Making Sense of Fertility Challenges: What Every Woman Should Know

Struggling to conceive often feels isolating and emotionally difficult, yet fertility challenges are much more common than most people recognize. According to the World Health Organization, fertility issues affect 1 in 6 people globally. This reality underscores the importance of reproductive health education and ensuring that women and their partners have access to clear, evidence-based guidance.

Advances in research and technology continue to expand the available tools, diagnostics, and treatment options, offering clearer pathways for managing fertility concerns. With the right information and guidance, many women can identify potential issues earlier, explore the full range of available options, and feel more confident as they make decisions about their reproductive health.

At Private Health Management (PHM), we provide clear, science-backed guidance so women can understand their reproductive health, feel supported in their decisions, and confidently navigate the path toward building a family.

What Is Infertility?
Infertility is defined as the inability to get pregnant after regular, unprotected intercourse after one year for women under 35, or six months for women over 35.¹ Earlier fertility evaluation may be helpful for those with known risk factors, such as irregular periods, polycystic ovary syndrome (PCOS), endometriosis, or a history of pelvic infections. Many people who seek care for fertility concerns go on to conceive, either naturally or with treatment.²

What Are Some Causes of Infertility?
Understanding the underlying cause of infertility is the first step in developing an effective, personalized care plan. Fertility depends on factors that affect both partners, and testing can identify a specific cause in about 85% of couples.² The most common contributors are ovulation issues, fallopian tube problems, and male factor infertility. In addition, 1 in 4 couples have more than one contributing factor, so it is important that both partners get evaluated.³ About 15% of couples are diagnosed with “unexplained infertility”, where testing does not reveal a clear cause that can be addressed, which can feel particularly frustrating.²

Below is a simplified overview of the most common categories and how they may affect conception.

When Women Should Seek Help
Early evaluation helps shorten the time to diagnosis and ensures access to effective treatments.^4,5 Women should seek support:

• Under age 35: after 12 months of trying
• Age 35 or older: after 6 months of trying
• Immediately if they experience irregular or absent cycles, known PCOS or endometriosis, prior pelvic infection or surgery, very painful periods, or two or more miscarriages
• At any age if something “feels off” or cycles become suddenly irregular
• If they have a family history of early menopause or premature ovarian insufficiency
• If they have undergone chemotherapy, radiation, or other treatments that may affect fertility
• If they are considering delaying pregnancy and want to explore fertility preservation options

A proactive approach, especially for women in their 30’s and 40’s can significantly expand the range of available treatment options.

Standard Fertility Treatment Options
Once the possible causes are identified, there are several treatment pathways that can help support conception. Some focus on optimizing natural fertility, while others involve medical or assisted reproductive technologies (ART). Most couples progress from lower-intervention strategies to more advanced treatments depending on their goals, age, test results, and response to earlier steps.^2,4–6

Optimizing Natural Fertility

• Timing Optimization: Tracking menstrual cycles, identifying ovulation, and timing intercourse accordingly can help increase the chance of conception. For some individuals, this approach can be enough to improve fertility outcomes.
• Lifestyle Support: Healthy habits, such as a Mediterranean-style diet, regular moderate exercise, stress-management strategies, 7–9 hours of sleep, and reducing tobacco, heavy alcohol use, and environmental exposures can benefit both partners. These changes can help regulate hormones, support ovulation, and improve sperm health.
• Ovulation-Induction Medications: Medications, such as letrozole or clomiphene, help stimulate ovulation in women who do not release eggs regularly. These are commonly used for those with PCOS or irregular cycles.
• Intrauterine Insemination (IUI): IUI involves placing washed, concentrated sperm directly into the uterus at the time of ovulation. It is often recommended for mild male-factor infertility.

