Getting pregnant can be easy for some women and more challenging for others. There are many factors that impact fertility and the ability to conceive. Age, health conditions, lifestyle factors, and frequency of sexual intercourse can all influence how quickly a woman gets pregnant.
What impacts fertility?
A woman’s age is one of the most significant factors that impacts fertility. As women get older, especially over age 35, it becomes harder to get pregnant for several reasons:
- Egg quality and number decline with age, making it harder to conceive and increasing the risk of chromosomal abnormalities.
- The likelihood of conditions like endometriosis, fibroids and polycystic ovary syndrome increases, which can cause infertility.
- Regular menstrual cycles become less frequent as women near menopause, making ovulation less predictable.
In addition to age, other health and lifestyle factors influence a woman’s fertility, including:
- Being over- or underweight – Body weight that is higher or lower than normal can lead to hormone imbalances that disrupt ovulation.
- Smoking – Smoking has been linked with reduced fertility in women.
- Alcohol use – Drinking more than 1-2 drinks per day can negatively impact fertility.
- Chronic conditions – Health problems like polycystic ovary syndrome (PCOS), endometriosis, diabetes, autoimmune disorders and thyroid disease can impair fertility.
- Medications – Certain prescription drugs, like antidepressants, blood pressure medications and strong painkillers can make getting pregnant difficult.
- Recreational drug use – Using marijuana, cocaine and other drugs can interfere with fertility.
- Environmental toxins – Exposure to chemicals like pesticides and lead can reduce fertility in both men and women.
- Stress – High levels of ongoing emotional stress and anxiety may interfere with the hormones needed to ovulate.
Additionally, sexual health factors impact a couple’s ability to conceive, such as:
- Low sperm count or poor sperm health in the male partner.
- History of sexually transmitted infections.
- Problems with the fallopian tubes or uterus.
- History of pelvic inflammatory disease.
When is getting pregnant considered difficult?
Most experts define infertility as not being able to get pregnant after one year of having regular, unprotected sex. Women over 35 who have been trying to conceive for 6 months without success should also see a doctor, since fertility declines more rapidly with age.
Here are some signs that may indicate potential fertility problems in women:
- No pregnancy after 12 months of trying.
- No pregnancy after 6 months of trying for women over 35.
- Menstrual cycles longer than 35 days or irregular periods.
- Periods have stopped for 90 days when not pregnant, breastfeeding or in menopause.
- Endometriosis, fibroids, PCOS or pelvic inflammatory disease.
- History of multiple miscarriages.
- Family history of early menopause.
Around 10-15% of couples experience fertility difficulties. The main causes include:
- Ovulation disorders – problems with ovulation account for about 25% of infertility cases.
- Tubal occlusion – blockages or damage to the fallopian tubes cause around 20% of infertility cases.
- Uterine or cervical abnormalities – uterine fibroids, endometrial polyps or cervical issues cause up to 10% of cases.
- Endometriosis – affects up to 50% of infertile women.
- Polycystic ovary syndrome – accounts for around 15% of infertility cases.
- Poor sperm quality or function in the male partner – contributes to around 30-40% of infertility cases.
- Unexplained infertility – no identified cause is found in around 15% of couples.
What steps can women take to improve fertility?
For women wanting to enhance their natural fertility, here are some tips that may help:
- Maintain a healthy BMI – Being under or overweight can disrupt hormones needed for ovulation. Aim for a BMI between 18.5-24.9.
- Take a prenatal vitamin – Folic acid and other vitamins help support a healthy pregnancy.
- Eat nutrient-rich foods – Consume fruits, vegetables, whole grains, lean protein and healthy fats.
- Increase physical activity – Regular exercise, like walking 30 minutes a day, can help regulate ovulation.
- Quit smoking and limit alcohol – Cigarette smoking reduces fertility. Limit alcohol to 1-2 drinks per week.
- Reduce stress – Consider mind-body techniques like meditation, yoga and acupuncture to lower stress.
- Get medical conditions under control – Have chronic health problems like diabetes or thyroid disease managed.
- Use an ovulation predictor kit – Kits measure luteinizing hormone to identify peak fertility days.
- Time intercourse wisely – Have sex every 2-3 days during the fertile window – about 5 days before and 1 day after ovulation.
What are common treatments for fertility problems?
If natural conception has not occurred after 12 months of trying (or 6 months for women over 35), it’s recommended to consult a fertility specialist. Common medical treatments for fertility include:
- Medications to induce ovulation – Oral drugs like clomiphene citrate help stimulate ovulation in women.
