Understanding Infertility: Symptoms, Causes and Treatments

Nothing is more frustrating or heartbreaking than trying to plan a pregnancy… and realizing it might be more of a challenge than you thought it would. 

Scary words like ‘infertility’ may cross your mind, and you may even find yourself lying awake at night, Googling infertility symptoms and endless questions like “Am I infertile?” or “Why can’t I get pregnant?” 

Instead of panicking or doom-scrolling – let’s get real about what infertility is. Read on to learn about the common signs of infertility, why you may be struggling to get pregnant, and what you can do about it. 

Understanding Infertility 

Infertility is defined by the World Health Organization as the inability to achieve pregnancy after at least 12 months of regular unprotected sex. Both men and women can struggle with infertility. Globally, it’s estimated that one in six people experience infertility at some point in their life. 

Male Infertility

An estimated 9% of men have problems with infertility. 

The most common causes of infertility in men relate to sperm health. For example, hormone imbalance, hormone disorders, infection, substance abuse, heat stress, and certain genetic diseases can all interfere with the health of sperm. 

Other potential causes of male infertility are related to the sperm’s ability to physically move through the genital tract. For example, birth defects, infection, inflammation, and the presence of scar tissue can cause sperm blockage, meaning sperm cannot be ejaculated. 

Female Infertility

When it comes to women, an estimated 11% struggle with infertility. 

The most common causes of infertility in women relate to ovulation (i.e. the release of an egg from the ovaries during the menstrual cycle). For example, disorders such as polycystic ovary syndrome (PCOS), over/underactive thyroid, and premature ovarian failure can interfere with the body’s ability to ovulate. 

Other potential causes of female infertility relate to structural problems within the female reproductive system. For example, scarring, fibroids, polyps, and endometrium-like tissue growth (see endometriosis) may cause damage to reproductive organs – making it difficult for an egg to travel from the ovaries, through the uterine tubes, and to the uterus for implantation. 

Infertility Symptoms and Signs

Irregular Menstrual Periods

A menstrual period is considered irregular if the gap between periods is longer or shorter than 21 to 35 days. Other signs of an irregular period include:

• The length of the menstrual cycle and/or period differs from cycle to cycle
• Menstrual bleeding lasts fewer than two days or longer than eight days
• Menstrual bleeding is heavy and interferes with daily life

If the menstrual period is irregular, this may be a sign that ovulation is not occurring regularly or even at all. 

Painful Periods

Another symptom of infertility is painful periods. Chronic menstrual pain may be an indicator of certain underlying conditions, such as fibroids, endometriosis, and pelvic inflammatory disease. While light to moderate menstrual cramping is considered ‘normal’, the pain is not considered normal if it interferes with your day-to-day life, becomes increasingly severe over time, and if it flares up during intercourse or when you use the bathroom. 

Hormone Imbalances

Another sign of fertility problems is hormone imbalance, which can interfere with cycle regularity and the body’s ability to ovulate.

If you pay attention to your body, you may be able to ‘sense’ that your hormones are out of balance. For example, common signs of hormone imbalance include: 

• Changes to the menstrual cycle (i.e. your period is longer, shorter, heavier, or lighter than normal). 
• Changes to your hair – for example, the hair on your head may be thinner than normal. You may also experience unwanted hair on your face or chin. 
• Changes to your skin – for example, you may notice an increase in acne or dark spots. 
• Changes to your weight – for example, weight gain/loss that is sudden or unexplained

Other signs of hormone imbalance include low libido, painful sex, vaginal dryness, mood swings, increased irritability, trouble falling or staying asleep, and digestive issues. 

Factors that Influence Fertility

Age

For women, reproductive years last (on average) between the ages of 15 and 45 (although this can vary among individuals). According to the American College of Obstetricians and Gynecologists, 25% of women in their 20s and early 30s will conceive in any given menstrual cycle. This estimate drops to only 10% by age 40.  

It’s only normal for fertility to decline with age – however, it doesn’t mean that pregnancy is impossible if you’re in your late 30s or 40s. To learn more, check out our article Getting Pregnant After 40. 

Lifestyle

Lifestyle is another big factor that can influence fertility. For example, maintaining a healthy weight, getting plenty of sleep, minimizing stress levels, and limiting the intake of toxic substances (such as tobacco, alcohol, and recreational drugs) can help keep your hormones in balance. In turn, this contributes positively to your fertility. 

Environmental Toxins

Certain chemicals in our daily environment can interfere with our hormones, and in turn, have a negative impact on fertility. The three most common chemicals (often referred to as ‘endocrine disruptors’) to be aware of include:

• Bisphenol A (BPA) – found in plastic
• Phthalates – found in plastic and cosmetic products
• Triclosan – found in cosmetic products

It’s nearly impossible to avoid these chemicals altogether. However, you can reduce your exposure by using glass containers and organic, non-toxic personal care products when possible.

