Written by Our Editorial Team
Last updated: 8/23/2022

WHAT IS FEMALE INFERTILITY?

Infertility is referred to as the failure to become pregnant after 12 months of intercourse using no contraceptives. It can also refer to a woman who has frequent miscarriages.

PREVALENCE

Approximately 50% of infertility is due to a female factor, and the chances of being infertile increase with age.

According to the CDC, 1 in 5 women aged 15-39 experience infertility and 1 in 4 women aged 15-39 experience difficulty conceiving and carrying a pregnancy to term.

FEMALE INFERTILITY CAUSES

PCOS:

  • PCOS (polycystic ovary syndrome) is the #1 driver of infertility in women.
  • It is a hormonal disorder that occurs in women of reproductive age.

If you have any of these symptoms and think you may have PCOS, we recommend that you screen with thorough diagnostic lab tests.

At Marek Health, we offer a blood test panel that aids in diagnosing PCOS by assessing biochemical hyperandrogenism and ruling out other disorders that mimic PCOS symptoms. Our medical team is well versed in treating PCOS and improving fertility outcomes.

HIGH/LOW BMI:

  • A body mass index (BMI) greater than 30 is associated with infertility and ovulatory dysfunction in women. Elevated BMI can reduce fertility by 50%. If you struggle with an elevated BMI, talk to our medical team about medical weight loss and nutrition coaching.
  • Women with a BMI of less than 18.5 can develop hormone imbalances that affect ovulation and the chance of getting pregnant. Underweight women are more likely to experience infertility. Ensure you are eating sufficient calories by tracking your intake on a free app on your phone, such as Cronometer or MyFitnessPal.

OTHER CONDITIONS:

  • Age
  • Iron deficiency anemia
  • Hormone imbalance/abnormal menstrual cycle
  • Structural problems (problems with the fallopian tubes, uterus, or ovaries)
  • Uterine fibroids
  • Cysts/Tumors
  • Autoimmune disorders
  • Sexually transmitted infections (STIs)
  • Primary Ovarian Insufficiency (POI)
  • Endometriosis
  • Substance abuse
  • Smoking
  • A past ectopic (tubal) pregnancy

TREATMENT

MEDICATIONS:

Letrozole

  • Letrozole limits estrogen production by preventing the conversion of androstenedione and testosterone to estrone and estradiol. Decreasing estradiol levels reduces the pituitary’s negative feedback, increasing Follicle-Stimulating Hormone production.
  • It is FDA-approved for treating breast cancer and is used off-label to induce ovulation.
  • Several scientific studies support the effectiveness and safety of its use in the induction of ovulation.

Side Effects:

  • Headaches
  • Fatigue, hot flashes, irritability
  • Abdominal bloating
  • Breast pain
  • Ovarian hyperstimulation syndrome may occur. Symptoms include abdominal or pelvic pain, weight gain, discomfort, and distention.
  • Multipregnancy is more likely to occur (up to 14.3% in some studies)

Clomiphene

  • Clomiphene is a selective estrogen receptor modulator (SERM).
  • Clomiphene inhibits the negative feedback from estrogen in the hypothalamus by blocking estrogen at the receptor site. This causes an increase in the release of GnRH, leading to higher FSH levels.

Side Effects:

  • Mood swings
  • Hot flashes
  • Abdominal discomfort
  • Visual disturbances
  • Nausea
  • Thinning of the uterine endometrial lining
  • Reduced production of cervical mucus
  • Higher chance of having twins

At Marek Health, we offer Enclomiphene, which is an isomer of Clomiphene that shows improved fertility outcomes and improved side effect profile when compared to Clomiphene.

Progesterone

  • Progesterone is essential for promoting & maintaining pregnancy and is also used as a supplement for women during IVF fertility treatment.
  • Sufficient progesterone levels are essential for the successful implantation of the embryo and the continuation of pregnancy.

At Marek Health, we offer bioidentical progesterone treatments.

SUPPLEMENTS

Folate

  • Women trying to conceive should take folate and other prenatal supplements at least a month before attempting to get pregnant.
  • Folate does not increase fertility but makes getting pregnant safer for you and your baby.

Iron

  • Studies show that women who regularly take an iron supplement were 40% less likely to have difficulty getting pregnant.

Recommended Prenatal Supplements

  • Marek Health recommends the Prenatal Pro Multivitamin by Designs for Health for any female with fertility goals. It contains highly absorbable forms of folate, iron, and other essential prenatal vitamins. This high-quality supplement is available via Marek Health.

LIFESTYLE INTERVENTION TO BOOST FERTILITY

Ovulatory Cycle Tracking

  • Tracking your menstrual cycle can help you time sexual intercourse better to improve your chances of conceiving.
  • Look for fertility signs during days 10-14 of your menstrual cycle, such as cervical mucus with the consistency of egg whites, and by using at home test strips that confirm ovulation.
  • We recommend using an app on your phone to track your menstrual cycle such as:
    • Flo
    • Ovia
    • Glow Ovulation
    • Period Tracker

Exercise

  • Physical activity positively affects fertility, especially for obese individuals.
  • Aim for at least 150 minutes of cardiovascular exercise and at least 120 minutes of resistance training per week.
  • Exercise but in moderation. A study found that women who were extremely physically active were more than 3 times more likely to have fertility problems.

Diet

  • Avoid trans-fats and focus on monounsaturated fats from avocado, olives, and raw seeds/nuts.
  • Eat lean animal proteins and incorporate a variety of vegetables.
  • Eat more foods high in fiber, as well as low glycemic carbohydrates.
  • Increase non-heme iron intake (primarily found in plant foods).

Dairy

  • Full-fat dairy consumption is associated with a lower risk of ovarian dysfunction and supports healthy ovulation.
  • According to a 2007 study, women who consume high-fat dairy products daily are 27% less likely to be infertile.

A multidisciplinary approach to healthcare is the standard of care that provides the best patient safety. Therefore, we recommend that you work in tandem with an OBGYN.

Our references consist of studies conducted by peer-reviewed journals, academic research institutions, and medical organizations.. We strive to use primary sources and refrain from using tertiary references.

This blog post/article is for informational purposes only and does not constitute medical advice. This is not a substitute for professional medical advice and should not be relied upon. If you are considering a treatment, always consult your primary care physician to discuss the risks and benefits.

Sources:

  1. Ciampaglia, Walter, and Graciela E Cognigni. “Clinical Use of Progesterone in Infertility .” Wiley Online Library, 8 Sept. 2015, https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/aogs.12770.
  2. Collins, Gretchen Garbe, and Brooke v Rossi. “The Impact of Lifestyle Modifications, Diet, and Vitamin Supplementation on Natural Fertility.” BioMed Central, 25 July 2015, https://fertilityresearchandpractice.biomedcentral.com/articles/10.1186/s40738-015-0003-4.
  3. “Female Hormone Physiology .” Straight Healthcare, https://www.straighthealthcare.com/female-hormone-physiology.html.
  4. Sharma, Rakesh, et al. “Lifestyle Factors and Reproductive Health: Taking Control of Your Fertility.” Reproductive Biology and Endocrinology : RB&E, BioMed Central, 16 July 2013,