Female fertility explained

A woman’s age plays an important part when it comes to your chances of conceiving.

You’re born with all the eggs you’ll have in your lifetime, and your eggs will age as you do. This means that as you age, the quality and quantity of your eggs decreases, meaning your chances of getting pregnant declines.

On average, a woman in her early to mid-20s has a 25-30% chance of getting pregnant in a monthly cycle. Fertility will start to decline in her early 30s. From 35 to 40, this decline speeds up, and by the age of 41, the chances of getting pregnant in a monthly cycle is only 4%.

While your health and fitness can improve your chances of getting pregnant and having a healthy baby, it doesn’t override the effects that age has on female fertility.

The fallopian tubes connect the ovaries to the uterus. These can become blocked from issues such as infections, a sexually transmitted infection (like chlamydia), previous surgery, or endometriosis.

Blocked fallopian tubes can prevent sperm from meeting an egg and fertilising it, and is a common cause of female infertility.

Performing laparoscopic surgery to remove the blockage may allow for a natural pregnancy. If surgery is not viable, then IVF is an option as this bypasses the fallopian tubes, allowing pregnancy to occur.

Endometriosis is a progressive and chronic condition, meaning it gets worse over time. 1 in 7 women live with endometriosis and it’s often not diagnosed until you struggle to conceive.

Endometriosis is when body tissue like the lining of the uterus grows in other parts of the body where it is not meant to. It can affect the ovaries, pelvic lining, uterus and fallopian tubes. Tissues can become irritated and form scar tissue and bands of fibrous tissues can form and cause organs to stick together. It can also cause fertility problems.

Treatments for endometriosis can be as simple as medication, however, if you are trying to fall pregnant, we may possibly recommend laparoscopic surgery to remove as much of the disease as possible, increasing your ability to conceive.

Up to 80% of women of reproductive age experience fibroids, and certain types can affect fertility.

Fibroids are benign growths that can form in your uterus. While generally they are non-threatening, they can impact your ability to conceive.

The type, location and size of your fibroid will determine your treatment. You may not require any treatment, however, if it is affecting your fertility, you may require a hysteroscopy or laparoscopy for it to be removed.

PCOS is a complex hormonal condition that affects around 10% of women. It can cause small cysts to grow in the ovaries preventing follicles from growing and maturing.

PCOS affects ovulation which can result in irregular or absent periods. It can also cause dark, thick hair growth, acne, issues with sugar metabolism and often weight gain.

Treatments include insulin-sensitising agents, ovulation-inducing medications, FSH injections and weight reduction.

Polyps are abnormal tissue growths. There are two types that relate to female fertility, Uterine Polyps; which can be found in the lining of the uterus, and Cervical Polyps; which occur on the cervix.

Polyps can affect fertility by obstructing your fallopian tubes, interfering with a fertilised egg implanting in the uterus, and it can affect the uterine environment, which can influence embryo implantation and foetal development.

Removal of polyps is commonly done via a hysteroscopy, polypectomy or by medication.

PID is an infection of the reproductive organs, including the uterus, fallopian tubes and ovaries, that can cause inflammation, scarring and damage to the organs. It is often caused by sexually transmitted infections (STIs) like chlamydia and gonorrhoea, as well as bacterial vaginosis.

Along with damaging the organs, PID can also raise the risk of ectopic pregnancies, where a fertilised egg implants outside of the uterus, often in the fallopian tubes. It also causes chronic pelvic pain.

Early treatment for PID is crucial to prevent long-term complications and generally involves antibiotics to treat the infection. If undiagnosed, scarring and damage may impact your ability to fall pregnant and fertility treatments like IVF may be required.

While the average age of menopause is 51 years, there are a number of women who start experiencing menopause symptoms in the late 30s and early 40s. If a woman’s ovaries stop working properly before the age of 40, it’s known as premature ovarian failure.

Perimenopause is the lead up to menopause where your body’s getting ready for the next ‘phase’, causing periods to become less frequent, ovulation to be erratic and oestrogen levels to decline.

While it is still possible to get pregnant during this stage, it’s less likely, may take longer, and often requires the help of fertility treatments.

There are various medical conditions that can impact your fertility, from issues with your reproductive system to the effects of cancer.

There are cancer treatments that can cause problems with female fertility or carrying a pregnancy. It’s advisable to speak with your oncologist to understand the risks and effects your cancer treatment can have on your fertility.

The effect your cancer treatment may have on your fertility depends on factors including the age at the time of your treatment, the type of cancer you had, the treatment you underwent, the duration and dose of your treatment and the amount of time that’s passed since your treatment. Cancer treatments may harm your reproductive organs and the hormones that control fertility.

For example, chemotherapy can affect the ovaries, causing them to stop releasing eggs and producing oestrogen. Hormone therapy to treat cancer can disrupt your menstrual cycle.

Radiation therapy, specifically around the abdomen, pelvis or spine, can harm reproductive organs. Radiation therapy to the ovaries can cause ovarian insufficiency, to the uterus can affect blood flow, or to the brain can harm the pituitary gland, which signals the ovaries to make the hormones needed for ovulation. These can be temporary or permanent symptoms of your treatment.

We strongly advise women who have been diagnosed with cancer to consider egg freezing before they start treatment. This form of fertility preservation means that after your treatment, you still have the chance to create a family with your healthy, preserved eggs.