Below is a list of conditions which may and can impact fertility in women.  This is not exhaustive and it’s important for you to work with your GP and OB-GYN to explore what may be causing your specific issues.

Pro Tip: Make sure you keep a record of your symptoms – using a tool like Fertility Friend can be helpful – and take this with you to your appointments.  This will help you remember the details and will make your discussion with your practitioner more engaged and valuable.

In addition, you will find some more info under the diagnosis section which will help you with what tests and procedures you should ask for to support your diagnosis.

Adenomyosis – a condition in which the inner lining of your uterus (the endometrium) breaks through the muscle wall of your uterus (the myometrium). It can cause menstrual cramps, lower abdominal pressure, and bloating before menstrual periods and can result in heavy bleeding.

Adrenal insufficiency – sometimes called ‘adrenal fatigue’, this is a condition in which your adrenal glands do not produce adequate amounts of steroid hormones. This is primarily cortisol but can also include aldosterone, which regulates sodium conservation, potassium secretion and water retention. 

Anovulation – is when your ovaries do not release an oocyte (egg) during a menstrual cycle.  Therefore, ovulation does not take place. However, a women who does not ovulate at each menstrual cycle is not necessarily going through the menopause.  Chronic anovulation is a common cause of infertility.

Bacterial Vaginosis (BV) – is a disease of the vagina caused, as the name suggests, by excessive growth of bacteria. Common symptoms include increased vaginal discharge that can smell like fish.  The discharge is usually white or grey in colour.  Burning with urination can also occur, although you can be completely symptom free with it.  Left untreated it can cause PID (see below) and infertility.

Cancer – treatment of cancer can impact your fertility and your consultant and treatment team will usually discuss the potential issues and options with you at the time. 

Diabetes – there are two main types of Diabetes. Type 1 is where the body’s immune system attacks and destroys cells that produce insulin.  Type 2 is where the body doesn’t produce enough insulin/the cells don’t react to it. Symptoms include feeling thirsty, urinating more regularly, feeling tired, weight loss, slow healing wounds, blurred vision and itching around the genitals/frequent episodes of thrush.

Endometriosis – is often a painful disorder in which tissue that normally lines the inside of your uterus grows outside of your uterus. It most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis.  It is almost impossible to diagnose without surgery and can sometimes cause no symptoms at all, or the symptoms can be mistaken for other conditions.

Uterine Fibroids – Fibroids are non-cancerous growths that develop in or around your uterus.  The growths are made up of muscle and fibrous tissue and vary in size. Abnormal uterine bleeding is the most common symptom of fibroids, although many women will have no symptoms at all.  If the fibroids are near the uterine lining, or interfere with the blood flow to the lining, they can cause heavy periods, painful periods, prolonged periods or spotting.

Hyperthyroidism (over active thyroid) – is the condition that occurs due to excessive production of thyroid hormone by the thyroid gland. Symptoms vary between people but can include muscle weakness, irritability, sleeping problems, fast heartbeat, heat intolerance, diarrhoea, weight loss and enlargement of the thyroid. Thyroid hormone levels are thought to play a critical role in fertility and it is therefore important to ensure any issues are treated and addressed.

Hypothyroidism (under active thyroid) – is the condition that occurs due to the thyroid gland producing too little thyroid hormone. Symptoms include feeling cold (hands and feet), fatigue, muscle weakness, constipation, weight gain, depression and disordered sleep. As with Hyperthyroidism, thyroid hormone levels it is important to ensure any issues are treated and addressed.

Irregular periods (Polymenorrhea or Oligomenorrhea) – menstrual cycles may be defined as irregular if they are shorter than 21 days (poly) or longer than 36 days (oligo).

Leaky gut (SIBO) – Small Intestine Bacterial Overgrowth (Leaky Gut or SIBO) is defined as the presence of excessive bacteria in the small intestine.  SIBO is often linked to malabsorption of nutrients, unintentional weight loss and intestinal issues. It can be difficult to diagnose and symptoms include indigestion, gas, pain, bloating and diarrhoea. This condition can impact fertility because it interferes with the absorption of key nutrients and vitamins such a folic acid and vitamin D.

Menopause – is the time when a woman stops having periods and she is no longer able to get pregnant.  The age at which a woman goes through the menopause varies but it is usually between 40 and 58.  Symptoms include hot flushes, night sweats and mood changes.

Menorrhagia (heavy periods) – this is the medical term for abnormally heavy or prolonged bleeding.  Whilst many women experience heavy menstrual periods, most do not lose enough blood to be classed as suffering from menorrhagia.  Symptoms include bleeding for longer than a week, soaking through sanitary towels/tampons every hour, having to change your protection overnight, passing large clots or other symptoms such as fatigue or shortness of breath related to anaemia.

Metrorrhagia – this is vaginal bleeding between expected periods.

Perimenopause – this means ‘around menopause’ and refers to the time during which your body makes the natural transition to menopause. Usually this starts around age 44 but can be earlier in some women.  Symptoms include hot flashes, sleep problems and vaginal dryness.

