Key Takeaways
- Some gynaecological conditions may affect fertility by interfering with ovulation, fertilisation or implantation.
- Common conditions that may influence fertility include endometriosis, polycystic ovary syndrome (PCOS), uterine fibroids, adenomyosis and pelvic inflammatory disease (PID).
- Early assessment can help identify underlying conditions and support timely management where needed.
- Fertility health screening evaluates factors that may influence your ability to conceive and guides further investigations when needed.
- A fertility specialist can recommend appropriate management based on your symptoms, reproductive health and family planning goals.
How Can Gynaecological Conditions Affect Fertility?
Not every gynaecological condition affects fertility, and having one does not necessarily mean you will have difficulty becoming pregnant. However, some conditions can interfere with different stages of conception depending on how they affect the reproductive organs.
For example, certain conditions may disrupt ovulation, alter the shape of the uterus, block the fallopian tubes or create inflammation within the pelvis. These changes can make it more difficult for an egg to be fertilised, implant successfully or develop into a healthy pregnancy. Identifying these conditions early helps guide appropriate investigations and management based on your individual circumstances.
Five Gynaecological Conditions That May Affect Fertility
Endometriosis
Polycystic Ovary Syndrome (PCOS)
Polycystic ovary syndrome (PCOS) is a hormonal condition that commonly affects ovulation. Women with PCOS may experience irregular or absent menstrual periods, acne, excessive hair growth or difficulty conceiving, although symptoms vary widely.
Because ovulation may occur less frequently or not at all, becoming pregnant can be more challenging for some women with PCOS. However, many women with PCOS conceive successfully with lifestyle modifications, ovulation induction or other fertility treatments when appropriate.
Uterine Fibroids
Fibroids are non-cancerous growths that develop within or around the uterus. Many fibroids do not cause symptoms or affect fertility, particularly if they are small or located on the outer surface of the uterus.
However, fibroids that distort the uterine cavity or are positioned near the openings of the fallopian tubes may interfere with implantation or increase the risk of certain pregnancy complications. Whether treatment is recommended depends on the size, number and location of the fibroids, as well as your reproductive goals.
Adenomyosis
Adenomyosis occurs when tissue similar to the lining of the uterus grows into the muscular wall of the uterus. It commonly affects women in their 30s and 40s and may cause heavy menstrual bleeding, painful periods or chronic pelvic pain, although some women experience few symptoms.
The relationship between adenomyosis and fertility is still being studied. However, adenomyosis may affect implantation and has been associated with an increased risk of miscarriage in some women. If you have symptoms of adenomyosis and are planning a pregnancy, a fertility specialist can assess whether further evaluation or treatment is appropriate.
Pelvic Inflammatory Disease (PID)
Pelvic inflammatory disease (PID) is an infection of the female reproductive organs, most commonly caused by untreated sexually transmitted infections. Symptoms may include lower abdominal pain, abnormal vaginal discharge, fever or pain during intercourse, although mild cases may go unnoticed.
If left untreated, PID can damage the fallopian tubes through inflammation and scarring, making it more difficult for the egg and sperm to meet. Prompt diagnosis and treatment can reduce the risk of long-term complications, including fertility problems.
When Should You Consider Fertility Health Screening?
Fertility health screening is not only for couples who are struggling to conceive. It can also help identify factors that may affect your fertility before you begin trying for a pregnancy, allowing appropriate investigations or treatment to be considered if needed.
You may benefit from fertility health screening if you:
- Have been trying to conceive for 12 months without success if you are under 35, or for 6 months if you are aged 35 or older.
- Have irregular or absent menstrual periods.
- Have been diagnosed with a gynaecological condition such as endometriosis, PCOS, fibroids or adenomyosis.
- Experience persistent pelvic pain, painful periods or other ongoing gynaecological symptoms.
- Have a history of pelvic inflammatory disease, sexually transmitted infections or pelvic surgery.
- Have experienced recurrent pregnancy loss or previous fertility concerns.
- Wish to better understand your reproductive health before planning a pregnancy.
A fertility health screening typically includes a review of your medical and menstrual history, followed by appropriate investigations based on your individual circumstances. Depending on your symptoms and medical history, this may include hormone blood tests, pelvic ultrasound scans and other fertility investigations to assess ovarian function, the uterus and other aspects of reproductive health.
Understand Your Fertility with Dr Kelly Loi
Understanding your reproductive health is an important step when planning for pregnancy, particularly if you have symptoms or a known gynaecological condition that may affect fertility. A comprehensive fertility health screening can help identify potential concerns early and guide appropriate next steps based on your individual circumstances.
At Health & Fertility Centre for Women, fertility health screening is tailored to your medical history, reproductive goals and any symptoms you may be experiencing. From comprehensive fertility assessments and diagnostic investigations to ongoing fertility care and treatment planning, your care is coordinated to provide clarity and support at every stage of your fertility journey.
Dr Kelly Loi is a senior consultant obstetrician & gynaecologist with a special interest in reproductive medicine and assisted conception. She provides evidence-based fertility assessments and works closely with each patient to identify factors that may influence fertility and recommend appropriate management based on their individual needs.
To learn more about fertility health screening or discuss your reproductive health, schedule a consultation with us.
FAQs About Gynaecological Conditions That May Affect Fertility
Fertility health screening provides information about factors that may affect your fertility, but it cannot predict whether or when you will become pregnant. Fertility depends on multiple factors, including age, reproductive health and your partner's fertility.
There is no single age at which fertility health screening is recommended for everyone. It may be appropriate if you are planning a pregnancy, have known risk factors for infertility or would like a better understanding of your reproductive health before delaying childbearing.
Not necessarily. Fertility health screening often begins with a consultation, a review of your medical history and non-invasive investigations such as blood tests and a pelvic ultrasound. Additional tests are only recommended if they are clinically indicated.
