If you’ve been trying to conceive for a couple months but haven’t had any success, it’s normal to wonder about infertility. It can take up to a year to get pregnant, but if it takes any longer than that, it may be time to see a doctor. Here are some common causes of infertility in both women and men — and what you can do.


Women: polycystic ovary syndrome (PCOS)

Your doctor may suggest that you get tested for PCOS if you’re having trouble conceiving. Approximately five to ten percent of women suffer from PCOS, a hormone disorder that can affect fertility. In order to be diagnosed with the syndrome, you must have at least two of the following issues: irregular periods, excess male hormone levels and ovaries with multiple small cysts.

If you’ve been diagnosed with PCOS and are overweight, your doctor may first suggest you lose weight to see if you and your partner can conceive naturally. Next, your doctor may prescribe oral medications or injections to stimulate egg growth. If those don’t work, your doctor may suggest in vitro fertilization (IVF).


Women: endometriosis

Endometriosis is a surprisingly common condition, affecting ten percent of women in the U.S. It occurs when uterine tissue is found outside the uterus — such as on the ovaries, fallopian tubes, or even on the bladder or intestines. While some women may not experience any symptoms, others may experience painful periods and/or pain during sex and diarrhea during periods, according to Gregory Starks, MD, an OBGYN with Research Medical Center in Kansas City, MO. About 30-50 percent of women with endometriosis may experience infertility.

If you have endometriosis and are having trouble conceiving, your doctor may suggest surgically removing the tissue to help you get pregnant.


Women: uterine fibroids

Uterine fibroids are benign tumors that grow in the wall of the uterus or even in the cervix. Usually, fibroids have no effect on fertility, but about five to ten percent of women with the condition may experience trouble getting or staying pregnant. It all depends on the size and location of the fibroid. Large fibroids and those found inside the uterine cavity are known to decrease fertility.

If you have uterine fibroids, a fertility specialist can determine if they are threatening your ability to get pregnant and provide a treatment plan that works best for your body.


Men and women: age

The American Society for Reproductive Medicine estimates that 20-30 percent of couples younger than 30 are able to conceive in the first three months. However, women over 35 should visit a fertility specialist after six months of trying to conceive without any success. In fact, fertility declines rather sharply after about age 35.

While sperm quality deteriorates gradually as men get older, there is no set age at which men cannot conceive. However, the risk of gene defects in the sperm increases slightly in older men, particularly after age 60.


Men and women: body weight

Abnormal body weight (either too high or too low) causes infertility in about one in eight couples. While obese men may experience fertility problems, women in particular need to be at a healthy weight before pursuing fertility treatment. Turns out, more than 70 percent of women who have fertility issues as a result of body weight disorders will naturally conceive once they reach a healthy weight.


Men: sperm issues

In 40 percent of infertile couples, the man is either the sole or contributing cause of infertility. The most common reasons for male infertility are azoospermia (where no sperm cells are produced) or oligospermia (where few sperm cells are produced). Sometimes men may have enough sperm, but the sperm are immature or don’t move normally; and sometimes, men aren’t able to make or ejaculate sperm. In other cases, medical conditions such as diabetes, cystic fibrosis or previous treatment with chemotherapy or radiation may cause infertility.


Men and women: tobacco and alcohol

One study found that women who smoked were 54 percent more likely than nonsmokers to take more than one year to conceive. However, guys aren’t completely off the hook. Men who smoke are at increased risk for erectile dysfunction and a low sperm count. Additionally, secondhand smoke is almost as dangerous to your fertility as smoking yourself, so encourage those around you to kick the habit as well.

Studies show that alcohol also decreases fertility in women and men, but the exact amount of alcohol that could affect conception is unclear. Bottom line: If you’re trying to get pregnant, stop drinking alcohol and quit smoking for good.


Men and women: STIs

Roughly one in three men and women will contract a sexually transmitted infection (STI) before age 24. If that stat isn’t scary enough, STIs often have few or no visible symptoms, so many men and women are unaware they’ve contracted an infection. Left untreated, some STIs can hinder fertility in both men and women.


Gregory Starks, MD

Obstetrics & Gynecologist, Reproductive Endocrinologist at Midwest Women’s Healthcare Specialists

Learn Dr. Gregory Starks care philosophy and fertility services at bit.ly/gregorystarks