8 Signs of Infertility You Should Know

If you’re having trouble getting pregnant, it’s natural to wonder about signs of infertility. But before freaking out, remember: It can take up to a year on average for a healthy individual under 35 to become pregnant if actively trying. The odds of getting pregnant begin to decrease exponentially, however, after turning 30 (more so after 35).

Knowing this, when exactly should one begin to suspect real fertility issues? Here are eight symptoms to watch out for in women—and men—that may indicate the need to be seen by a health care provider for possible infertility.

Signs of Infertility in Women

Many of the signs pointing to infertility in women generally revolve around periods, as well as general health and well-being. Fortunately, many of these can be treated if caught in time.

Irregular periods

One of the first indicators that you may struggle with infertility is having a history of irregular periods, in part because irregular periods may indicate other issues that can inhibit fertility.

“A common cause of irregular periods is polycystic ovarian syndrome [PCOS],” says Lynn Marie Westphal, M.D., chief medical officer for Kindbody, which offers fertility and gynecology services. “It is the most common endocrine disorder in reproductive-age women and a common cause of infertility.”

Because of this, it’s important to keep track of periods, preferably for a lengthy amount of time to see whether there are any factors contributing to the irregularity. If you use an app like Clue or FitBit to input period information monthly, you can also take this information to your doctor in order to figure out what is causing the irregularity.

“There are medications that can be used to help improve ovulation and pregnancy,” says Westphal—but it’s important to discuss the best course of action with your health care provider.

Missing periods

Another major indicator of infertility is amenorrhea—i.e., a complete absence of periods. Amenorrhea is diagnosed when you’ve had three or more missing periods and can be brought on by a number of factors, including stress, low body weight, excessive exercise, taking certain medications, uterine scarring, and lacking certain reproductive organs, according to the Mayo Clinic.

The disappearance of your period can also indicate menopause. “About 1% of women will have menopause before the age 40,” Westphal says. “This can be due to genetic causes or from past chemotherapy—although a cause may not always be found.” In these instances, Westphal says, women may consider obtaining eggs from a donor.

Painful periods

Many women experience some degree of minor cramping while menstruating, but according to Westphal, it should only minimally impact normal activity. In other words, if it doesn’t get better after taking some ibuprofen, it’s worth getting evaluated, she says.

That’s because painful periods are often caused by other issues which may lead to infertility. One is pelvic inflammatory disease (PID), which is frequently linked to STDs. PID is treatable but, if left untreated, can cause scar tissue to form in and around the fallopian tubes, which can lead to infertility.

Another cause of painful periods is endometriosis—a condition in which uterine lining grows outside the uterus. “There are a lot of varying statistics on endometriosis,” Westphal says. Endometriosis occurs in about 6% to 10% of women, according to the American College of Obstetricians and Gynecologists, “but may be as high as 30% to 50% in infertile women and even higher than that in women with chronic pelvic pain,” Westphal says. “It can cause infertility a number of ways, such as forming cysts in the ovaries and scarring of the fallopian tubes.”

While surgery can be performed to remove the endometriosis, Westphal warns that fertility may not be completely normal afterward, adding that in vitro fertilization (IVF( is generally the most effective treatment in those cases.

Cancer treatment

Battling cancer and undergoing cancer treatments can be especially harsh on fertility.