Signs of Infertility: When to Seek Help and Treatment Options

Infertility is a diagnosis no couple wants to hear. However, despite how difficult it can be to hear, prompt diagnosis and treatment provided by an OB-GYN are critical to addressing the issue.

Conceiving is a complex matter with lower success rates than you might think. In truth, the chances of successful conception are pretty low, and troubles with it don’t automatically equate to infertility. Women between 20 and 24 years old often only have an 86% chance of success with it, and it dwindles as women age. Add to that, there are also male factors of infertility that make it doubly challenging.

With that, it gets easy to confuse general difficulties with conceiving as infertility. However, if you do suspect infertility (especially if you’ve been trying to conceive for a while), there are more concrete signals you can watch out for.

Below, we’ll discuss these signs and symptoms so you can understand your situation better.

Symptoms of Infertility in Men and Women

Both men’s and women’s fertility plays an essential role in conceiving a baby. Hence, when you and your partner suspect infertility, your OB-GYN will assess both of you before recommending treatment options. You can watch out for these signs and symptoms at home in each of you.

Common Symptoms of Infertility in Women

Compared to men, women have more easily noticeable signs and conditions that might suggest infertility. These signs and symptoms can look like:

• Irregular periods. These are typical indicators of hormonal imbalances associated with conditions like polycystic ovary syndrome (PCOS). These imbalances can disrupt ovulation, causing cycle length variations or a cycle’s complete absence. This situation should prompt further evaluation for potential underlying endocrine disorders.
• Painful menstruation. Dysmenorrhea or painful periods, particularly when severe, is often linked to endometriosis. This condition is characterized by overgrowth of uterine tissue in areas outside the uterus. This tissue can cause inflammation, scarring, and pain, potentially leading to infertility. If you’re experiencing disruptive or worsening painful menstruations, you must consult a doctor for further evaluation. Early detection and treatment are crucial to managing symptoms and preserving fertility.
• Cumbersome, light, or unpredictable menstrual cycles. Excessive, abnormally light, or unpredictable menstrual flow may signal various reproductive health issues. These issues could span uterine fibroids, hormonal imbalances, or thyroid dysfunction. Heavy bleeding can indicate fibroids or polyps, while light periods may suggest hormonal deficiencies. Unpredictable cycles could indicate that you are not ovulating regularly, making it challenging to track fertile days.
• Absence of menstruation (amenorrhea). The complete absence of menstruation or amenorrhea can suggest issues with ovulation. You can develop amenorrhea, especially when you’re going through a lot of stress, extreme weight changes, or ovarian insufficiency.

Common Symptoms of Infertility in Men

On the other hand, men might face infertility issues without any overt symptoms. Because of this, it is essential to be aware of even the most subtle signs, such as:

• Low sperm count. Also known as oligospermia, low sperm count is a significant indicator of male infertility and is typically identified through a semen analysis. Genetic factors, hormonal imbalances, or lifestyle influences such as smoking and obesity can all contribute to its development. Low sperm counts mean you can still produce sperm, but in quantities insufficient to achieve fertilization naturally.
• Erectile dysfunction (ED). While ED doesn’t directly cause infertility, it can be a sign of underlying issues that have been linked to infertility, like cardiovascular disease, diabetes, or hormonal deficiencies. Additionally, ED makes it difficult to achieve and maintain an erection enough to accomplish intercourse and ejaculation, thus complicating efforts to conceive. Men experiencing persistent ED must seek medical advice to address the root and improve sexual function.
• Hormonal imbalances. Low testosterone levels can severely impact sperm production and male fertility. Testosterone is crucial for the development of sperm, and insufficient levels can lead to reduced sperm count, poor sperm motility, and decreased libido. Conditions such as hypogonadism, where the testes produce little or no hormones, should be diagnosed and treated promptly to restore hormonal balance.
• Presence of varicoceles. Varicoceles, which are enlarged veins within the scrotum, are a common cause of reduced sperm quality and male infertility. These dilated veins can elevate the temperature in the testes, impairing sperm production and leading to lower sperm counts, decreased motility, and abnormal sperm morphology. Men with varicoceles may experience a heavy, dragging sensation in the scrotum, and surgical correction may be necessary to improve fertility potential.

If you notice any of these signs in you or your partner, seeking immediate help from fertility care specialists is critical to preserve or increase your chances of conceiving a child.

Causes of Infertility in Men and Women

Infertility can result from a variety of causes, and understanding these can help in tailoring the right treatment plan. Both female and male factors can contribute, and in some cases, the cause may remain unexplained even after extensive evaluation.

