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So, you’re finally ready to start a family: You’ve checked all of the boxes that fit into your plan, whether that’s a committed relationship or secure finances (or both!). There's nothing left to do but try to conceive!
Cut to about six months later, and your at-home pregnancy tests are still negative. The last thing you had on your TTC bingo card was infertility, but here we are. There’s no sugarcoating the fact that infertility sucks, but it is quite common. According to the Centers for Disease Control, 1 in 5 (19%) of married women are unable to get pregnant after one year of trying. Within this group, about 1 in 4 (26%) women have difficulty getting pregnant or carrying a pregnancy to term.
If you think you’re dealing with infertility, the first step is to make an appointment with your healthcare provider to discuss your concerns. There are also a few specific warning signs you should look out for, whether you’re currently TTC or thinking about growing your family, that may help you determine the cause of your fertility struggles.
Possible signs of infertility in women
“These warning signs are your body telling you that there is an issue, similar to the check engine light coming on in your car,” says Sydney Chang, M.D., a double-board-certified OB/GYN & reproductive endocrinologist and infertility specialist (REI), and founding partner and medical director of CCRM Fertility of Austin. “Failure to heed these warning signs will likely result in the delayed diagnosis of an issue that may be preventing you from getting pregnant, resulting in frustration and lost time.”
The general recommendation for people trying to get pregnant is to wait about six months before seeking reproductive assistance (although this varies by the patient’s age). But knowledge of infertility warning signs is critical because if you’re experiencing any of these symptoms, Dr. Chang advises seeing an REI specialist immediately: “Prompt diagnosis and treatment is critical to ensure that you can correct any issues as quickly as possible.”
Read on for Dr. Chang’s breakdown of possible infertility warning signs.
Irregular periods
Not surprisingly, all roads to fertility — and overall female health — begin and end with the menstrual cycle. “Women should think of their menstrual cycles as the fifth vital sign (along with blood pressure, body temperature, heart rate, and respiratory rate),” says Dr. Chang. Therefore, not getting a regular period could signal that there’s a fertility-related problem.
“An irregular cycle may mean that a woman is not ovulating regularly (or possibly at all), which would be an impediment to getting pregnant.” If you’re trying to get pregnant, and you experience irregular periods, it’s imperative you contact your physician to determine the cause of your cycle issues. “Irregular cycles can be a result of a common endocrine condition called polycystic ovary syndrome (or PCOS), changes in weight, thyroid abnormalities, or perimenopause,” explains Dr. Chang.
Heavy or painful periods
Saying it louder for those in the back: Heavy and painful periods are not normal. They can impact your fertility and they should be addressed by your medical provider. Heavy periods may be a symptom of uterine fibroids, while painful periods could indicate endometriosis, says Dr. Chang. She also advises not ignoring any spotting in between periods, as this could be the result of a polyp. In short, if you’re experiencing heavy periods, painful periods, and/or spotting, call your doctor, stat.
Your age
Like it or not, age is undoubtedly a factor when it comes to fertility. Female fertility begins to gradually decline as early as age 30. By your mid-30s, this decline starts to speed up, so it’s important to be mindful of where you are age-wise. “In the early stages of reproductive aging, menstrual cycles initially shorten before becoming longer and more irregular, until eventually there are no periods for an entire year,” says Dr. Chang. She recommends tracking your cycle length over time to monitor your ovarian reserve.
Infertility warning signs in men
While it’s hard for women to ignore symptoms like irregular and abnormal periods, the infertility warning signs for men tend to be more subtle, explains Dr. Chang: “They’re often not seen until a semen analysis is performed.” But there are a few red flags she says male patients can be on the lookout for, such as erectile dysfunction and decreased libido, “which could indicate low hormone levels.”
She also mentions that “swollen, painful, or tender testicles could point to a condition that results in enlarged veins in the scrotum, which can affect sperm quality.”
Taking charge of your fertility
There are a couple of lifestyle modifications to consider if your menstrual cycle changes are due to weight fluctuations (either from weight gain or excessive dieting/exercise). “If the issue is weight gain, losing as little as 5-10 pounds can lead to the resumption of regular cycles,” says Dr. Chang.
Bear in mind that extreme weight loss could affect a patient’s fertility as well. “With excessive exercise or dietary restriction, the body perceives physical stress and the need to conserve energy,” explains Dr. Chang. This can result in the menstrual cycle (and, by extension, reproduction), shutting down, which is “one way the body can shunt its resources to support critical functions.” To allow for a healthy pregnancy, Dr. Chang says “a patient would need to increase caloric intake and decrease exercise to maintain enough fat to support sufficient hormone production.”
The bottom line is that if you or your partner are experiencing any of the symptoms Dr. Chang mentioned, the most important step is making an appointment with your healthcare provider. Once the infertility cause is determined, your doctor can advise on treatment and a personalized course of action.
Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist, having written and reported on subjects ranging from TV and pop culture to health, wellness, and parenting over the course of her career. Her work has appeared in Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. A staunch mental health advocate, Sarene also hosts the podcast “Emotional Abuse Is Real.” Visit her website here, or follow her on Instagram or Twitter.