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What are the signs of infertility in women?

Medically reviewed by Neka Miller, PhD on April 13, 2020. Written by Jordana White. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.


Trying to conceive is a journey for every couple—something that might ring especially true for you if you've ever struggled to conceive. Infertility has the potential to affect women of all ages, including women in their 20s and 30s, and about 10% of American women (in the 15-44 age range) have difficulty getting pregnant. Health problems that affect your fertility may cause no other symptoms, so many women aren't aware that there's something wrong until they've been trying to conceive for at least a year.


The Everlywell at-home Women's Fertility Test measures five key hormones that affect female fertility. Levels of these hormones can give you a broad overview of the hormones related to fertility—and reveal any potential imbalances that may be contributing to fertility problems.


Here, you'll learn more about the signs of infertility in women, possible causes of infertility, and more—so keep reading.

Understanding conception

Conceiving a child is largely about timing. During your monthly cycle, you have a window of time where your egg is the most viable for conception—specifically, the days just before ovulation. If you miss your window of fertility, you'll have less of a chance of becoming pregnant until your next cycle—so tracking your cycle and timing intercourse can help you conceive.

How does pregnancy occur? During your monthly cycle, one of your ovaries releases an egg. The egg travels down your fallopian tubes toward your uterus. Your partner's sperm likewise travels toward the uterus. If the timing is right, a sperm cell fertilizes the egg. Next, the fertilized egg implants on the lining of your uterus, and from there it can develop into a baby.

What are the symptoms of infertility in females?

In basic medical terms, infertility is the inability to get pregnant after trying for one year. There can be multiple explanations for what's causing your infertility, although the term itself just means that you're not able to conceive. You may or may not experience other symptoms.

What are signs of infertility in a woman?

Female infertility has many possible causes, and each condition is associated with various symptoms. Possible signs of infertility in women may include:

• Pelvic pain

• Abnormal bleeding

• Irregular menstrual cycles

• Hot flashes

• Weight gain

• Changes in hair growth

• Night sweats

Though infertility doesn't always have a clear cause—and other symptoms may not be noticeable—fertility testing may help identify the source of issues.

Do I need fertility testing?

If you've been trying to get pregnant for over a year, it may be time to consider a fertility test. Your provider may also recommend testing if you're over 35 and you've been trying for at least six months.

Healthy women in their 20s or 30s may not need a fertility test right away—but if you have any unexplained symptoms like the ones mentioned above, talk with your healthcare provider (and consider taking a home fertility test to see if your fertility-supporting hormones are balanced). Symptoms like pelvic pain or skipped periods can be a sign of an underlying health problem, and without treatment, these health problems may lead to infertility.

What causes female infertility?

There are several possible causes of female infertility, many of which are directly involved with the female reproductive system—particularly the ovaries. Your ovaries allow for ovulation, which is a necessary step for fertilization.

Read on to find out more about the possible causes of female infertility.

Ovulation disorders

Ovulation disorders prevent your ovaries from releasing an egg. Ovulation occurs about once a month, during the middle of your cycle. After ovulation, the egg travels from your ovaries to your uterus for fertilization (and conception). If you're experiencing anovulation, however, your ovaries may not release an egg during each menstrual cycle. Hormone imbalances are often responsible for anovulation. Levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estradiol are typically low if anovulation is connected with a hormonal imbalance. (You can check all 3 of these hormones with the at-home Women's Fertility Test.)

Infections

Sexually transmitted infections (STIs or STDs) that go untreated are another possible cause of female infertility. Over time, untreated chlamydia and gonorrhea can result in pelvic inflammatory disease (PID). PID causes scarring along the fallopian tubes, which can make it difficult for sperm to reach the egg.

An easy way to check for the STIs is with the at-home Chlamydia & Gonorrhea Test—which includes the option to speak with a physician if your results are positive (and, if it's right for you, they may prescribe medication to treat the infection).

Implantation failure

Infertility often suggests an issue with fertilization: your ovaries may not be releasing any eggs, or your partner's sperm may not be reaching them. Sometimes, however, the issue lies with implantation—not fertilization.

An implantation failure occurs when a fertilized egg doesn't attach to the uterine lining.

Implantation failure can be due to genetics, but you might also experience implantation failure if you have:

• A thin endometrium

• Endometriosis

• Progesterone resistance

• Scar tissue in the uterine cavity

Endometriosis

The endometrium is the innermost lining of the uterus. This lining creates the place for a fertilized egg to attach itself. If you don't get pregnant during your cycle, the lining is shed during your menstrual period. It then rebuilds itself for your next menstrual cycle.