Female-Specific Factors

Ovulation dysfunction

Ovulation dysfunction is a critical impediment to fertility because it directly disrupts the release of eggs, which is essential for natural conception. Without regular ovulation, the chances of an egg being available for fertilization are significantly reduced, making pregnancy difficult or impossible. Several specific conditions fall under ovulation dysfunction:

• PCOS is one of the most common causes of ovulatory dysfunction, characterized by the presence of multiple small cysts on the ovaries, hormonal imbalances, and irregular menstrual cycles. Women with PCOS may ovulate infrequently or not at all, significantly reducing their chances of conceiving naturally.
• Hypothalamic amenorrhea is a condition that occurs when the hypothalamus, a region of the brain responsible for regulating ovulation, fails to produce the necessary hormones to trigger ovulation. Causes can include excessive physical stress, extreme weight loss, or eating disorders, leading to the absence of menstruation and ovulation.
• Premature Ovarian Insufficiency (POI), also known as early menopause, is characterized by the loss of normal ovarian function before the age of 40. Women with POI may have irregular periods or no periods at all, resulting in reduced egg supply and compromised fertility.
• Hyperprolactinemia is a condition that involves elevated levels of prolactin, a hormone that can interfere with ovulation by suppressing the production of other reproductive hormones. Benign pituitary tumors, certain medications, or thyroid imbalances can cause it.

Tubal factors

Tubal factors are significant barriers to fertility because they affect the fallopian tubes, which are crucial for transporting the egg from the ovary to the uterus. Blocked or damaged fallopian tubes prevent sperm from reaching the egg or the fertilized egg from reaching the uterus, leading to infertility. Specific conditions categorized under tubal factors include:

• Tubal blockage can occur due to infections, such as pelvic inflammatory disease (PID), or previous surgeries, causing scarring and obstruction in the fallopian tubes. Blocked tubes prevent the egg and sperm from meeting, thus preventing fertilization.
• Hydrosalpinx is when the fallopian tubes are filled with water, usually due to infection or inflammation. The fluid can create a hostile environment for the egg and sperm, preventing fertilization or embryo implantation.

Uterine factors

Uterine factors deter fertility because they directly impact the ability of an embryo to implant and develop within the uterus. Abnormalities or conditions affecting the uterine environment can lead to difficulties in conception, recurrent miscarriages, or other pregnancy complications. Conditions under uterine factors include:

• Fibroids are non-cancerous growths in the uterus that can distort the uterine cavity, interfere with embryo implantation, and cause heavy menstrual bleeding. Large or multiple fibroids can block the fallopian tubes or disrupt the blood supply to the endometrium, reducing fertility.
• Endometrial polyps are overgrowths of the uterine lining that can obstruct sperm entry into the uterine cavity or interfere with embryo implantation. Polyps can also cause irregular menstrual bleeding and may contribute to infertility.
• Asherman’s syndrome is a condition characterized by the formation of scar tissue (adhesions) within the uterine cavity, often following surgery or severe infection. These adhesions can reduce the space within the uterus, impairing embryo implantation and leading to recurrent miscarriages.

[H3] Male-Specific Factors

Male infertility is frequently associated with disruptions in sperm production or function, which are critical for fertilization. These issues can arise from a variety of factors, each affecting different aspects of sperm health:

Sperm Abnormalities

Abnormalities in sperm count (oligospermia), motility (asthenozoospermia), or morphology (teratozoospermia) are common contributors to male infertility. These conditions can stem from genetic defects, hormonal imbalances, or environmental exposures. They lead to sperm that are either insufficient in number, incapable of proper movement, or improperly shaped, thereby reducing the likelihood of successful fertilization.

Hormonal Imbalances

Hormones play a crucial role in regulating sperm production, and imbalances can severely impact male fertility. Low testosterone levels, for example, can lead to reduced sperm production, diminished libido, and erectile dysfunction. These imbalances may be caused by conditions such as hypogonadism, where the testes produce insufficient hormones, or by disruptions in the pituitary or hypothalamic glands, which control testosterone levels.

Testicular Problems

The health of the testes is vital for sperm production and quality. Conditions such as varicoceles, which are enlarged veins in the scrotum, can increase the temperature within the testes, negatively affecting sperm production and quality. Infections, particularly those that cause inflammation in the testes, can also damage the delicate structures involved in sperm production. Previous testicular trauma or surgeries can further compromise sperm health and fertility.

