Infertility is commonly defined as the inability to conceive when trying for more than a year. Infertility can take its toll mentally and emotionally, but understanding and addressing the potential root causes helps bring confidence and hope to your journey! In this post, I’m going to share with you some of the most common causes of infertility.
Fertility typically starts to decline from the late 20s onward. Infertility affects 15+% of couples – although many believe that number is much higher. Infertility is due to a combination of male and female factors in about 1/3 of the cases, female only factors in about 1/3 of the cases, and male only factors in about 1/3 of the cases. It’s important to address both the man and the woman when looking for the root causes of infertility.
Common Causes of Infertility
- Ovarian failure increases with the age of the woman. In these women there is an insufficient number of eggs or the eggs have poor viability. This can be tested by measuring FSH on day 3 of your cycles, anti-mullerian hormone (AMH), or antral follicle count via ultrasound.
- DNA Damage is a common cause of infertility for both the egg and/or sperm. This damage may have happened to the woman before birth, but lifestyle and diet play a huge role in DNA damage. DNA damage tends to increase with age and is more likely in those who smoke or are nutrient deficient (especially antioxidants, folate, and B12). Stress and inflammation (gut health) also play a role in DNA damage. DNA damage can be an issue for both men and women.
- Stress is an often overlooked cause of infertility as we either think it can’t be avoided or that we can handle it all. Stress increases cortisol and reduces progesterone. Without adequate progesterone you won’t be able to get and stay pregnant. Stress also causes adrenaline surges and these surges can impair circulation to the uterus. Our bodies always choose survival over reproduction. Under lots of stress, your body is just trying to survive!
- PCOS is a common cause of infertility in the United States. PCOS causes hormonal imbalances which lead to irregular ovulation. Typically, increased insulin and testosterone are to blame. Without regular ovulation or poor egg maturity, getting pregnant is difficult. Additionally, the months without ovulation, no progesterone is produced which often leads to estrogen dominance…hello PMS symptoms.
- Hormonal imbalances
- Hypothyroidism (or low thyroid) affects estrogen and prolactin levels which can impact fertility. Low thyroid hormones can increase prolactin which suppresses GnRH (the hormone that triggers LH and FSH) and can cause irregular cycles or no cycles at all. Women with thyroid issues are more likely to also have PCOS which complicates matters a bit more. You can check TSH, Free T3, Free T4, Reverse T3, TPO and TG antibodies for a full picture of thyroid health.
- Elevated cortisol (stress) can directly contribute to hypothyroidism and create insulin resistance. Stress also depletes progesterone to produce more cortisol. As I mentioned above, your body promotes fertility when you are thriving, not when it thinks you are trying to survive. Elevated cortisol is telling your body you are in survival mode. You can check your cortisol via a saliva or urine hormone test.
- Estrogen dominance can be caused by xenoestrogens, previous birth control, body fat, a high glycemic diet and more. Estrogen dominance is common in women with PMS, PCOS, PMDD, endometriosis, and fibrocystic breasts.
- Insufficient progesterone is common in estrogen dominance, high stress, and luteal phase deficiency. Progesterone = pro-gestation, so you need plenty of it to get and stay pregnant.
- High prolactin (men or women) suppresses formation of triggering hormones such as FSH and LH. It can also cause hormonal imbalances and lower sperm counts.
- Endometriosis is another common cause of infertility that is present in about 50% of women with unexplained infertility. Endometriosis causes uterine tissue to grow outside the uterus which can cause anatomical issues, blocked ovulation, or impaired hormone production or use. Endometriosis is typically due to high estrogen exposure, and impaired immune system, or chronic inflammation.
Are you struggling with infertility?
Have you looked into these common causes of infertility and worked to address them at the root?
If you need help working through these issues to find healing and fertility, contact me for a free initial call.