Pre-Existing Conditions That Can Impact Fertility and How to Overcome Them

Infertility is defined as when a person struggles to conceive after a year or more of attempts. A woman’s fertility depends on a number of factors, including egg quality, timing, age, and pre-existing health conditions. Infertility in women is quite common and caused by a range of different issues, some more easily treated than others. As a result of its prevalence, there have been many advancements in fertility support treatment.

Preparing for infertility treatments like in vitro fertilization (IVF) is undergoing a lot of diagnostic testing to assess your fertility so that your infertility specialist can personalize your treatment cycles. Findings show that IVF works not only as a therapeutic solution to infertility but can also help doctors diagnose fertility issues such as slow embryonic development and a lack of viable eggs. These findings can help assess why infertility is an issue for the woman and work to address her specific needs.  

While going through IVF treatment, your doctor will conduct tests assessing your uterine health and the quality of your embryos. This information will help them determine what fertility support can be offered to maximize your chances at a successful pregnancy. 

 
Different pre-existing conditions that could impact fertility  

You may be wondering what kind of conditions can affect your chances of a successful IVF treatment cycle. They range from simpler issues, such as egg and embryo quality, to more complex factors, such as tumors and autoimmune disorders. For each condition, there are a range of solutions offered thanks to new assisted reproductive technology, meaning that no matter its severity, you should not lose hope that your IVF treatment will yield success.  

Hormonal factors  

Hormones play an important role in many of our bodily functions. They are involved in regulating stress, aging, fertility, and even play a role in preventing infection. There are a few hormones that play a crucial role in fertility support: gonadotropin-releasing hormone (GnRH), follicle stimulating hormone (FSH), estrogen, luteinizing hormone (LH), and progesterone.  

At the beginning of the ovulation cycle, the hypothalamus produces gonadotropin-releasing hormone (GnRH), which in turn stimulates the production of follicle-stimulating hormone (FH) and luteinizing hormone (LH). FSH supports the growth and development of the eggs within the follicles. As these follicles mature, they begin to produce estrogen. Estrogen plays a key role in the process, stimulating the growth of the uterine lining (the endometrium). As estrogen levels rise, the hypothalamus reduces the level of GnRH produced, in turn diminishing the FSH and LH levels. Once the follicles have matured, a burst of luteinizing hormone is once again released, triggering ovulation. 

Progesterone is released as the uterus begins to prepare for pregnancy during a woman’s menstrual cycle, just after ovulation has been triggered. If the progesterone is not released at the correct moment, this can affect your ability to conceive. It is important to talk to your doctor and arrange to have your hormone levels assessed to determine if fertility support is necessary.  

Endometriosis  

Endometriosis is a disorder where the uterus grows cells that live in other parts of the pelvic cavity. A common symptom of this condition is unusually heavy bleeding during menstruation accompanied by more painful cramping. Unfortunately, endometriosis can also impact fertility as these cells tend to attach themselves to the ovaries, fallopian tubes and the outside of the uterus, causing cysts and scarring that can diminish ovarian reserves, cause blockages, or prevent embryos from implanting properly. 

There are a few courses of treatment that can be done in order to suppress endometriosis. Hormonal options include birth control, Gonadotropin-releasing hormone (GnRH) medications, and danazol. These medications work to suppress hormones involved with the menstrual cycle. If you have a more severe case of endometriosis, your doctor might recommend a laparoscopy, which is a surgical procedure. When preparing for infertility treatments, your infertility specialist will assess the severity and location of your endometriosis, and adjust your personalized treatment accordingly. 

Autoimmune disorders  

Certain autoimmune disorders have a high likelihood of disrupting IVF success rates. Among those which can cause infertility in women are type 1 diabetes, lupus and antiphospholipid syndrome. One of the most important aspects of undergoing IVF with an autoimmune disorder is taking the proper precautions to stabilize the condition. Certain infertility treatments can cause flare-ups of your autoimmune disorder, so it’s important that your infertility specialist and doctor assess which assisted reproductive technology is right for you.  

Blocked fallopian tube & hydrosalpinx  

Hydrosalpinx is a condition where fluid build-up occurs in the fallopian tubes. This condition could lead to two possible outcomes that result in infertility: either the sperm is unable to reach and fertilize the egg, or the embryo is blocked from reaching the uterus and implanting itself. If the embryo implants in the fallopian tubes because it is unable to reach the uterus, it can cause an ectopic pregnancy, posing a threat to both yourself and the embryo. 

Infertility is often the first and only symptom of blocked fallopian tubes. This condition is typically caused by an untreated infection, and so treating the infection may increase the likelihood that your IVF cycle is successful. In more severe cases, your doctor might recommend removing your fallopian tubes or surgically unblocking them prior to undergoing IVF treatment.