Underlying Medical Conditions

Sometimes infertility is completely out of our control and caused by underlying medical conditions. The most common underlying medical conditions that may cause problems with fertility include PCOS, thyroid disorders, premature ovarian failure, pelvic inflammatory disease (PID), endometriosis, uterine fibroids, and uterine polyps. In very rare cases, infertility may be caused by genetic disorders or cancer. 

Seeking Professional Help

If you have been actively trying to conceive with regular sex for at least one year (if under the age of 35) or six months (if over the age of 35), it’s a good idea to book an appointment with your doctor for further support. 

Potential Tests and Examinations

When you speak with your doctor, they’ll likely ask about your cycle patterns and characteristics, lifestyle habits, and TTC (trying to conceive) goals. They may also want to conduct the following fertility tests: 

• Pelvic Examination – to check for infection or signs of inflammation, fibroids, or endometriosis. 
• Ultrasound Scan – to check the health of the ovaries, uterine tubes, and uterus. 
• Hysterography – to check the health of the uterus and uterine tubes. 
• Hysteroscopy – to check the inside of the cervix and uterus

Your doctor may also recommend a blood test to check certain hormone levels. In addition to a standard blood test, they may also recommend at-home hormone tests which can provide further insights into various elements of your cycle and fertility. 

For example, the Mira Hormone Monitor enables you to track up to four key fertility hormones in urine at home. Your results are then displayed as numeric concentration levels, allowing you to see your unique hormone curve from cycle to cycle. This is critical when planning a pregnancy, as it allows you to see when (and if) you’re ovulating so that you can plan sex accordingly. 

Mira’s Panorama Fertility Lab Test is another at-home test you can try. This is a one-time blood test that tests for five key fertility hormones – Anti-Müllerian hormone (AMH), thyroid-stimulating hormone (TSH), Free Thyroxine (fT4), Prolactin, and Free Testosterone. When tested together, these hormones can provide insights into your ovarian reserve, thyroid functioning, menstrual cycle, hormone balance, and overall fertility health. 

*Please note that Mira’s Panorama Fertility Lab Test is not the same as the Mira Monitor. The Panorama Fertility Lab Test is a one-time screening that provides a broad picture of overall reproductive health and ovarian reserve. The Mira Monitor is designed for ongoing use to help monitor hormonal trends related to fertility and ovulation. 

Available Treatments

After your doctor has assessed your situation, they may recommend any of the following treatment plans based on your TTC goals: 

• Medication – certain medications (such as Clomid and letrozole) can help to induce ovulation. 
• Surgery – in rare cases, surgery may be necessary to repair the uterine tubes or remove fibroids or cysts. 
• Assisted Reproductive Technologies (ARTs) – If you are still struggling to ovulate and conceive naturally, your doctor may refer you to a fertility specialist who can advise on options for intrauterine insemination (IUI), in-vitro fertilization (IVF), and sperm/egg donation.

Further Support

If you are struggling to juggle all the different elements of planning a pregnancy, it’s worth seeking integrative support from a fertility coach who can take a holistic view of your health and fertility. For example, Mira’s own fertility coaches in our Hormone Health Clinic for Fertility can provide advice on all things hormone health – from tracking ovulation, interpreting hormone charts, balancing hormones naturally, navigating the world of IUI/IVF, and managing emotional health throughout the process. 

Lifestyle Changes to Improve Fertility

One of the best things you can do to improve fertility is to prioritize your overall health and well-being. This not only sets your pregnancy up for success, but it can also help keep your hormones in balance. Here are just a few lifestyle considerations to make while TTC. 

Diet and Nutrition 

Doctors recommend maintaining a well-balanced diet that is rich in whole grains, lean proteins, fruits, vegetables, and healthy fats. To ensure the body is receiving enough vitamins and minerals, it’s also recommended to take a prenatal vitamin (such as Mira’s own prenatal vitamin). And for a bonus boost of vitamins and antioxidants, check out Mira’s Fertility Tea!

Exercise

Physical exercise not only helps us maintain a healthy weight, but it also helps to balance hormones, reduce stress, and improve our quality of sleep each night. Even walking around your neighborhood or on a treadmill for at least 15-20 minutes each day is beneficial. 

Sleep

Sleep is absolutely essential for keeping hormones in balance. Aim for at least seven or more hours of uninterrupted sleep each night. 

Managing Stress

High stress levels have been associated with reduced fertility. When we are stressed, our bodies release cortisol and adrenaline – which can lead to hormone imbalance. Strategies for mitigating day-to-day stress include journaling, exercise, yoga, speaking with someone you trust, engaging in creative activities, and setting healthy boundaries in your personal and professional life. 

Final Thoughts

It’s important to remember that all pregnancy journeys are unique, and many women go on to have healthy pregnancies even if they’ve struggled with infertility. 

If you would like to learn more about how Mira can help with the TTC process, check out the following resources: 

• How Mira Works
• Mira’s Success Stories
• Mira Fertility Club

For further support, check out our library of free webinars, ebooks, and blogs. 

Frequently Asked Questions