Female Infertility

Many couples struggle with infertility and if you are unable to conceive here are few things you need to understand about infertility. Female infertility can be defined as an inability to conceive after trying for one year or is six months for the woman who is 35 or older. Pregnancy loss or frequent miscarriages in women is also referred to as infertility. In such conditions, it is advised to meet your doctor to undergo infertility evaluation. However, if you have a history of irregular menstrual cycles, pelvic inflammations, or endometriosis, you should consider getting evaluated much earlier. Healthy pregnancy in a woman is a multi-step procedure, and to conceive successfully, these steps are essential. Failure of any of these steps can result in infertility:

• Your body must release an egg from the ovaries (ovulation).
• The egg should travel through the Fallopian tube towards the uterus.
• Your male partner’s sperm should fertilize the egg.
• The fertilized egg needs to attach to the uterus (Implantation).

Female Infertility Symptoms

As discussed above, getting pregnant or carrying a healthy pregnancy involves many steps, and anything goes wrong during this process, leads to infertility. The main symptom of infertility is the inability to get pregnant. Some other common symptoms of pregnancy are:

• • Irregular menstrual cycle
  • Severe pain during menstruation
  • Some hormonal fluctuations, causing skin issues, facial hair growth, and obesity.
  • Pain during sex

When to get evaluated for infertility:

• • • Below age 35 – try for at least one year for pregnancy before consulting a doctor.
    • 35 to 40 years – try for six months to conceive before meeting a doctor.
    • Above 40 years – better to get evaluated right away and undergo some tests and treatments.

Female Infertility Problems/Causes

If you have trouble conceiving, you should consult an infertility doctor to understand the possible causes and their treatment. Most commonly, female infertility is caused due to problems associated with ovulation. If you have irregular or absent menstruation, that means you are not ovulating correctly. It is not possible to conceive without producing a healthy egg. There are a number of things that may be the reason for your infertility:

1. Ovulation disorders

   One in four infertile couples suffers from ovulation disorder, where there is either infrequent ovulation or no ovulation at all. The underlying causes for ovulation disorders can be:

• • • Polycystic ovulation syndrome or PCOS – It is caused by hormone imbalance associated with insulin resistance and obesity, leading to acne and abnormal facial hair growth.
    • Primary ovarian insufficiency – It is an autoimmune condition causing premature loss of eggs from ovaries. Genetics or chemotherapy can be the reason for this condition.
    • Excess prolactin – Pituitary gland producing excess prolactin decreases the estrogen production causing infertility.
    • Dysfunction of the hypothalamus – Excessive stress or weight gain can disrupt the hormone production of the pituitary gland. This affects ovulation and causes irregular menstruation.

2. Damage to Fallopian tubes (tubal infertility)

Fallopian tubes transport your eggs from ovaries to the uterus. Any damage or block of this passage can prevent the fertilization of the egg. Damage or blockage of Fallopian tubes occur due to;

• • • Pelvic inflammation, causing the infection of Fallopian tubes in conditions like gonorrhea, chlamydia, or sexually transmitted diseases
    • Previous surgery involving your abdomen or pelvis.
    • Pelvic tuberculosis can also be the cause.

3. Endometriosis

When uterine tissue that generally seen lining inside the uterus grows outside, it is called endometriosis. The presence of this extra tissue or scarring caused by the removal of this tissue can result in blockage of Fallopian tubes. Endometriosis also affects the implantation of the fertilized egg leading to infertility.

4. Uterine or cervical causes

Uterine or cervical causes can impact your fertility by interfering with the implantation of the fertilized egg. This results in loss of pregnancy or miscarriages.

• • • Polyps or benign tumors can cause blockage of Fallopian tubes, or interfere with implantation affecting your fertility.
    • Anatomical anomalies of the uterus can also be the reason for your infertility.
    • Any damage to the cervix can cause cervical stenosis or narrowing of the cervix.
    • The inability of the cervix to produce an adequate amount of mucus to allow the sperm to travel.

5. Unexplained infertility

   Sometimes the underlying cause of infertility can not be determined. Several factors together in both couples can be the reason for infertility.

Female Infertility Diagnosis

   Infertility evaluation involves physical examination followed by medical and sexual history. Your fertility doctor may advise you to undergo several tests, including a blood test to evaluate your hormonal levels and endometrial biopsy to examine your uterine lining.

Hysterosalpingography (HSG)
   This procedure helps to determine if there is any blockage in your Fallopian tubes. It involves ultrasound or x-ray of your reproductive organs during which the doctor injects a special dye or saline into your cervix to locate the blockage.

Laparoscopy
   It is a minor surgery performed to get a better view of your reproductive organs. A small tool called a laparoscopy is inserted into your lower abdomen through a small incision. This laparoscopy carries a camera that allows your doctor to check for any abnormalities. Determining the specific cause of infertility can be a long and emotional process. Seek help from your partner or family when needed. If you are having any anxiety or depression, discuss it with your doctor. Take all the required measures to help your doctor in finding the right cause and best possible treatment.

Female Infertility

Infertility is commonly treated with medication, artificial insemination, surgery, or assisted reproductive techniques. Many times doctors preferred a combined approach for treating infertility. Depending on your test results, age, health, and history, your doctor will plan the line of treatment.

• • • During any tubal or pelvic diseases or any cysts, laparoscopy is done to treat the condition.
    • Hysteroscopy is done to remove polyps or fibroid tumors or scar tissue and to open blocked tubes.
    • Drugs will be prescribed if you are having issues with ovulation.