Risk Factors for Infertility in Women
Main Page | Risk Factors | Symptoms | Diagnosis | Treatment | Screening | Reducing Your Risk | Talking to Your Doctor | Living With Infertility | Resource Guide
A medical risk factor may increase or decrease your chances of getting a disease or condition. Although a person with specific risk factors may be at an increased risk, anyone can develop infertility. Having one or more of the risk factors listed below does not necessarily mean that you will develop infertility. If you do have specific risk factors, talk with your healthcare provider about what you can do to lower your risk.
Age
Woman over 35 are more likely to have fertility problems. The ovaries become less effective in producing eggs that can be successfully fertilized.
Disorders of the reproductive tract and/or infection and trauma are more likely with advancing age.
Medical Conditions
Many medical conditions influence the risk of infertility.
Fallopian Tube, Ovary, and Uterus
Conditions That Influence Ovarian Function
- History of heavy menstrual bleeding or menstrual cycles that are unusually short (less than 24 days) or long (more than 35 days)
- Polycystic ovary syndrome , which is often characterized by excessive facial hair, acne , obesity , and irregular menstrual cycles
- Abnormal thyroid function
- Pituitary tumors
Conditions That May Damage or Block Fallopian Tubes
- Endometriosis —Uterine tissue implanted on other pelvic structures can interfere with normal functioning.
- Sexually transmitted diseases—Infections, such as gonorrhea or chlamydia , often produce no symptoms in women. If left untreated, these infections can lead to pelvic inflammatory disease , which may cause scarring and adhesions that block the fallopian tubes.
- History of ectopic pregnancy —When a fertilized egg begins to develop within the fallopian tube, it can cause the tube to rupture. As the injury heals, scar tissue may block the tube, thereby reducing fertility.
Other Medical Conditions or Diseases
- Anatomical abnormalities in the reproductive tract
- History of abnormal Pap smears or infection with human papillomavirus (HPV) that have resulted in cervical treatments such as cryosurgery or cone biopsy
- History of two or more spontaneous miscarriages or elective abortions
- Uterine surgery
- Uterine fibroids
- Diabetes
- Lupus
- Arthritis
- Hypertension
- Asthma
- Kidney disease, including kidney failure
- Cirrhosis (scarring) of the liver
- Sickle cell anemia
- HIV infection
- Epilepsy
- Ulcerative colitis and Crohn’s disease
- Any chronic medical condition may reduce the chances of a successful pregnancy.
Medications
Many of the drugs listed below are extremely important for treating serious and chronic conditions. Do not cut back or stop your medications on your own. Discuss your concerns with your healthcare provider. In some cases, the following drugs may increase your risk of infertility:
- Hormones
- Antidepressants
- Chemotherapeutic agents used to treat cancer
- Acetaminophen (Tylenol)
- Ibuprofen (Advil, Aleve, Motrin)
- Pain medications
- Antibiotics
These medications have received lay-press coverage as possible causes of infertility. There is very limited evidence of a causal effect in humans. You should notify your doctor if you are taking these medications on a daily basis, and discuss possible withdrawal from these drugs.
Body Fat
Very high or very low levels of body fat often affect hormone levels, which can alter ovarian function.
Excessive Exercise
Excessive exercise is often associated with low levels of body fat but may influence fertility through other means as well.
Smoking
Smoking cigarettes and passive exposure to cigarette smoke may reduce fertility.
Caffeine
Caffeine consumption, in the form of coffee, tea, or soft drinks, has been linked to infertility in some studies.
Alcohol
Alcohol consumption, even in moderation, appears to reduce fertility.
Occupational Exposures
Many work activities, such as standing for long periods of time or being chronically exposed to dust or loud noises, increase the risk of infertility. Other evidence suggests that the risk of infertility may be higher in women who frequently switch from working day shifts to night shifts. Job-related exposure to high temperatures, chemicals, radiation, pesticides, and other toxic substances have also been linked to infertility in women.
References:
American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/ .
American Medical Association webiste. Available at: http://www.ama-assn.org/ .
American Society for Reproductive Medicine webiste. Available at: http://www.asrm.org/ .
International Council on Infertility Information Dissemination, Inc. website. Available at: http://www.inciid.org/ .
RESOLVE: The National Infertility Association website. Available at: http://www.resolve.org/site/PageServer .
US National Library of Medicine: National Institutes of Health website. Available at: http://www.nlm.nih.gov/ .
Last reviewed November 2008 by Jeff Andrews, MD, FRCSC, FACOG
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.