Endometrial cells are supposed to grow only within the uterus, but sometimes these cells may grow around the ovaries and fallopian tubes. They can also grow on the outside of the uterus or within the abdomen. This abnormal growth is known as endometriosis.

Endometriosis can cause scarring around the ovaries and fallopian tubes. Over time, this scar tissue can lead to fertility issues and prevent implantation. About 30–50% of women with endometriosis are infertile.

Women with endometriosis often suffer from painful, heavy periods. Some also have severe pelvic pain throughout their cycle. Others, however, may experience no symptoms at all—but it's worth noting that endometriosis can affect your fertility even if you don't have painful or heavy periods.

Polycystic ovary syndrome (PCOS)

Women with PCOS have high levels of various hormones. These hormones can prevent ovulation and create cysts within the ovaries. PCOS is relatively common, affecting about 10% of American women who are of reproductive age. Many women with PCOS have trouble getting pregnant.

PCOS can also cause:

• Irregular periods

• Excess hair growth

• Severe acne

• Weight gain

• Pelvic pain

• Skin changes

Thyroid problems

Thyroid hormones play a role in metabolism, energy levels, mood, and fertility—so if these hormones aren't balanced, you may experience difficulty getting pregnant.

For one, thyroid hormone imbalances can prevent ovulation. They can also cause heavy, painful, or skipped periods. Fortunately, thyroid issues may be easy to detect with a thyroid blood test (which you can take at home) and a physician's evaluation.

Early menopause

Ovulation ceases as you enter menopause—which typically occurs during a woman's late 40s and early 50s. You also stop having a period, and your hormone levels shift.

During your reproductive years, your body produces a hormone called estradiol (the main form of estrogen in women). As you reach menopause, your estradiol levels drop. After menopause, your body produces very little of this hormone. In the U.S., most women reach menopause around age 50, but some women enter menopause sooner. Women who go through early menopause may experience an early loss of fertility.

Early menopause can be a symptom of some health problems, including an autoimmune disease. Chemotherapy and radiation can also trigger early menopause. Genetics can play a role, as well: if a female relative reached menopause early, you might too.

(The Everlywell at-home Women's Fertility Test is a convenient way to check your estradiol levels. If your levels are low, this may be a sign that you're entering menopause.)

Primary ovarian insufficiency (POI)

The ovaries usually stop releasing eggs around menopause, but if you have primary ovarian insufficiency (POI), they may stop releasing eggs before you transition into menopause. The cause of POI isn't completely understood, but hormone levels can indicate whether you have this condition. High FSH levels and low estradiol levels can suggest POI (you can check both of these hormones with the at-home Women's Fertility Test).

Uterine fibroids

Fibroids—growths that develop inside or around your uterus—can affect fertility in women. A high percentage of women develop at least one uterine fibroid by age 50. While most women with fibroids can conceive naturally, large fibroids can block the sperm from reaching the egg. Fibroids inside the uterus can also prevent implantation.

Autoimmune disorders

If you have an autoimmune disease, your immune system may mistakenly attack healthy tissue. These diseases can affect your ability to get pregnant.

Researchers aren't sure why autoimmune diseases are linked to infertility, but these conditions can cause widespread inflammation that may spread to the reproductive organs. Without treatment, the inflammation might prevent fertilization or implantation.

What can I do if I have difficulty getting pregnant?

If you've been trying to conceive for at least several months, consider talking with your healthcare provider. They will know the typical signs of infertility in females, and can help determine whether it's time for specialized fertility testing.

It may also be a good idea for your male partner to talk with his healthcare provider: for 50% of heterosexual couples who have difficulty conceiving, male-factor infertility plays a role. Your partner may need a semen analysis to check his sperm count and mobility, or have other kinds of specialized testing. If there's a problem with your partner's sperm, his provider can recommend solutions.

Some women are diagnosed with unexplained infertility, which means that it wasn't possible to determine the cause of fertility issues. Even if infertility doesn't have a clear cause, though, treatment may nevertheless increase the odds of conception and pregnancy.


The Everlywell at-home Women's Fertility Test measures five key hormones that affect female fertility. Levels of these hormones can give you a broad overview of the hormones related to fertility—and reveal any potential imbalances that may be contributing to fertility problems.


How do you boost fertility?

Women’s fertility and age: knowing what to expect

What are normal estradiol levels in women?


References

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