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Risk Factors for Infertility in Women

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A medical risk factor may increase or decrease your chances of getting a disease or condition. Although a person with specific risk factors may be at an increased risk, anyone can develop infertility. Having one or more of the risk factors listed below does not necessarily mean that you will develop infertility. If you do have specific risk factors, talk with your doctor about what you can do to lower your risk.

Age

Woman over 35 are more likely to have fertility problems . The ovaries become less effective in producing eggs that can be successfully fertilized.

Disorders of the reproductive tract and/or infection and trauma are more likely with advancing age.

Medical Conditions

Many medical conditions influence the risk of infertility.

Fallopian Tube, Ovary, and Uterus
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Conditions That Influence Ovarian Function
  • History of heavy menstrual bleeding or menstrual cycles that are unusually short (less than 24 days) or long (more than 35 days)
  • Polycystic ovary syndrome , which is often characterized by excessive facial hair, acne , obesity , and irregular menstrual cycles
  • Abnormal thyroid function
  • Pituitary tumors
Conditions That May Damage or Block Fallopian Tubes
  • Endometriosis —Uterine tissue implanted on other pelvic structures can interfere with normal functioning.
  • Sexually transmitted diseases—Infections, such as gonorrhea or chlamydia , often produce no symptoms in women. If left untreated, these infections can lead to pelvic inflammatory disease , which may cause scarring and adhesions that block the fallopian tubes.
  • History of ectopic pregnancy —When a fertilized egg begins to develop within the fallopian tube, it can cause the tube to rupture. As the injury heals, scar tissue may block the tube, thereby reducing fertility.
Other Medical Conditions or Diseases

Any chronic medical condition may reduce the chances of a successful pregnancy.

Medications

Many of the drugs listed below are extremely important for treating serious and chronic conditions. Do not cut back or stop your medicines on your own. Discuss your concerns with your healthcare provider. In some cases, the following drugs may increase your risk of infertility:

  • Antidepressants
  • Chemotherapeutic agents used to treat cancer
  • Acetaminophen (Tylenol)—if taken chronically
  • Ibuprofen (Advil, Aleve, Motrin)—if taken chronically
  • Pain medicines
  • Antibiotics

These medicines have received lay-press coverage as possible causes of infertility. There is very limited evidence of a causal effect in humans. You should notify your doctor if you are taking these medicines on a daily basis, and discuss possible withdrawal from these drugs.

Body Fat

Very high or very low levels of body fat often affect hormone levels, which can alter ovarian function. A certain amount of body fat cells in women are needed to produce sufficient estrogen along with the ovaries.

Excessive Exercise

Excessive exercise is often associated with low levels of body fat but may influence fertility through other means as well.

Smoking

Smoking cigarettes and passive exposure to cigarette smoke may reduce fertility.

Caffeine

Caffeine consumption, in the form of coffee, tea, or soft drinks, has been linked to infertility in some studies.

Alcohol

Alcohol consumption, even in moderation, appears to reduce fertility.

Occupational Exposures

Many work activities, such as standing for long periods of time or being chronically exposed to dust or loud noises, increase the risk of infertility. Other evidence suggests that the risk of infertility may be higher in women who frequently switch from working day shifts to night shifts. Job-related exposure to high temperatures, chemicals, radiation, pesticides, and other toxic substances have also been linked to infertility in women.

Revision Information

  • American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org . Accessed November 2009.

  • American College of Obstetricians and Gynecologists. Diabetes and pregnancy. The American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/publications/patient%5Feducation/bp051.cfm . Accessed July 2010.

  • American Medical Association website. Available at: http://www.ama-assn.org .

  • American Society for Reproductive Medicine website. Available at: http://www.asrm.org .

  • Cronin M, Schellschmidt I, Dinger J. Rate of pregnancy after using drospirenone and other progestin-containing oral contraceptives. Obstet Gynecol . 2009;114:616-622.

  • International Council on Infertility Information Dissemination, Inc. website. Available at: http://www.inciid.org .

  • RESOLVE: The National Infertility Association website. Available at: http://www.resolve.org .

  • United States National Library of Medicine: National Institutes of Health website. Available at: http://www.nlm.nih.gov .

  • 6/5/2009 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Luttjeboer FY, Verhoeve HR, van Dessel HJ, et al. The value of medical history taking as risk indicator for tuboperitoneal pathology: a systematic review. BJOG . 2009;116:612-625.