Female infertility is usually a team of troublemakers, the most common being:

• Ovulation disorders (like PCOS, hypothalamic dysfunction): 25%
• Endometriosis: 15%
• Tubal blockage/adhesions: 23% (includes PID history, chlamydia, past pelvic surgery)
• Uterine issues (fibroids, septum): 11%
• Other: Primary ovarian insufficiency, hyperprolactinemia, thyroid disorders.

Remember, sometimes a ‘male factor’ is along for the ride, so a couple’s approach is key.

Female fertility starts its slow slide around age 32, drops more sharply from age 37, and takes a running leap after 40.

• “Geriatric pregnancy”—formerly used at age 35—is now politely called Advanced Maternal Age (AMA), but in 2025, most experts consider 37+ as the new clinical “milestone” for higher-risk care.
• By the numbers:
• Infertility risk (the chance of not conceiving after 12 months of trying):
• Ages 15–34: about 7–9%
• Ages 35–39: rises to 25%
• Ages 40–44: 30% or more cannot conceive naturally within a year
• Miscarriage risk jumps: 13% (<35), 14–20% (35–40), 30–36% (40+).

IUI (Intrauterine Insemination):

• Process:
1. Medications may be used to gently stimulate ovulation (sometimes, not always).
2. At ovulation, your partner’s (or donor’s) sperm sample is “washed” and concentrated.
3. A thin catheter is used to place the sperm directly into your uterus—a quick, office procedure, usually painless.
4. You relax for a few minutes, then resume your day and wait two weeks for a test!
• Best for: Mild male fertility issues, unexplained infertility, cervical mucus problems, LGBTQ+ family building, or using donor sperm.
• Chances: Each cycle’s pregnancy rate is about 7–12%—relatively low, but cumulative rates improve over 3–6 cycles.

IVF (In Vitro Fertilization):

• Process:
1. You take hormone injections over 8–12 days to mature multiple eggs.
2. Once ready, eggs are retrieved using a minor day surgery (ultrasound-guided, with light sedation).
3. In the lab, eggs are fertilized with sperm, creating embryos.
4. After 3–6 days, the healthiest embryo(s) are transferred to your uterus with a thin catheter.
5. Remaining embryos can be frozen for future use.
• Best for: Blocked or damaged fallopian tubes, severe male factor infertility, older age, endometriosis, genetic screening, or when IUI hasn’t worked.
• Chances: Success rates are 32–40% per attempt under age 35; decrease with age (e.g., 20% per try by early 40s).

How to choose?

• If you’re younger, have unexplained infertility, or no major anatomical/blockage issues, IUI may be a gentle first step.
• If you’re over 35, have tubal problems, severe sperm issues, or have tried and failed IUI, IVF is usually the most effective path.

Both approaches are tailored to your history, diagnosis, and goals—your fertility team can help decide which “route” gives you the best odds for success!

• BC IVF program per-cycle success rates:
• 30–40% for those 34 and under
• 27% for ages 35–39
• 22% for 40+
• Cumulative pregnancy rates (including frozen embryo transfers) can exceed 60–80% over multiple cycles.
• How to access: Referral from your GP or fertility specialist to an accredited BC fertility clinic; funding covers a limited number of cycles and eligibility is expanding in 2025.

Bonus: Coverage for single individuals and LGBTQIA2S+ folks is increasing!

• First steps:
• Thorough menstrual and health history
• Bloodwork to check thyroid, prolactin, AMH/egg reserve
• Pelvic ultrasound for uterine/tubal structure
• Semen analysis for male partners (half of “infertility” is male factor!)
• Typically, couples are advised to seek help after 12 months unsuccessfully (<35 years) or 6 months (35+ or with risk factors).
• Testing is collaborative and compassionate—think of it as detective work, not judgment!

• Egg freezing (oocyte cryopreservation): Ovarian stimulation → egg retrieval → freezing. Most effective before 35, success declines with age/egg number.
• Best candidates:
• Women delaying childbearing for education/career
• Those about to undergo cancer treatment
• Family history of early menopause
• Modern techniques yield 70–80% survival per thawed egg and about a 25–40% chance of pregnancy per cycle for women <35.
• Consult with a fertility clinic to assess ovarian reserve and discuss timing.

