Female Infertility

Would you be surprised if we said that the women’s natural fertility rate is 20%? Yes, it’s true. This means that if 100 women are trying to get pregnant, only 20 conceive naturally, while the remaining 80 have to try again. Women’s “healthiest” reproductive age is between the mid-20s and early 30s.w

Reports also suggest that by and after 40 years, a woman’s natural chance at a successful pregnancy is slashed down to 5% per cycle. Female infertility is pretty common and affects close to 20% of the population, just in the U.S.

However, 90% of female infertility cases are treatable with modern medicine. It includes medication, surgical interventions, and sometimes psychological counseling to help women attain their joy of motherhood.

This article will dive deep into the basics of female infertility, its causes, symptoms, and available treatment options.

What is Female Infertility?

Female infertility is a medical condition where a woman fails to get pregnant after indulging in unprotected sex for 12 months or more.

Typically, one-third of the time, the infertility issues in a couple stem from female partners. The causes can be related to reproductive anatomy issues, hormonal imbalance, underlying disease, and many more concerns.

The general definition of female infertility is based on heterosexual, cis-gender couples. However, infertility can be a concern in same-sex couples, transgender individuals as well.

Besides the physical issues or the emotional turmoil, age is a crucial contributor to female infertility. Women above 40 experience depleting ovarian reserves that stand out as a critical marker for infertility.

Female Infertility – Possible Causes

Pregnancy is a multi-step process that involves a lot of key markers and factors in question. For a successful conception, the egg and the sperm have to fuse and fertilize to produce an embryo. Sometimes, due to anatomical restrictions or impotent cell structures, fertilization doesn’t happen, leading to infertility.

A successful conception includes:

One mature egg from either of the ovary is released

                                                                                                  ↓

The egg travels down to the fallopian tube

                                                                                                 ↓

Simultaneously, the sperm swims through the cervix, uterus and reaches the fallopian tube to fertilize the egg

                                                                                                 ↓

The successfully fertilized egg then traverses from the fallopian tube to the uterus for successful implantation.

                                                                                                 ↓

Once divided into multiple cells, the mature embryo is then successfully implanted into the uterus

                                                                                                 ↓

Results in a successful pregnancy

Any kind of inhibition along the process can result in an unsuccessful conception. We are going to discuss those possible causes now.

Ovulation disorders

As we saw in the flow chart above, the first step towards a successful conception is the release of the mature egg from the ovary. Sometimes, women face issues with the ovulation and menstrual cycles, leading to the release of no mature egg during the reproductive cycle.

There can be multiple contributors to the same, including:

Cause How does it Affect Fertility?
Polycystic ovary syndrome (PCOS)
  • Results in hormonal imbalance
  • Associated with insulin resistance that impairs ovulation
Hypothalamic dysfunction
  • Unregulated release of the follicular-stimulating hormone and luteinizing hormone
  • Marked by irregular menstrual cycles each month
  • Triggered by stress, obesity, malnutrition, etc.
Ovarian reserve depletion
  • Triggered by auto-immune response or excessive loss of eggs
  • Premature loss can happen due to chemotherapy or genetic predisposition
  • Low estrogen production in the body
Hyperprolactinemia
  • Excessive production of prolactin
  • Eventual reduction of estrogen production, leading to infertility
  • Could be a side effect of medications too

 Tubal Infertility

Female infertility can stem from anatomical abnormalities in the reproduction structure, not just the ovulation issues. Tubal infertility or damage to the fallopian tubes is the most common occurrence.

Blocked or damaged structure of the fallopian tube restricts the smooth passage of the egg and even inhibits fertilization. It can predominantly be a consequence of two factors:

  • Infection in the fallopian tubes, leading to blockages caused by Pelvic Inflammatory Disease (PID)
  • History of surgical negligence in the abdomen and pelvis. It could be an aftermath of an ectopic pregnancy.

Endometriosis

Moving ahead from the fallopian tube, we have the uterus. Some women struggle with painful periods, excessive cramping, etc. These are a sign of a medical condition called endometriosis.

Endometriosis is a condition in which the uterine tissues (predominantly from the endometrium) implant themselves to the other parts of the reproductive organs in a female. These outgrowths can adhere to fallopian tubes, ovaries, etc., leading to blockages and eventually resulting in infertility.

