When conception fails, there are several common factors that might be at play, particularly in women. These include age, polycystic ovary syndrome (PCOS), blocked or damaged fallopian tubes, endometriosis, and miscarriage.

  1. Age
    • Age is the most significant factor affecting a woman’s ability to conceive. Research shows that fertility slightly decreases at age 30 and sharply declines around age 40. As women age, the quality of their eggs diminishes, the likelihood of miscarriage increases, and the risk of conceiving a child with genetic abnormalities like Down syndrome (Trisomy 21) rises. For those who wish to delay pregnancy, egg freezing can be a valuable option to preserve fertility.
    • Even if both partners have no fertility issues, the natural likelihood of conceiving in one cycle decreases with age, from about 20% at age 30 to just 5% at age 40.
    • Although age is a critical factor, in vitro fertilization (IVF) can help older women increase their chances of conceiving.
  2. Polycystic Ovary Syndrome (PCOS)
    • PCOS is an endocrine disorder affecting approximately 1 in 5 women of reproductive age in developed countries. The incidence of PCOS is also rising in many other parts of the world, including China.
  3. Blocked or Damaged Fallopian Tubes
    • Blocked or damaged fallopian tubes can prevent sperm from meeting the egg. In such cases, IVF is often the best option for achieving pregnancy. For younger women with good ovarian function, laparoscopic surgery may be an option to try and clear the blockage.
  4. Endometriosis
    • Endometriosis is a common condition where tissue similar to the lining inside the uterus grows outside the uterus. It affects about 10% of women between menarche and menopause, with 3% experiencing difficulty in conceiving. Fortunately, there are many treatments available. Chapter 3 of the referenced text likely provides detailed information on the causes of endometriosis, its impact on fertility, and treatment options.
  5. Miscarriage
    • Miscarriage refers to the loss of pregnancy before 28 weeks, though in some countries, it is defined as before 20 weeks. Miscarriage is most common in early pregnancy, with the risk dropping significantly after 10 weeks. Many women experience a miscarriage but go on to have successful pregnancies. Therefore, it is important not to view miscarriage with excessive fear.
    • However, if a woman experiences two or more miscarriages without a successful pregnancy in between, it is classified as recurrent miscarriage, and it is essential to consult a doctor to analyze and identify the underlying causes.