Understanding a Woman's Fertility - possible causes of female infertility
When you start to look into all the factors at play in becoming pregnant naturally, you start to realise just how complex and delicate the process is.
Even the basics are complicated. The female must have regular periods, produce and release a mature egg each menstrual cycle, produce oestrogen and progesterone, and have clear fallopian tubes and an endometrial lining that can receive a fertilised egg. If one or more of these ‘basics’ isn’t quite right, you may experience fertility issues and find it difficult to become pregnant.
While age is the biggest factor affecting female fertility – especially for women aged 35 or over – it’s by no means the whole story. There are other things to consider, such as:
- Endometriosis – where the tissue lining the uterus grows outside the uterus (in the pelvis, for example), making it harder for the egg to fertilise and the embryo to implant. Symptoms include painful periods, and pain during intercourse. A fertility specialist can treat endometriosis with laparoscopic surgery
- Fibroids – ‘lumps’ of uterine cell tissue in or around your uterus. If these are a barrier to pregnancy, a fertility specialist can remove fibroids with straightforward surgery.
- Polycystic Ovarian Syndrome (PCOS) – your ovaries have many small follicles, and they can sometimes prevent your egg from maturing. Symptoms include irregular periods, acne, obesity and increased hair growth. There are a number of ways to treat PCOS, including medication, or IVF treatment.
- Understanding your menstrual cycle and fertile window
Every month, from puberty to menopause, you release an egg from a follicle in one of your ovaries. This is the menstrual cycle, which usually takes around 28 days to complete, but can take between 26 and 32.
The days leading up to ovulation are your most fertile. This is your ‘pregnancy window’, and when you should be having regular intercourse if you’re trying to conceive. When you ovulate – when the egg is released – it only survives for 24 hours, so to increase your chance of conception, the sperm should be ‘waiting’ for the egg.
The first day of bleeding is ‘day one’ of your menstrual cycle. In an average 28-day cycle, ovulation happens between day 12 and day 15. To work out when you ovulate, simply take 14 days from the number of days in your cycle – or use our Fertile Window calculator.
Your window of opportunity to fall pregnant typically lasts five to six days, and begins two or three days before ovulation. So if ovulation occurs on day 12 of your cycle, you should have intercourse regularly leading up to day nine.
- What if we're not falling pregnant?
TasIVF can carry out fertility tests to see what’s happening during your menstrual cycle. We can then discuss the most appropriate ways we can help increase your chances of conceiving.
- Age and Fertility
Statistically speaking, once you turn 36, your chance of conceiving naturally is half as much as when you were 20. By the time you are 41, this drops to just 4 per cent.
So, if you’re over 35 and haven’t become pregnant within six months of trying, we recommend seeking medical advice.
If you’re under 35, leave it 12 months – unless you know you have medical conditions such as endometriosis, PCOS, or if your partner has male fertility issues. In these cases we recommend seeing a specialist sooner rather than later.
- Does age increase the risk of miscarriage?
Unfortunately, a woman’s age does increase the risk of miscarriage, particularly from the late 30’s onwards. The cell division process during ovulation can become abnormal, which can mean distributing unequal amounts of genetic material – creating a greater risk of miscarriage or giving birth to a child with a genetic abnormality.
Most people start to consider seeking professional advice on fertility and conception if they have been trying for 12 months or more without success. It’s recommended to only wait six months if you’re over 35.
If you have any questions, you can discuss these with your GP, or with a TasIVF fertility specialist.