10 Common Female Infertility Questions Answered by an Expert

When people start researching female infertility they often ask these female infertility questions: what is female infertility, what causes it, what are the signs and symptoms, how does age affect female infertility and a woman’s ability to get pregnant, how do doctors determine the cause of the infertility, how is female infertility treated, and what are the odds that an infertile woman will become pregnant.

There are more female infertility questions in the world than can be answered here. However, certain questions about female infertility pop up time and time again, especially when people are starting to research infertility. This is a list of the questions most people ask first.

1. What is infertility?

Generally, female infertility is defined as a woman not being able to get pregnant after one year of well-timed intercourse if she’s under 35 and 6 months of well-timed intercourse if she’s over 35. The difference in the waiting time for diagnosis of women under and over age 35 is that the older woman doesn’t have time to wait and hope for the best. As women get older, fewer and fewer of their eggs are viable so it’s best to start fertility treatment with the best quality eggs possible. If a woman is under 35 and can get pregnant but has multiple miscarriages with no live births this is also considered infertility.

2. Who gets female infertility?

Approximately 30% of infertility cases are because the woman has a problem, 30% are because the man has a problem and the other 40% are either both partners contributing to the problems or it is due to unexplained infertility. The majority of women experiencing female infertility are over 35 and have not given birth to their first child yet. There is also a minority of women who have given birth in the past but cannot get pregnant again, this is called secondary infertility.

3. What are the risk factors for female infertility?

Some of the risk factors for female infertility are: age, stress, poor diet, athletic training, being over or underweight, smoking, alcohol use, STDs, tubal disease, endometriosis, DES exposure, disease treatment that can damage the reproductive system (like chemotherapy and radiation for cancer treatment), and health problems that cause hormonal changes.

4. What causes infertility in women?

The leading cause of infertility in women is problems with ovulation and egg quality. Regular ovulation with good quality eggs is one of the most vital steps to achieving a successful pregnancy. Other conditions that can cause infertility are blocked fallopian tubes caused by PID, endometriosis or a previous ectopic pregnancy. Physical problems with the uterus, especially uterine fibroids can also create issues but are less common.

5. What are the signs and symptoms of female infertility?

Often there are no signs or symptoms, the woman has no idea she is infertile until she tries to get pregnant. Generally she’s been trying not to get pregnant for many years and has succeeded. Since ovulation problems are the leading cause of female infertility the signs of ovulation problems, like irregular or absent periods or very painful periods, are good indicators that female infertility might be a problem.

6. How does age affect a woman’s ability to get pregnant?

Women’s most fertile years are before age 30. That’s when her egg quality is still good, egg supply is still adequate, and her ovaries are releasing eggs regularly. This is the reason that most egg donor programs will only accept women up to age 29. After a woman turns 30 her egg quality decreases, she is more likely to have a miscarriage, and is also more likely to have health problems that can interfere with conception and carrying a pregnancy to term.

7. How are fertility problems determined by a doctor?

Finding the cause of female infertility can be a long and drawn out process involving a lot of testing. The doctor usually starts with a complete history to look for obvious problems. The first thing doctors will look for is regular ovulation, this can be done by a blood test and ultrasound of the ovaries, home ovulation test or recording her basal body temperature each morning for several months. If nothing obvious with the ovulation testing comes up then the doctor will probably move on to a Hysterosalpingography. This is where a dye is injected into the uterus so the doctor can see if the dye moves normally through the uterus and into the fallopian tubes. Blockage in one of the tubes can prevent the egg from passing through or sperm from getting to the egg. If that proves normal then a Laparoscopy is performed. During a minor surgical procedure doctors make a small cut in the lower abdomen and insert a laparoscope so they can check the ovaries, fallopian tubes, and uterus for disease or scarring or endometriosis (uterine lining on the outside of the uterus).

8. Is it necessary to go through a lot of testing before starting fertility treatments?

Testing is expensive and time consuming and some people’s insurance doesn’t cover it. For this, and a number of other reasons, some doctors will start treating patients using less invasive procedures before a complete female infertility work-up has been done. Since ovulation problems are so high on the list of possible causes of fertility problems, many doctors will start a patient on a follicle-stimulating hormone drug like Clomid to stimulate the ovaries to produce one or more eggs. That is followed up with Intrauterine Insemination (IUI) where the sperm, which has been concentrated so there are more healthy sperm swimming around, is delivered directly to the uterus. If this protocol doesn’t work after a couple of months then most doctors will want a complete fertility work-up before moving on to more invasive procedures, like IVF.

9. How do doctors treat female infertility?

Most cases of female infertility are treated with either drugs, surgery or a combination. If there is blockage in the fallopian tubes it can usually be cleared out by surgery. Endometriosis can also be treated surgically as can some fibroid tumors in the uterus and other uterine problems. The majority of the drugs used to treat female infertility are used to stimulate ovulation and can increase the chance of multiple eggs being released at once. If minor surgery or medication alone don’t work then the next step is InVitro Fertilization (IVF). In IVF the woman is given ovulation stimulating medication, then her eggs are harvested and mixed with sperm to create embryos. Then up to two healthy embryos are placed directly into her uterus. Since only one or two embryos are implanted, there aren’t many pregnancies resulting in more than two babies anymore and most result in one baby. IVF is an invasive and time-consuming procedure but has a high success rate. If the woman’s eggs aren’t deemed viable, but she can carry a child, often a donor egg is used; these eggs come from young, healthy women and fertilize well.

10. How many women who are treated for female infertility end up having babies?

About two-thirds of women treated for female infertility go on to have successful pregnancies resulting in live births. Some of the women who are not successful with infertility treatment become mothers through surrogacy. This is when a woman carries a child she has no genetic relationship to for a woman who cannot carry the child herself. Others become parents through adoption. The road to parenthood is always a journey but well worth it in the end.