Assisted Reproductive Technologies (ART)

• In Vitro Fertilization (IVF): IVF involves retrieving eggs, fertilizing them in the laboratory, and transferring an embryo to the uterus. There are variations that are tailored to different fertility needs and medical situations, including:
  • Intracytoplasmic sperm injection (ICSI), where a single sperm is injected into an egg
  • Frozen embryo transfer, used widely due to improved success rates
  • Preimplantation genetic testing (PGT) in select cases to screen embryos for chromosomal or genetic conditions
• Fertility Preservation: Egg and embryo freezing allow women to preserve future reproductive potential, an important option for those delaying pregnancy or preparing for medical treatments such as chemotherapy.

PHM helps women compare the risks, benefits, success rates, and timelines of each option, ensuring they pursue the right path at the right time.

Key Recent Innovations in Fertility Care
In recent years, reproductive medicine has seen technological innovations that improve safety, personalize treatment, and increase the chances of a successful pregnancy. These advancements are reshaping how clinicians diagnose infertility and how they tailor treatment plans. Some of the latest developments include:

• AI-Enhanced Fertility Testing and Embryo Selection. Artificial intelligence tools are now being used to support clinicians in evaluating embryos, helping identify those with the best chance of implanting and possibly reducing the need for multiple IVF cycles.^7,8
• Personalized IVF Stimulation Protocols. Modern IVF no longer relies on a one-size-fits-all approach. Medication dosing is now tailored to markers such as hormone testing, egg supply, age, and metabolic health. This individualization enhances overall success rates.⁹
• Non-Invasive Biomarkers in Fertility Care. Researchers are exploring molecules in blood and reproductive fluids that may eventually help assess embryo quality and fertility outcomes without invasive testing.¹⁰

These innovations allow for more precise, less invasive, and higher-confidence fertility strategies, empowering women with more effective options than ever before.

How PHM Supports Women Facing Fertility Challenges
PHM provides personalized, evidence-based support throughout the fertility journey. Our Personal Care Teams:

• Review diagnostic history to ensure appropriate testing
• Connect women with leading fertility specialists and navigate complex or unexpected results
• Help them understand their employer-sponsored benefits and treatment coverage
• Provide unbiased information tailored to their age, goals, and medical situation
• Coordinate care across providers for a seamless experience
• Provide compassionate guidance every step of the way.

Our mission is to ensure women never navigate fertility challenges alone and that they have access to the very est of what modern medicine offers.

References

1. Treating Infertility. https://www.acog.org/womens-health/faqs/treating-infertility.
2. Carson, S. A. & Kallen, A. N. Diagnosis and Management of Infertility: A Review. JAMA 326, 65–76 (2021).
3. FAQ Quick Facts About Infertility – SRS. https://connect.asrm.org/srs/about/new-item9?ssopc=1.
4. Schlegel, P. N. et al. Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline Part I. J. Urol. https://doi.org/10.1097/JU.0000000000001521 (2021) doi:10.1097/JU.0000000000001521.
5. Fertility evaluation of infertile women: a committee opinion (2021). https://www.asrm.org/practice-guidance/practice-committee-documents/fertility-evaluation-of-infertile-women-a-committee-opinion-2021/.
6. Phillips, K., Olanrewaju, R. A. & Omole, F. Infertility: Evaluation and Management. https://www.aafp.org/pubs/afp/issues/2023/0600/infertility.html.
7. Khosravi, P. et al. Deep learning enables robust assessment and selection of human blastocysts after in vitro fertilization. Npj Digit. Med. 2, 21 (2019).
8. Ueno, S., Berntsen, J., Okimura, T. & Kato, K. Improved pregnancy prediction performance in an updated deep-learning embryo selection model: a retrospective independent validation study. Reprod. Biomed. Online 48, 103308 (2024).
9. Schouten, N. et al. Development and validation of a gonadotropin dose selection model for optimized ovarian stimulation in IVF/ICSI: an individual participant data meta-analysis. Hum. Reprod. Update 31, 116–132 (2025).
10. Farzizadeh, N. et al. Non-invasive biomarkers in assisted reproduction: a comprehensive review for predicting IVF success. J. Assist. Reprod. Genet. https://doi.org/10.1007/s10815-025-03707-y (2025) doi:10.1007/s10815-025-03707-y.