Identifying signs of infertility: Symptoms, causes and first steps

Reproductive endocrinologist consults with a couple

Infertility is more common than many may think. It affects one in eight heterosexual couples who are trying to get pregnant. Overall, 12 to 15% of people are infertile.

As a reproductive endocrinologist, my colleagues and I witness firsthand the impact that infertility has on people who desire to have a baby. It’s part of what drives our passion to help them find hope whenever possible. At the Center for Reproductive Medicine and Fertility, we start by identifying the causes of infertility in each person or couple, then exploring every possible option to help our patients build their families.

How do I know if my partner or I may be infertile?

Infertility is defined as the inability to conceive after one year of regular, unprotected intercourse. If you or your female partner are over the age of 35, you should see a fertility specialist after six months. After age 40, we recommend seeking help right away because we know fertility declines as age increases.

What are other signs and symptoms of infertility in females?

Aside from having trouble conceiving, symptoms can vary significantly from one person to another. Depending on the reason for infertility, sometimes women may experience pelvic pain, heavy periods, skipped periods or unpredictable vaginal bleeding. It’s important to discuss any unusual symptoms with your doctor. Some of these symptoms may represent underlying hormonal conditions that should be addressed even if you are not trying to conceive.

What are the most common causes of infertility?

Infertility can be a result of many different factors — even in one person or couple. The most common causes include problems with ovulation, structural issues in the uterus or fallopian tubes, or abnormalities in sperm.

In females, medical conditions such as uterine fibroids, endometriosis, polycystic ovary syndrome (PCOS), uterine polyps or a history of pelvic infections are often associated with infertility.

Can you still be infertile if you have a period?

Yes. Having regular predictable periods is a good indicator that you ovulate regularly. In other words, it means an egg is being released from your ovaries on a regular basis. But, ovulation alone does not guarantee that you can get pregnant. Sometimes there can be an issue with egg quality, how the egg is fertilized, its ability to be transported to the uterus, or how it becomes implanted in the uterus. There may also be a problem with the sperm. If you’re having a period and regular intercourse but have not conceived, it is important to talk to your health care provider about whether a referral to a fertility specialist is warranted.

How is infertility a unique health challenge for women of color?

Outcomes indicate that black, Asian and Hispanic or Latina women may have less success with fertility treatments compared to white women. Overall, we don’t know exactly why this happens. However, we do know certain medical conditions that can impact fertility occur more frequently in some races than in others. For example, women of color have a higher likelihood of having uterine fibroids than white women.

Additionally, studies show that women of color are more likely to be affected by socioeconomic factors that can make it more difficult to get treatment — or even to understand the need the need for treatment. At UChicago Medicine, we take a personalized approach to educating each patient about their reproductive health and family-building options. Our team is committed to providing excellent care for everyone.

What should I do if I think I’m infertile?

If you believe that you or your partner may be experiencing infertility, it’s important to seek an evaluation with a reproductive endocrinologist as soon as you can. Typically, the first steps will involve a visit to the doctor, blood tests, a pelvic ultrasound and a semen analysis.

Can infertility be cured?

Infertility isn’t cured but it can be treated. In many cases, factors that lead to infertility can be overcome with treatments like intrauterine insemination (IUI) or in vitro fertilization (IVF). Your doctor can help you understand which family-building options may work best for you.

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