Absolutely!

• Diet: Mediterranean, plant-rich diet improves ovulation and conception rates.
• Exercise & healthy weight: Women with BMI 20–25 have best chances; even a 5–10% weight loss can restore ovulation in PCOS.
• Sleep & stress management: Consistent, restorative sleep and stress reduction (yoga, mindfulness) are independently linked to higher conception rates.
• Timing sex to fertile window: Probability climbs from 10% (five days before ovulation) to 33% (on day of ovulation).

Here’s a detailed, evidence-based breakdown of natural treatments, supplements, and herbs that support female fertility—complete with clinical data, mechanisms, and caveats:

Vitex (Chasteberry):

• Clinical Data: Meta-analyses and RCTs show Vitex can regulate menstrual cycles and improve ovulation rates, especially in women with mild hyperprolactinemia or luteal phase defects.
• One RCT showed pregnancy rates nearly doubled (26% vs. 10%) after 6 months of Vitex compared to placebo in women with cycle irregularity.
• Mechanism: Believed to support dopamine and reduce prolactin, improving progesterone levels and cycle regularity.

Maca Root:

• Data: Randomized studies in both men and women show Maca (1.5–3g/day) can help manage infertility related to stress and hormonal imbalance.
• Effect: Modest improvements in ovulation regularity and libido have been demonstrated, but high-quality data remain limited.

Ashwagandha:

• Data: Several studies show ashwagandha may lower cortisol (stress hormone) and normalize thyroid/hormone balance, which can improve ovulation in women with PCOS or subclinical hypothyroidism.
• Mechanism: Adaptogenic effect on nervous and endocrine systems.

Folate (Folic Acid):

• Evidence: Folic acid (0.4–1mg/day) is essential for preconception and early pregnancy and reduces miscarriage risk by up to 36% in large prospective studies.
• Adequate levels are linked to better egg quality and lower rates of neural tube defects.

Folic Acid vs. 5-MTHF: What Does the Research Say?

• Folic acid is the synthetic form most commonly used in prenatal vitamins and public health efforts. Large trials and public health data prove it reduces the risk of neural tube defects (NTDs) by 72% and is safe and effective for the general population.
• 5-MTHF (5-methyltetrahydrofolate) is the active, natural form of folate already found in the body. It doesn’t require conversion by the MTHFR enzyme, a critical step some people with the MTHFR polymorphism (about 30–50% of the population) do less efficiently.
• In couples with a known MTHFR variant, RCTs and prospective series show that 5-MTHF supplementation bypasses the “bottleneck” and may improve folate status, lower homocysteine, and possibly improve pregnancy rates, especially for those with repeated miscarriages or ART failures.
• 5-MTHF does not accumulate as unmetabolized folic acid (UMFA), which can be a theoretical concern with very high-dose folic acid in sensitive individuals.
• However, a large RCT found no significant difference in miscarriage rates between 5-MTHF and standard folic acid in women with the MTHFR polymorphism—though 5-MTHF did raise blood folate levels more efficiently.
• For most people: Both folic acid and 5-MTHF are highly effective at preventing NTDs and supporting fertility (assuming adequate dosing: 0.4–1mg/day or higher for those with risk factors). There is no convincing evidence that 5-MTHF is superior for miscarriage prevention or fertility outcomes in the general population, but it can be preferable for those with a known MTHFR mutation or sensitivity to synthetic folic acid

Omega-3 Fatty Acids:

• Data: RCTs show omega-3 supplementation (1–2g EPA/DHA) can improve egg quality and endometrial receptivity, and reduce inflammation, especially in women with PCOS or endometriosis.
• Omega-3s are tied to improved live birth rates in several IVF studies.

Zinc:

• Evidence: Zinc deficiency impairs ovulation and hormone production.
• Supplementation improves egg quality, luteal function, and conception rates in those who are deficient.

Acupuncture:

• Data: Systematic reviews of IVF patient trials demonstrate that acupuncture around embryo transfer boosts pregnancy rates by 7–9%.
• Effect: Modulates blood flow, decreases stress, improves hormonal signalling and cycle regularity.