- Hormonal therapies – Gonadotropin injections stimulate ovulation in women who don’t respond to oral drugs.
- Intrauterine insemination (IUI) – Sperm is placed directly in the uterus around the time of ovulation.
- Assisted reproductive technology (ART) – Procedures like in vitro fertilization (IVF) help achieve pregnancy through advanced medical techniques.
- Surgery – Operations to correct uterine abnormalities, remove endometrial tissue or reverse tubal occlusion may be warranted.
Treatment plans are personalized based on the underlying fertility issue(s) and prognosis for success with different options. IVF has the highest per cycle success rates for many causes of infertility.
What is the success rate of fertility treatments?
The success rates of fertility treatments vary greatly based on a woman’s age, the specific type of treatment, and the cause of infertility. Here are the approximate average success rates per treatment cycle:
| Treatment | Success Rate Per Cycle |
|---|---|
| Ovulation induction medications (clomiphene, gonadotropins) | 8-15% |
| Intrauterine insemination (IUI) | 10-20% |
| IVF for women under 35 | 41-43% |
| IVF for women 35-37 | 33-36% |
| IVF for women 38-40 | 23-27% |
| IVF with frozen embryos for women under 35 | 29.5% |
| IVF with frozen embryos for women 35-37 | 28% |
| IVF with frozen embryos for women over 38 | 20.7% |
Younger women generally have higher success rates with fertility treatments. After age 37-40, success rates drop substantially. For women in their 40s, donor eggs may offer the best chance for conception.
How can age impact the ability to get pregnant?
Age has a significant effect on female fertility, especially after the mid-30s. Here’s how age can influence the ability to get pregnant:
- At age 30, approximately 86% will conceive after 1 year of trying.
- At age 35, approximately 78% will conceive after 1 year of trying.
- By age 40, approximately 64% will conceive after 1 year of trying.
Egg quantity and quality both diminish as a woman gets older. By age 30, follicle number declines to about 12,000 and by age 40, only 3,000 remain. Egg quality also worsens with age, resulting in higher rates of genetic abnormalities.
In addition to egg quantity/quality, other age-related fertility declines include:
- Less regular ovulation and menstrual cycles.
- Higher risk of fibroids, endometriosis and PCOS.
- Reduced uterine elasticity and muscularity.
- Increased chance of chromosomal abnormalities.
- Higher miscarriage rates.
Due to the marked decline in fertility after 35, women in their mid-30s or older may need to seek treatment sooner if conception difficulties arise.
How soon should a woman under 35 be concerned?
For women under 35, up to 1 year of regular, unprotected intercourse is considered normal before infertility testing is pursued. About 90% will get pregnant within 1 year of trying through intercourse timed with ovulation.
After 6 months of unsuccessful trying, about 60% will conceive in the next 6 months if they continue attempts.
By 12 months of trying, approximately 86% will have conceived. The remaining 14% meet the medical definition of infertility and should consult a doctor.
Some signs in women under 35 that may warrant an earlier infertility evaluation include:
- No pregnancy after 6 months of trying despite timing intercourse around ovulation.
- Menstrual cycles longer than 35 days.
- Periods extremely irregular, heavy or painful.
- Endometriosis, PCOS or pelvic inflammatory disease.
- History of multiple miscarriages (2 or more).
- Known tubal damage or pelvic scarring.
- Male partner with very low sperm count or motility.
If any of these fertility risk factors are present before trying, it’s reasonable to see a specialist sooner than 12 months. Otherwise, women under 35 should try to conceive for at least 6 months before seeking a fertility evaluation, and 12 months if over 35.
Conclusion
For some couples, pregnancy occurs quickly and easily. But for others, getting pregnant can be challenging and require medical intervention. A woman’s age is a major factor, as fertility starts to decline significantly in the mid-30s. Other health, lifestyle and sexual health factors can also impact the ability to conceive.
It’s considered clinically infertility if a woman under 35 can’t get pregnant after trying for 1 year, or 6 months for women over 35. About 10-15% of couples deal with fertility problems like ovulation disorders, blocked tubes, endometriosis or poor sperm health.
Women can optimize their natural fertility through a healthy lifestyle and ovulation tracking. But if pregnancy doesn’t happen after the defined periods of trying, seeing a fertility specialist for an evaluation and treatment is recommended. Options range from oral medications to intrauterine insemination to IVF. Success rates vary widely based on a woman’s age and the specific treatment pursued.