An infertility doctor will be able to tell you if you have a blockage in your fallopian tubes, and what options exist to treat it. Surgery can be necessary to clear the fallopian tubes in some cases, however undergoing IVF is often used as a treatment option to compensate for blocked tubes as the egg retrieval procedure can bypass the fallopian tubes if necessary.  

Uterine conditions 

There are a number of uterine conditions that can impact your ability to get pregnant and carry a baby to full term. Most of these conditions have to do with the shape of the uterine cavity, which can impact endometrial receptivity and embryo implantation. The following are some examples of common uterine conditions: 

• Unicornuate uterus (UU): This condition occurs when only one fallopian tube and half the uterus is fully developed. 
• Septate uterus: This occurs when the inside of the uterus is divided by a wall of the septum. 

• DES-related uterus: Diethylstilbestrol (DES) is a chemical that can cause the uterus to develop in a T-shape. 
• Arcuate uterus (AU): This occurs when the fundus, the top of the uterus, is indented slightly both inside and outside. 

Infertility testing for women will likely identify is any of these conditions are present, which will allow your infertility specialist to adjust your treatment accordingly. 

Egg/embryo quality 

The quality of a woman’s eggs plays a huge role in IVF success rates. Egg quality can be affected by factors such as age, stress, immune disorders, and weight. It is recommended by infertility specialists that women freeze their eggs when they are younger to ensure that they have healthy embryos when they are ready to conceive.  

An infertility doctor can also provide solutions to increase the chances of your in vitro fertilization cycle being successful. It’s important to do all the necessary testing prior to beginning IVF, so that both you and your doctor are aware of any irregularities that could affect the development of the embryo.  

Tumors, cysts & fibroids 

There are different types of cysts that can affect your fertility, the most common being functional cysts. They are typically a sign that your ovaries are not functioning as they should be, but they often shrink within 60 days. Other types of cysts include cystadenomas (formed on the surface of the ovary), dermoid cysts (teratomas), endometriomas, and ovarian cancer cysts (tumors).  

Thankfully, the majority of ovarian cysts tend to shrink quickly. However, it is still crucial that you see your doctor immediately if you have any abnormal symptoms such as pelvic pain, pain during sex, or unusual vaginal discharge. These can be signs of a cyst, and you do not want to leave it untreated despite the fact that they can shrink on their own. If the ovarian cyst is a functional one, it can possibly go away without treatment. However, your doctor will most likely want to do regular checkups with an ultrasound in order to ensure that it is in fact shrinking and is not causing any other potential health issues.  

Fibroids are small growths that can appear in the uterus. They are very common, however sometimes they can cause problems with fertility. The presence of fibroids can obstruct the fallopian tubes and impair the transport of reproductive (gamete) cells, impeding the production of follicles.  

Fertility can still be preserved even in cases where ovarian cancer (tumors) is present. If you talk with an infertility doctor before undergoing cancer treatment, fertility treatment options, such as embryo freezing, ovarian shielding, and others, can help you to preserve your ability to conceive. So, try not to worry too much; there is still hope for successful in vitro fertilization even if you have tumors or cysts.  

Sexually transmitted infections (STIs)  

STIs are common, and that is why everyone should be undergoing regular STI screenings. When left untreated, certain STIs such as chlamydia, gonorrhea, and syphilis can cause Pelvic inflammatory disease (PID), which can lead to infertility. Thanks to advances in science and medicine, antibiotic cures exist for many STIs and can help ensure that it does not lead to permanent infertility issues. Infection related infertility issues can be prevented by using protection during sex, and by getting screened for STIs regularly.  

The fertility journey and what it means to you  

The journey of in vitro fertilization is a difficult one. Fertility treatments can take a toll on you, mentally and physically. Mentally, it can be stressful and draining to undergo multiple failed rounds of IVF treatments.  When your deepest desire is to welcome a child, it’s important to remind yourself that trial and error is a common part of the IVF journey, and with the help of new assisted reproductive technology, hopefully your next round will be a success. There is no right or wrong way to deal with the stress of infertility, as we are all different. Some tips to help reduce this stressor are engaging in self-care, going to a therapist who specializes in infertility, being conscious of the IVF content you are engaging with online, and talking with friends or family members who can empathize with you. 

With synthetic hormones flowing throughout your body, it is common to experience symptoms such as nausea, hot flashes, weight gain, and breast tenderness. These symptoms can be uncomfortable and deceptive, as they mimic some pregnancy symptoms, but regularly checking in with your doctor can ensure that your hormones are circulating properly.