Fertility declines with age. It generally begins in the late 20s, then drops off more steeply by age 37. In and past the late 40s, it’s very rare to conceive a child naturally, because aging eggs don’t fertilize, implant, or respond to stimulation medications as well as younger eggs. Older eggs also present an increased risk of pregnancy loss and babies with chromosomal abnormalities.

Amenorrhea means the absence of menstrual periods. There are two types: primary and secondary. Primary is often diagnosed when a female does not have any menstrual periods before the age of 16. Secondary can occur when someone has previously menstruated, but then stops menstruating for 3-6 months or longer.

Endometriosis is a common condition that occurs when endometrial tissue, which lines the uterus, grows outside the uterine cavity. This tissue may implant and grow anywhere in the body, most commonly within the abdominal cavity.

Endometriosis can hinder conception by producing scar tissue, inflammation or adhesions which bind the ovaries, fallopian tubes and intestines together. These adhesions can interfere with the release of eggs from the ovaries or the pick-up of eggs by the fallopian tube, thereby reducing the chances of conception.

To produce a fertilizable egg each month, a series of complex steps must take place. One step out of place and you might not be able to get pregnant – making ovulatory conditions the most common cause of female infertility.

Some of the conditions that can interfere with, or prevent, ovulation, include:

• Polycystic Ovarian Syndrome (PCOS)

• Thyroid disease

• Hyperprolactinemia, a hormone that stimulates milk production and suppresses ovulation

• Low levels of fertility hormones (Hypothalamic Amenorrhea, FSH and LH)

• Premature Ovarian Failure

• Extreme weight loss or weight gain

• Excessive exercise

• Eating disorders

Polycystic ovary syndrome (PCOS), or polycystic ovary disease (PCOD), is an endocrine disorder. It is one of the most common hormone problems women of reproductive age face. Despite the name, ovarian cysts are not usually present, although some women have many small follicles visible on ultrasound. Egg production is affected by the hormone imbalance. Some women with PCOS experience irregular ovulation, often having less than eight menstrual cycles per year. Other women with PCOS can have more than one period of bleeding per month and each episode can be lengthy.

Other symptoms can include fat around the belly area, facial hair, acne, and thinning of hair on the top of your head.

A pregnancy that is lost prior to 20 weeks’ gestation is known as a miscarriage. It occurs in 15-20% of pregnancies, with the risk increasing with age (by age 45, the risk is greater than 50%). Most miscarriages occur within the first trimester. If someone experiences more than one miscarriage, it is known as recurrent pregnancy loss.

The most common cause of recurrent pregnancy loss is an abnormal chromosome pattern in the embryo. Some other potential factors may include:

• Abnormalities in the shape of the uterus

• Uterine fibroids

• Genetic abnormalities

• Hormonal disorders

• Immunological factors

• Infection

Sperm issues account for approximately 40% of fertility challenges. There are several factors that could affect the quantity and health of a male’s sperm, including Azoospermia (the absence of sperm in the ejaculate) or Oligo-astheno-teratospermia (OATS) (sperm of low concentration, reduced mobility and abnormal morphology.)

Nutrition and exercise can also contribute to sperm issues. Unhealthy habits such as smoking, drinking and recreational drug use can have a detrimental effect on male fertility.

The fallopian tubes play a crucial role in successful fertilization and pregnancy. As many as 25% of fertility-challenged females learn that damaged tubes are the cause. Modern techniques, however, have enabled many females with tubal damage to have healthy pregnancies.

Unexplained infertility is defined as more than three years of infertility even though ovulation, semen, fallopian tubes and pelvic cavity all appear to be normal. Depending on their age and the length of infertility, these individuals have a 30% or lower chance of conceiving naturally.

If you suffer from unexplained infertility, our Heartland Fertility physicians will discuss it with you and may recommend advanced infertility treatments, such as IUI and IVF.