Environmental and Lifestyle Factors

Lifestyle choices and environmental exposures can significantly influence male fertility. Smoking, excessive alcohol consumption, obesity, and exposure to environmental toxins such as pesticides or heavy metals can impair sperm production and function. Additionally, occupational hazards like prolonged exposure to heat or chemicals can lead to a decline in sperm quality, making conception more difficult.

Unexplained Infertility

In some instances, couples may undergo comprehensive testing only to find no identifiable cause of infertility. This is known as unexplained infertility. Although frustrating, this diagnosis does not mean that treatment will be unsuccessful. 

Various factors might be at play, such as subtle hormonal imbalances, undetected tubal issues, or sperm-egg interaction problems. Despite the lack of a precise diagnosis, treatment options like ovulation induction, intrauterine insemination (IUI), or in vitro fertilization (IVF) can still be effective in achieving pregnancy.

When to Seek Help: Timelines and Guidelines

Earlier, we mentioned that women’s chances of conceiving can decrease as they age. This, along with other factors, asserts how pertinent the timeline or window period for treatment is to yield the best outcomes.

When to Seek Help Based on Age

Age plays a pivotal role in fertility, particularly for women. For your guidance, here is when women should seek fertility advice according to age:

• Under 35 years old: Seek medical advice if they have been trying to conceive for over a year without success. 
• Over 35 years old: Seek help after six months of trying. This timeline is shortened because fertility naturally declines with age, and early intervention can increase the likelihood of conception.

Men are also encouraged to seek evaluation if conception has not occurred within these time frames, as male fertility can be affected by various factors at any age.

Specific Circumstances That Warrant Early Intervention

Certain health conditions and medical histories may necessitate earlier intervention. Women with a history of irregular periods, known reproductive health issues such as endometriosis or polycystic ovary syndrome (PCOS), or those who have undergone treatments like chemotherapy should consider consulting a specialist sooner. 

Similarly, men with a history of testicular injuries, surgeries, or known hormonal imbalances should seek early evaluation. Couples who have experienced multiple miscarriages or who suspect underlying genetic issues should also consider early intervention to explore the available diagnostic and treatment options.

Treatment Options: Exploring Your Path to Parenthood

Once the cause of infertility has been identified, various treatment options are available to help couples achieve pregnancy. These treatments range from non-invasive methods to more advanced surgical and assisted reproductive technologies.

Non-Invasive Treatments

Non-invasive treatments are often the first line of approach for many couples. These can include one or a combination of the following:

• Lifestyle changes, such as improving diet, exercise, and reducing stress, can significantly enhance fertility.
• Ovulation induction, using oral medications like Clomid, helps stimulate the ovaries to release eggs, increasing the chances of conception.
• IUI is another non-invasive procedure where a concentrated semen sample is inserted directly into the uterus, placing sperm closer to the egg and improving the likelihood of fertilization.

Surgical and Assisted Reproductive Technologies (ART)

For more complex cases, surgical interventions and ART are considered. Some procedures your OB-GYN can explore with you include:

• Laparoscopy is a minimally invasive surgery used to diagnose and treat conditions like endometriosis or pelvic scarring, which may be affecting fertility. 
• Hysteroscopy, another minimally invasive surgery, is used to remove uterine polyps, fibroids, or scar tissue. 
• IVF is often recommended when other treatments have failed. It involves retrieving eggs from the ovaries, fertilizing them with sperm in a laboratory, and then transferring the resulting embryo into the uterus. 

When to Consider Specialist Referral

There are situations where a referral to a fertility specialist is necessary, especially when conventional treatments have not yielded results. Couples who have not conceived after several cycles of ovulation induction or IUI may need to consider advanced treatments like IVF. 

Additionally, those facing severe male infertility, recurrent pregnancy loss, or requiring donor eggs or sperm will benefit from specialized care. Consulting a specialist early can help navigate the complexities of infertility treatment and explore the most effective options tailored to individual needs.

Final Thoughts

Infertility is a difficult diagnosis to confront for any couple. However, the fear of the diagnosis should not hinder you from seeking the medical help you and your partner need. 

As conception is inherently a time-sensitive matter (among other things), prompt assessment and diagnosis are critical to ensuring the best reproductive health outcomes. An awareness of the symptoms and treatment options above should allow you to catch the signs early and seek the advice of an OB-GYN.

Should you have further concerns about infertility, know that our OB-GYN experts at Northside/Northpoint OB-GYN are equipped and ready to give you expert and compassionate care.