Signs and symptoms of infertility

Infertility is when women cannot get pregnant after having unprotected, regular sex for six months to one year, depending on her age. Infertility may be caused by a variety of conditions.  Both partners should be investigated together for possible causes of infertility.

Couples trying to conceive should be aware of signs and symptoms of infertility associated conditions. This will facilitate early detection and treatment.

Symptoms in women:

• The main symptom of infertility is not being able to become pregnant. About 85% of women are able to become pregnant within 12 months of trying. The remaining 15% may need some type of treatment to achieve this goal. Women may or may not have any other symptom of infertility or other associated conditions.
• There are many health conditions which can result in difficulty in becoming pregnant. Symptoms of these conditions are diverse and depend on what is causing infertility.
• Changes or irregularity in the menstrual cycle may be a symptom of a disease associated with infertility (e.g. polycystic ovarian syndrome, hyperprolactinemia, reduced ovarian reserve).
• Painful periods (dysmenorrhea): Women may experience some back pain, pelvic pain, and cramping during periods. This is considered normal. However, excessive pain during periods and may be associated with conditions such as endometriosis or pelvic infection.
• Some health problems associated with infertility can cause hormonal changes leading to skin conditions such as acne and hair growth on the lips, chest, and chin. Some women may experience hair loss or thinning (alopecia).
• Changes in sex drive and desire.
• Weight gain.
• Milky white discharge from nipples unrelated to breastfeeding (e.g. high prolactin hormone levels).
• Pain during sexual intercourse.

Symptoms in men:

Male factor is the cause of infertility in about 30-40% of couples. Male infertility is most commonly due to abnormal sperm parameters (e.g. low sperm count, low sperm motility, poor sperm morphology) which are easily detectable by a routine semen analysis. In up to 10% of men, infertility may be due to the total absence of sperm in the semen (azoospermia).

Most men with infertility may not have any symptom at all or the symptoms may be vague. They may go unnoticed until a man tries to have a baby.

Some symptoms include:

• Problems with erections and ejaculation.
• Small, firm testicles.
• Changes in sexual desire.
• Changes in hair growth.
• Pain, lump, or swelling in the testicles.

When to See the Doctor

Arrange an appointment to see your gynecologist or a fertility specialist if you are under 35 and have been trying to get pregnant without success for a year. Women 35 and older should see their doctor after six months of trying.

As an initial investigation, blood tests and ultrasound imaging will be performed to discover why you are having trouble getting pregnant. A sperm analysis can be done to check for sperm count, motility, and morphology. Further testing will be requested if needed to determine most appropriate treatment.

By Dr. Erdal Budak

Specialist IVF