertility situations.
In Vitro Fertilization
In vitro fertilization (IVF) involves retrieving eggs from the ovaries, fertilizing them with sperm in a laboratory, and transferring an embryo into the uterus.
IVF may be recommended for certain causes of infertility, including some cases involving blocked fallopian tubes, severe endometriosis, diminished ovarian reserve, or unexplained infertility.
Does Infertility Mean You Cannot Have a Baby?
No.
Infertility means that pregnancy has not occurred within the expected timeframe or that a condition is affecting the ability to conceive. It does not automatically mean that pregnancy is impossible.
Some couples conceive naturally after an evaluation, while others may benefit from medication, surgery, IUI, IVF, or other fertility treatments.
The appropriate approach depends on the underlying cause and individual circumstances.
When Should You Talk to a Gynecologist About Fertility?
You should consider speaking with a gynecologist if:
- You have been trying to conceive for 12 months and are under 35.
- You have been trying for 6 months and are 35 or older.
- You are over 40 and want to become pregnant.
- Your menstrual periods are irregular or absent.
- You have severe menstrual pain.
- You have a history of endometriosis.
- You have had pelvic infections or reproductive surgery.
- You have experienced recurrent miscarriages.
- You have been diagnosed with fibroids, PCOS, or another reproductive condition.
- You have concerns about your fertility or reproductive health.
Seeking an evaluation does not necessarily mean that you will need fertility treatment. It is an opportunity to understand your reproductive health and identify potential factors affecting conception.
Frequently Asked Questions About Female Infertility
How long should I try to get pregnant before seeing a doctor?
Women younger than 35 generally should consider an evaluation after 12 months of trying. Women 35 and older should generally seek evaluation after 6 months. Women over 40 may benefit from an evaluation sooner.
Can irregular periods cause infertility?
Irregular periods can indicate that ovulation is not occurring consistently, which can make conception more difficult. Conditions such as PCOS and thyroid disorders can cause irregular cycles.
Can endometriosis cause infertility?
Yes. Endometriosis can affect fertility through inflammation, scar tissue, adhesions, and changes involving the ovaries or fallopian tubes.
Does age affect female fertility?
Yes. Fertility generally decreases with age, particularly because the number and quality of eggs decline. The decline becomes more significant during the mid-to-late 30s and continues into the 40s.
Can I become pregnant after an infertility diagnosis?
Yes. Many women diagnosed with infertility eventually become pregnant, either naturally or with medical assistance. The likelihood depends on the underlying cause, age, ovarian reserve, and other reproductive factors.
Should I get tested even if my periods are regular?
Regular periods are generally a positive sign, but they do not guarantee that all aspects of fertility are normal. If you have been trying to conceive without success or have other risk factors, an evaluation may still be appropriate.
Take the Next Step Toward Understanding Your Fertility
Infertility can have many possible causes, and identifying the underlying factor is an important first step toward choosing the appropriate treatment. Problems with ovulation, age-related fertility changes, endometriosis, fibroids, blocked fallopian tubes, and other reproductive conditions can all affect a woman’s ability to become pregnant.
If you have been trying to conceive without success, have irregular periods, or have a condition that may affect fertility, a gynecological evaluation in Eagle Pass, Texas, can help determine the next appropriate steps for your reproductive health.
This article is intended for general educational purposes and should not replace professional medical evaluation, diagnosis, or treatment.
