Infertility in Women – Causes, Diagnosis and Treatment of Female Infertility

Female Infertility

Female Infertility – Infertility is a condition that affects approximately 1 out of every 6 couples. According to the World Health Organization (WHO), infertility can be described as the inability to become pregnant, maintain a pregnancy, or carry a pregnancy to live birth.

Infertility can be broken down into primary and secondary infertility. Primary infertility refers to the inability to give birth either because of not being able to become pregnant, or carry a child to live birth, which may include miscarriage or a stillborn child.
Secondary infertility refers to the inability to conceive or give birth when there was a previous pregnancy or live birth.

CAUSES OF FEMALE INFERTILITY

The most common causes of female infertility include:

1. Problems with ovulation.

Ovulation problems may be caused by one or more of the following:

  • A hormone imbalance
  • A tumor or cyst
  • Eating disorders such as anorexia or bulimia
  • Alcohol or drug use
  • Thyroid gland problems
  • Excess weight
  • Stress
  • Intense exercise that causes a significant loss of body fat
  • Extremely brief menstrual cycles

2. Damage to fallopian tubes or uterus.

Damage to the fallopian tubes or uterus can be caused by one or more of the following:

  • Pelvic inflammatory disease
  • A previous infection
  • Polyps in the uterus
  • Endometriosis or fibroids
  • Scar tissue or adhesion
  • Chronic medical illness
  • A previous ectopic (tubal) pregnancy
  • A birth defect
  • DES syndrome (The medication DES, given to women to prevent miscarriage or premature birth can result in fertility problems for their children.)

3. Problems with the cervix.

Problems with the cervix causing female infertility

At the top of the vagina is the neck or entrance to the uterus, called the cervix. Ejaculated sperm must travel through the cervix to reach the uterus and fallopian tubes.

4. Problems with the uterus causing female infertility

The fertilized egg lodges in the lining of the uterus. Some uterine problems that can hamper implantation include:

Fibroids – non-malignant tumors inside the womb
Polyps – overgrowth’s of the endometrium, which can be prompted by the presence of fibroids.

5. Chemotherapy

Chemotherapy poses a high risk of infertility. Chemotherapies with high risk of infertility include procarbazine and other alkylating drugs such as cyclophosphamide, ifosfamide, busulfan, melphalan, chlorambucil and chlormethine

6. Age can contribute to infertility because as a woman ages, her fertility naturally tends to decrease.

DIAGNOSIS OF FEMALE INFERTILITY

The healthcare provider may order tests that include the following

  • Hormone testing, to measure levels of female hormones at certain times during a menstrual cycle
  • Day 2 or 3 measure of FSH and estrogen, to assess ovarian reserve
  • Measurement of progesterone in the second half of the cycle to help confirm ovulation
  • An endometrial biopsy, to verify ovulation and inspect the lining of the uterus
  • Pap smear, to check for signs of infection
  • Pelvic exam, to look for abnormalities or infection
  • laparoscopy, which allows the provider to inspect the pelvic organs
  • Special X-ray tests

TREATMENT OF FEMALE INFERTILITY

Most women who get infertility treatment take medication at some point. The medications are intended to treat hormone and ovulation problems.

Two of the most common treatments include:

1. Intrauterine Insemination (IUI)

Semen is collected from a man. A procedure called “sperm washing” is done to separate the healthy sperm from the rest of the semen. A health care provider puts the sperm directly into the uterus. This puts the sperm closer to the egg. It cuts down the time and distance sperm have to travel to reach an egg. IUI is often referred to as donor insemination, alternative insemination, or artificial insemination.

2. In Vitro Fertilization (IVF)

A woman takes medication to make several eggs ripen. A health care provider removes the eggs. Semen that has been collected from a man is put together with the eggs in a lab. After some eggs have been fertilized, one or more of them is put into the uterus. Pregnancy happens if one or more of them implant in the wall of the uterus.

It is important to contact your healthcare provider if you experience any of the following symptoms:

  • Abnormal bleeding
  • Abdominal pain
  • Fever
  • Unusual discharge
  • Pain or discomfort during intercourse
  • Soreness or itching in the vaginal area.

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  1. Smit Shah

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