7 Causes of Delayed Childbearing and Effective Diagnostic & Treatment Methods

You may long for a baby who has not yet arrived, without knowing the reason behind the delay in conception. The truth is that the causes are numerous and complex, and often difficult to pinpoint. However, in many cases, it is possible to identify the underlying reason and choose the appropriate treatment method, allowing you to prepare for welcoming your newborn. So, what are the main causes of delayed childbearing? And how can infertility be treated in both women and men?

Causes of Delayed Childbearing

The possible causes of delayed childbearing include:

1. Missing the Fertile Window

A woman typically has about 6 fertile days each month (the five days before ovulation and the day of ovulation itself). If she is not aware of these specific days, the fertile window may be missed. The chances of conception are higher with regular intercourse during this fertile period.

The main challenge lies in identifying those most fertile days, especially if menstrual cycles are irregular. Speaking with a doctor can help you recognize subtle bodily changes or signs that indicate ovulation, to avoid unnecessary delays in conception.

2. Advancing Age

Age plays a significant role in fertility and the chances of pregnancy. According to the American College of Obstetricians and Gynecologists, healthy women in their 20s and early 30s have about a 25% chance of conceiving in any given cycle. By age 40, the chance drops to about 10%, and by 45, natural conception becomes highly unlikely.

3. Birth Control Pills

Do birth control pills delay conception? If you have recently stopped using hormonal contraceptives, such as birth control pills, it may take some time for your menstrual cycle to normalize. Hormonal methods are often associated with longer delays in the return of fertility compared to non-hormonal methods.

If six months have passed since stopping hormonal contraceptives without a return to regular cycles or clear signs of ovulation, it is advisable to consult a doctor.

4. Health Problems

Certain health conditions may delay or even prevent conception, including:

• Irregular menstrual cycles
• Polycystic ovary syndrome (PCOS)
• Diabetes
• Obesity
• Thyroid disorders
• Fibroids
• Endometriosis
• Blocked fallopian tubes

If you are experiencing difficulty conceiving and have any of these conditions, it is best to consult a doctor to address them first before attempting pregnancy.

5. Excessive Stress

High stress levels can interfere with conception. Elevated cortisol can negatively affect ovulation and fertility. This does not refer to everyday stress, but to chronic, high-level stress.

Consulting a therapist or adopting stress-relieving strategies such as exercise, journaling, or deep breathing can be helpful.

6. Male Health Issues

The reason behind delayed conception may not be from the woman but from the man. Infertility cases are roughly 40% due to male factors, 40% due to female factors, and 20% due to both.

Men’s fertility may decline with age, as both sperm count and motility decrease. Reduced sperm quality regardless of cause can delay conception, requiring specialist consultation for proper management.

7. Smoking

Smoking harms fertility in both men and women. Long-term smoking accelerates the loss of eggs, reduces sperm count, and affects sperm health. Quitting smoking may be necessary for couples seeking to improve their chances of conception.

Diagnostic Tests for Delayed Conception

Several tests may be needed to determine the cause of infertility (though sometimes no clear cause is found). Key investigations include:

• Pelvic exam: To detect structural abnormalities or disease signs.
• Blood tests: To check hormone levels and identify potential imbalances.
• Transvaginal ultrasound: To examine the reproductive system for possible obstacles to conception.
• Hysteroscopy: A scope is inserted into the uterus to detect abnormalities that may hinder conception.
• Laparoscopy: A minimally invasive procedure to detect issues such as endometriosis, fibroids, or scar tissue.
• Semen analysis: To assess sperm quality and detect abnormalities that may cause infertility.
• Scrotal ultrasound: To identify male fertility problems such as varicocele or other testicular conditions.

Treatment of Delayed Conception

Treatment varies between men and women, depending on who has the underlying issue and the specific cause. Options may include medications, surgery, or assisted reproductive technologies.

Treatment for Women

• Medications: Such as ovulation-stimulating drugs to increase egg production and improve chances of pregnancy.
• Surgery: May help in cases like blocked fallopian tubes, fibroids, or scar tissue removal.

Treatment for Men

• Medications: For example, drugs to increase testosterone levels (when deficient) or erectile dysfunction treatments.
• Antibiotics: To treat reproductive tract infections that may impair fertility.
• Surgery: Useful in cases such as varicocele repair or correction of vas deferens blockages.

Treatment for Both Men and Women

When previous treatments are unsuccessful, assisted reproductive techniques may be recommended:

• In vitro fertilization (IVF): Eggs are retrieved and combined with sperm in a lab dish, and a fertilized egg is transferred to the uterus.
• Intracytoplasmic sperm injection (ICSI): A single sperm is directly injected into an egg before transferring the fertilized egg to the uterus.
• Intrauterine insemination (IUI): Sperm is placed directly into the uterus during ovulation using a thin tube.

Tips for Preventing Infertility

Some lifestyle changes can help preserve fertility and prevent infertility:

• Treat underlying health issues such as obesity, fibroids, or varicocele.
• Exercise regularly but avoid overtraining.
• Do not delay pregnancy until an advanced age.
• Quit smoking.
• Follow a healthy, balanced diet to maintain a healthy weight.
• Minimize stress as much as possible.