Six Factors That May Impact Your Fertility

If you’re trying to get pregnant and it’s taking longer than you thought, you might be worrying about infertility. Is there something preventing you from getting pregnant, in your physiology or your lifestyle? The only way to find out for sure is to have a complete infertility evaluation performed. Dr. Jason Bromer of Shady Grove Fertility’s Frederick office says there are some common symptoms of infertility that couples should not ignore.

Women who have irregular periods or who don’t get a period at all many have a sense that their ability to get pregnant might be affected. Menstruation is tied to ovulation, the process whereby the ovary releases a mature egg every month to be fertilized. If you don’t ovulate or you only ovulate sometimes, it will be very difficult or even impossible to get pregnant.
“An irregular or nonexistent period almost always means there is an underlying ovulation disorder. This is a really common cause of infertility in women,” says Dr. Bromer. “The good news is that, in most cases, all we have to do is get you to ovulate, and you can get pregnant.” The process of getting the woman’s body to start ovulating again is called ovulation induction and can be as simple as taking an oral medication.
“We will always do a full evaluation of a woman who has irregular menses to make sure nothing else is wrong,” says Dr. Bromer, “but if ovulation is the only problem, we can start with very simple and low tech treatments and her chances for pregnancy are very good.”

A woman’s age affects the quality of her eggs. As she gets older, the quality of her eggs declines and her chances for pregnancy decrease. At the same time, the chances of miscarriage and of genetic abnormalities begin to increase.
“A lot of women think that at the age of 35, their fertility just falls off a cliff,” says Dr. Bromer. “The reality is that it starts to decline in their 30s, but the decline accelerates more rapidly over 35. This means that every year over the age of 35 matters more and more. For example, there isn’t a great difference between being 25 and being 27 in terms of getting pregnant, but there is a big difference between being 35 and being 36. And your chances are better at 36 than they are at 37, and so on.”
One common misunderstanding is that fertility treatment can reverse this decline, allowing older women the same chances to get pregnant as younger women. Dr. Bromer says that sadly, for women using their own eggs, this is not the case. “Age is the one problem that we really cannot fix,” he says. “The effectiveness of fertility treatments also goes down as a woman’s age goes up.”
He adds, “What this means for treatment is that we will be more aggressive. We might move to IVF sooner because we want a treatment that will work faster. We might also suggest moving from IVF to donor eggs sooner or, in some cases, just going directly to donor eggs.”
The great thing about using donor eggs is that the chances of success depend on the age of the donor, not on the age of the recipient. At Shady Grove Fertility, all our donors are healthy women between the ages of 21 and 32, so the success rates are very high.

Some women have heard the guidelines about when to seek help from a fertility specialist. Women under the age of 35 are often told to try on their own for a year while women over 35 are asked to try naturally for just six months. The catch with these time frames is that they only consider the time you have been having unprotected intercourse not the amount of time you have “been actively trying to conceive.”
“The definition of infertility is one year of unprotected intercourse without a pregnancy,” says Dr. Bromer. “It doesn’t matter if you’ve been actively trying at the right time of the month. After a year, 85% of couples will be pregnant. The rest need to be evaluated.”
Dr. Bromer adds, “If you meet the criteria for infertility – one year of unprotected sex without pregnancy – all it means is that an evaluation is warranted. It doesn’t necessarily mean you need fertility treatment, but you should definitely have a complete infertility workup and find out what’s going on.”

Sexually Transmitted Diseases (STDs), even those that are successfully treated, can affect a woman’s fertility. STDs, especially chlamydia and gonorrhea, can cause inflammation and scar tissue that damage the fallopian tubes. Any damage to the fallopian tubes can prevent pregnancy or make it much more difficult. It also increases the risk of ectopic pregnancy, which is a pregnancy where a fertilized egg is stuck in the fallopian tube and must be removed.
“A history of STDs doesn’t necessarily mean that you will have infertility, but it’s worth getting checked out,” says Dr. Bromer. “We have simple tests that can evaluate the health of the fallopian tubes. Once we have the results, we will know whether the patient needs treatment or we can take a wait and see approach.”

We all know you’re not supposed to smoke when you’re pregnant, but it turns out that smoking, including regular exposure to second-hand smoke, also makes it much harder to get pregnant. Smoking affects the quality of a woman’s eggs. It affects the ability of the fallopian tubes to transport the egg and sperm, which makes getting pregnant harder and increases the risk of an ectopic pregnancy. Smoking by men affects their production of sperm and can cause erectile dysfunction. “Even with fertility treatment,” says Dr. Bromer, “pregnancy rates go down dramatically if the patient smokes.”
In fact, studies of patients undergoing IVF treatment have found that female smokers need higher doses of hormones to stimulate their ovaries, have fewer eggs obtained, more canceled cycles, lower implantation rates, and undergo more cycles with failed fertilization than nonsmokers. For this reason, Shady Grove Fertility won’t start treatment with a patient who smokes. “We don’t think it’s appropriate for patients who smoke to go through the effort and expense of fertility treatment. It’s like fighting with one hand tied behind your back,” says Dr. Bromer.
Quitting smoking is difficult, but it does make a difference. Experts believe that if you stop smoking, even just 2 months before you start fertility treatment, it significantly improves your chances of getting pregnant. “When we see patients who are smokers, we strongly encourage them to stop smoking, and we provide them with resources they can consult for help.”

Pain, above and beyond the normal cramps associated with your period, can be a sign of a condition called endometriosis. In this condition, the uterine lining, called endometrium attaches and grows outside the uterus in the abdominal cavity. This endometrial tissue bleeds and causes inflammation and scarring. That scar tissue can block the fallopian tubes or interfere with their function. Endometriosis can also cause cysts in the ovaries that affect their ability to release eggs.
“If you have painful periods and you’re trying to conceive, you should be evaluated for endometriosis,” says Dr. Bromer. “How much endometriosis affects your ability to get pregnant depends on the health of your fallopian tubes and ovaries. With an infertility workup, we can assess the situation and decide whether treatment is necessary and what treatment might be best. With the right treatment, women with endometriosis have a good chance of getting pregnant.”
If you recognize one of these symptoms in yourself, it’s best to talk to your doctor about it right away. There are ways to treat almost every problem associated with fertility, so none of these symptoms have to be a roadblock to your success.
For more information or to schedule an appointment with one of our physicians, please speak with one of our friendly New Patient Liaisons by calling 888-761-1967.