Fertility Problems

What Increases Your Risk

Infertility has many causes that involve either the woman's, the man's, or both partners' reproductive systems. Some factors that increase your risk of infertility are within your control; others are not.

Risk factors you cannot control include:

• Aging. Rates of infertility (not due to surgical sterilization) in women increase with age and are about:³
  • 7% in women ages 20 to 24.
  • 9% in women ages 25 to 29.
  • 15% in women ages 30 to 34.
  • 22% in women ages 35 to 39.
  • 29% in women ages 40 to 44.
• Problems with the male or female reproductive system that were present at birth (congenital birth defects).
• Exposure to DES (diethylstilbestrol) before birth.
• Moderate or severe endometriosis, the growth of uterine lining (endometrial) cells in other parts of the abdominal cavity (such as the ovaries or fallopian tubes, the outer surface of the uterus, the bowels, or other abdominal organs).
• Past exposure to very high levels of environmental toxins, certain drugs, or high doses of radiation (including cancer chemotherapy or radiation).
• Past infection with a sexually transmitted disease (such as gonorrhea or chlamydia) that has since damaged the reproductive system.

Risk factors you can control include:

• Polycystic ovary syndrome, which is related to a hormone imbalance that interferes with normal ovulation. When weight loss with diet and exercise does not stimulate ovulation (or is not necessary), medication often helps.
• Tobacco or marijuana use, which reduces sperm counts and female fertility.
• Drinking more than 2 to 4 alcoholic beverages daily for several months, which decreases male fertility and causes injury to sperm.
• Frequent (daily) or infrequent (every 10 to 14 days) ejaculation, either of which can temporarily lower sperm count.
• Timing and frequency of intercourse—some experts say that the ideal frequency is every day for 3 days during the midpoint in the woman's cycle, ending the day before ovulation.³ Others say that given a normal sperm count, daily sex during the fertile period may lower sperm count, but it does increase the overall chance of pregnancy.⁴
• Increased temperature in a man's scrotal area, which can damage sperm (common causes are hot tub use and high fever).
• Exercising intensely for months or years, which may affect a man's sperm count and prevent a woman's ovulation.
• Prior surgical sterilization, such as vasectomy or tubal ligation. Surgical sterilization reversal may be successful, depending on the procedure used and how much time has passed since original surgery.

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Author:	Shannon Erstad, MBA/MPH Carrie Henley	Last Updated August 16, 2006
Medical Review:	Adam Husney, MD - Family Medicine Joy Melnikow, MD, MPH - Family Medicine Kirtly Jones, MD - Obstetrics and Gynecology Femi Olatunbosun, MB, FRCSC - Obstetrics, Gynecology and Reproductive Medicine
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