Concerned about your chances of ever getting pregnant? Are you experiencing the warning signs of infertility?

Research suggests that most people, especially women, are concerned about their chances of ever having a family, even if they aren’t actively trying to get pregnant.

It’s true that for many, getting pregnant may take longer than they anticipate. This can bring about strong emotions, including stress, helplessness and even depression or shame.

We wish that weren’t the case, as it is common to experience challenges conceiving, with as many as 1 in 8 couples experiencing infertility. It’s also getting easier than ever to overcome these challenges with the help of assisted reproductive medicine.

So how do you know if you need help? Here are some signs of infertility that may mean it’s time to speak to a fertility specialist.

Trying to get pregnant for more than a year (6 months for women over age 35)

Getting pregnant takes timing, and time. For the timing aspect, knowing about ovulation and timing intercourse is key. And the study cited above says about 40% of women do not understand the ovulation cycle.

For the time aspect, it’s typically not a concern until a couple or person with regular monthly periods has been trying at least a year. This is because it usually takes some time to get pregnant: A healthy 30-year-old woman only has a 20% chance of getting pregnant each month, according to the American Society for Reproductive Medicine.

And because many reproductive factors decline over time as we age, women over 35 should be concerned sooner than younger women and seek help after six months of trying. At that point, the female partner is scientifically defined as experiencing “infertility.”

This doesn’t mean she is actually infertile, it just means she may need some extra help getting pregnant. In someone over 40, the chance of conceiving naturally is 5% per month, so it’s smart to see a specialist to make sure there aren’t any issues that could cause that number to be even lower.

It may also surprise many, but women are not the only ones who have a biological clock when it comes to reproduction. The relationship between male age and fertility is called andropause.

Male sperm production drops off by about 11% each year after age 40. Older men wishing to become fathers should not overlook the effects of aging on their fertility.

Missed periods or irregular periods

Irregular periods or missed periods don’t always affect fertility, and many women experiencing fluctuations in their menstrual cycles have no trouble getting pregnant on their own.

However, abnormal periods with painful or heavy bleeding, going months without bleeding at all, or extreme fluctuations with period cycles may be a sign of potential conditions affecting fertility. These can include endometriosis, polycystic ovary syndrome (PCOS), uterine polyps and more.

Any one of these underlying issues can make it more difficult to conceive, but are often treatable if diagnosed.

Underlying health conditions can be signs of infertility

As mentioned above, some underlying health conditions can influence the delicate balance of hormones and our body’s ability to reproduce. Some common health conditions causing infertility include:

• Endometriosis.
• Ovulation disorders.
• Sexually transmitted diseases (STDs).
• Thyroid disease.
• Uterine fibroids.
• PCOS.
• Primary ovarian insufficiency (POI).
• Varicocele in males.

And while not a direct cause of infertility, several lifestyle factors among men and women can contribute to difficulties conceiving. This includes an unhealthy diet, smoking, excessive caffeine or alcohol consumption, and stress.

Recurrent miscarriages as a sign of infertility

Miscarriages are a natural part of conception, occurring in about 10% to 25% of all recognized pregnancies, meaning those that are confirmed with an ultrasound or the presence of fetal tissue. That number is much higher if counting pregnancy losses before a woman even tests positive.

However, experiencing two or more miscarriages is a concern and defined as recurrent miscarriage or recurrent pregnancy loss. This can be a possible sign of infertility or a form of infertility that a fertility specialist should evaluate to identify possible problems.

Cancer treatments can harm fertility

Cancer treatments of chemotherapy or radiation involve powerful drugs or radiation that can damage or even kill cells. This is a good thing if fighting cancer, but it can also damage reproductive tissue and cells. Surgery to remove cancer tumors on or in the area of reproductive organs can also cause infertility.

Age at the time of exposure, specific treatments and cancer type all influence the risk of infertility.

Ideally, anyone diagnosed with cancer should discuss taking proactive measures to preserve fertility before undergoing treatment, which is known as oncofertility.

You are not alone

Starting a family is not always the journey we expect, and there is no shame in not being able to get pregnant. For anyone struggling, don’t delay discussing your concerns with your family doctor or seeking help from a fertility specialist. It is the first, important step to understanding your options and possibly getting closer to the family of your dreams.