Uterine-Cervical Issues

Nine out of ten times, several women go undiagnosed with several uterine and cervical issues throughout their lifetime. Until they cannot conceive, many individuals don’t even realize that they aren’t in the best of their reproductive health.

Some of the common uterine-cervical issues include:

Possible Conditions What is it?
Benign Polyps, Fibroids Fibroids, and myomas are benign outgrowths of tissues in the uterus and sometimes around the cervical structure. These structures end up blocking the fallopian tubes or obstruct the successful implantation, resulting in infertility.
Congenital disabilities Abnormally shaped uterus, flipped uterus are some conditions that are present from birth and are often left undiagnosed until one is having a hard time conceiving.
Cervical stenosis Results in narrowing of the cervix, caused by malformation or even damage to the cervical lining or tissues.
Dry lining of the cervix For the sperm to successfully travel through the cervix, it is crucial for the cervical lining to produce enough mucus. In some cases, the cervix lacks that, resulting in infertility.

Idiopathic Conditions

Sometimes, there are situations where the tests and diagnosis come back normal. There can be major issues or sometimes issues that don’t even matter. If your fertility specialist can’t answer the problem, the chances are that they will ask to let it happen normally.

Besides these medical conditions, several other risk factors contribute to female infertility, including:

  • Age
  • Bodyweight (obese and underweight)
  • Eating disorders
  • Alcohol consumption
  • Smoking
  • Sexual history

What are the Symptoms of Female Infertility?

Female infertility can be a devasting situation for many. However, you need to realize that early diagnosis can ensure quicker treatments and tangible results. Ideally, we’d recommend focusing on paying attention to the symptoms.

Instead of taking the minor symptoms for granted, get them checked immediately.

Some of the common signs and symptoms to look out for are:

  • Not getting pregnant after 12 months of unprotected sexual intercourse
  • Irregular or unregulated periods
  • Excessive pain during periods
  • Over the age of 35-40 years

Consulting the right specialist on time can help resolve the issues quicker and with fruitful results. So, instead of pushing things to the back, take charge and see a doctor immediately before it’s too late.

Treatment for Female Infertility – When to See a Doctor?

If you are tired of trying and not seeing any results, consulting a fertility specialist is essential. The consultation will generally start with a basic rundown of the medical and sexual history of the couple.

A doctor can never predict whether you are infertile or not if they don’t conduct the right tests for a medical diagnosis. The list of tests include:

Type of Test What is it?
Ovulation testing Checks the hormonal balance and levels of luteinizing hormone, prolactin, and progesterone to check the ovulation cycle in women.
Hysterosalpingography Involves x-ray of the uterus. Also passes fluid through the uterus into the fallopian tube to check for any blockages along the way.
Ovarian reserve testing Checks for the remnant eggs available in the ovaries. Ideally, a prerequisite for women above the age of 35.
Imaging Pelvic ultrasound checks for anomalies in the fallopian tube and uterine structure.
Laparoscopy A minimally invasive surgical procedure is done to check the reproductive organs’ insides for lesions, scarring, blockages, infection, etc.
Genetic testing Checks for gene mutations or abnormalities to determine the causes of infertility.

 

Depending on the cause, your fertility specialist will proceed with a treatment option. It can either start with fertility drugs or proceed to Assisted Reproductive Technology (ART) if nothing is working out for the female patient.

Some of the common treatments include:

Type of Treatment Options Available
Medications Clomiphene citrate

Gonadotropins

Bromocriptine

Metformin, etc.

Surgical Interventions Laparoscopic or hysteroscopic surgery

Tubal surgeries

Reproductive assistance Intrauterine insemination (IUI)

Assisted reproductive technology

 

Conclusion

Female infertility is often talked about with a negative connotation in society. This impacts the self-confidence and emotional well-being of several women globally. However, you need to realize that the condition is pretty normal and often corrected with simple medical interventions.

Struggles with infertility aren’t the end of the road. Getting the correct prognosis for your infertility can help the fertility specialist develop an aligned treatment plan and help you (and your partner) enjoy the bliss of parenthood. 

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