PID (Pelvic Inflammatory Disease/Disorder) – is an infection of the upper part of the female reproductive system (namely your uterus, fallopian tubes and ovaries) and inside of your pelvis. Often there can be no symptoms but if there are, they can include lower abdominal pain, vaginal discharge, pain with sex and irregular periods. The disease is caused by bacteria that spread from the vagina and cervix. If left untreated, PID can result in infertility, ectopic pregnancy, chronic pelvic pain and even cancer.

PCOS (Poly-cystic Ovarian Syndrome) – PCOS is a set of symptoms due to elevated androgens (male hormones) in females. Symptoms include irregular or no menstrual cycle, heavy periods, excess body and facial hair, acne, pelvic pain, difficulty conceiving and patches of thick, darker, velvety skin.

Polyps – an endometrial or vaginal polyp is a mass in the inner lining of your uterus.  They may have a large, flat, base (sessile) or be attached to your uterus by an elongated pedicle or stalk (pedunculated).  Pedunculated polyps are the more common.  They can range in size from a few millimetres to several centimetres.  They are normally benign and quite common.  Symptoms include irregular or excessive bleeding, bleeding/spotting between menses and infertility.

Sexually Transmitted Diseases (STDs) – the top five STDs affecting fertility are Chlamydia, Gonorrhoea, PID (see above), Syphilis and HPV (Human Papillomavirus). Some can cause scarring and damage to the fallopian tubes or result in PID as the infection spreads without detection. Some treatments of HPV (such as biopsy) can cause changes in your cervix which may make it harder to become pregnant naturally, or to maintain a pregnancy.

Infertility in men

Whilst it’s important for you to be checked out and to understand the various medical conditions that can impact your chances of successfully conceiving a baby, there are also a number of conditions that impact male fertility and it is important that you and your partner are aware of them too.

Male infertility is a factor in 40-50% of cases and it affects approximately 7% of all men. A few of the key conditions are listed below.

Azoospermia – is where the semen contains no sperm.

Coeliac disease – there is some evidence that suggests men with coeliac disease have reduced fertility. Studies have shown that their sperm quality improved and hormone levels normalised once they followed a gluten free diet. 

Diabetes – can cause male infertility in a number of ways.  It causes erectile dysfunction by effecting the health of small blood vessels and lowering testosterone levels.  Lower testosterone levels also lower sex drive.  It can also reduce the ejaculate volume by affecting the small nerves that control ejaculation (and again by lowering testosterone).

Hydrocele – is the accumulation of serous fluid in a body cavity. In the male reproductive system, this can occur around the testicle (hydrocele testis)

Hypospadias – is a relatively common congenital condition (there from birth) in men in which the opening for the urethra is on the underside of the penis. There is some debate as to whether this really is a factor in fertility but it is felt that it could play a part if it has not been corrected.

Impotence (Erectile Dysfunction) – is a type of sexual dysfunction characterised by the inability to develop or maintain an erection of the penis during sexual activity. This can be caused by stress or fatigue, heart disease, high blood pressure, diabetes, obesity, Parkinson’s disease and metabolic syndrome.

Oligospermia – is where there is limited sperm concentration in the semen.  Often semen with low numbers of sperm may also show significant abnormalities in morphology and motility (Oligoasthenoteratozoospermia). Causes can include use of drugs, alcohol and smoking, strenuous riding (bikes, horseback) and medications. Age, genetic defects, varicocele, trauma, hydrocele, mumps and malaria, duct obstructions and infection can also cause problems.

Prostatitis – is the inflammation of the prostate gland and can be acute or chronic.

Retrograde ejaculation – occurs when semen is redirected to the urinary bladder and not ejaculated from the body. Normally the sphincter of the bladder contracts before ejaculation forcing semen to exit via the urethra. This is likely to mean that there is very little ejaculate after organism.  It’s not a harmful condition but is clearly a cause of male infertility.

Undescended (cryptorchid) testicles – is the most common birth defect in male genitalia and normally corrects in the first year of life (80% of cases).  Men who have this condition, even after correction in infancy, have a higher rate of infertility than other men (around 38% with bilateral and 10% with unilateral). They are also at higher risk of testicular cancer.

Varicocele – this is an enlargement of the veins within the scrotum.  They are common and usually form during puberty.  Symptoms include soft lumps (usually above the testicle and to the left) and there may be pain or heaviness in the scrotum. Varicocele can cause DNA fragmentation in sperm and is therefore a potential cause of male infertility.

Vas deferens obstruction – the vas deferens (or ductus deferens) is part of the male reproductive system.  It is a partially coiled tube which exits the abdominal cavity through the inguinal canal and transports the sperm to the ejaculatory ducts. It can be blocked or in some cases, there can be a congenital absence of it altogether. Blockages can be caused by infections.

STDs – as with women (see above) STDs can cause fertility issues for men, including blocking the urethra and ejaculatory duct.