Health 101: Infertility in Women

What increases my risk of infertility?

More than anything else, age has the biggest impact on your ability to get or stay pregnant. Regardless of how healthy or fit you are, the quality of your eggs and your ability to ovulate normally decreases over time.

For example, less than 10 percent of 20-something couples have fertility problems, but nearly 30 percent of those in their early 40s do, and more than 50 percent of those older than 45 do, according to the American Society for Reproductive Medicine. Of course, women over 40 get pregnant all the time, but it may take longer or require help from a fertility specialist.

Although you can't control your age, the following factors also increase your risk of infertility. Making a lifestyle change may boost your ability to conceive -- and your all-around health.

• Smoking cigarettes. Volumes of research have shown that smoking cigarettes may interfere with ovulation and damages eggs, making them more prone to genetic defects that can lead to miscarriage. One recent study found that couples who smoked were more than three times as likely to take more than six months to get pregnant compared to couples who didn't smoke.
• Excess alcohol and caffeine intake. According to the most recent research on these somewhat controversial areas, an occasional cocktail or daily cup of coffee does not increase your risk of infertility. While heavy drinking is definitely harmful for conception and pregnancy, most well-designed studies have found no solid evidence that moderate drinking (say, a glass of wine a day) has an impact on your ability to get pregnant. The evidence on caffeine is mixed too, although most research shows that having less than two cups of coffee a day won't affect your fertility or a healthy pregnancy.

Bottom line: If you're actively trying to get pregnant, avoid alcohol (most women don't know they're expecting in the earliest stages of pregnancy, so it's better to play it safe anyway) and limit caffeine intake.

• Being significantly overweight or underweight. Women with a body mass index (BMI) below 20 or above 27 are less likely to conceive than woman with BMIs that fall within that range. The main reason: Weighing too little (from excessive exercise or not eating enough) or too much may throw your hormones off-balance and interfere with ovulation.

• Sexually transmitted diseases. STDs like chlamydia and gonorrhea (both easily treatable with antibiotics) may lead to pelvic infections that interfere with conception.
• Extreme stress. While getting regular massages or taking yoga is unlikely to speed up conception, some research shows that extreme stress may impact fertility indirectly. Major life changes -- like a death in the family, job loss, etc. -- may cause hormonal swings that make ovulation less regular. And if you're totally burned out or anxious all the time, you're probably less likely to be in the mood for babymaking.