Female Infertility – Causes, Treatment and Diagnosis – Fertility Problem in women

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Introduction

It is always the fantasy of most ladies to bear their very own offspring.

In any case, sadly, several women have issues conceiving. Many still are not able to carry their baby till the due date of delivery, otherwise experiencing what is popularly known as a miscarriage.

Statistically speaking, female infertility contributes more than 50% of infertility cases around the world.

There could be a lot of factors contributing to this problem, but a portion of the reasons for this issue is because of fertility issues in ladies, and at times, it might be from the man.

No doubt, this infertility issue in certain circumstances might be inferable by both of the man or the woman, or other common cases that have not been characterized. The good news is that there are a few ways to tackle this issue.

 

Overview

I guess this topic doesn’t need much definition or introduction.

But as a way of definition, infertility can be referred to as trying to get pregnant for at least one year with constant sexual intercourse without success.

Infertility can be defined as trying to get pregnant for at least one year (with constant sexual intercourse) without any success. Click To Tweet

Infertility results from female factors around 33% of the time and male factors around 33% of the time. The reason can either be unknown or a blend of the male and female factors in the rest of the cases.

Female infertility causes in some cases can be hard to diagnose. There are numerous accessible medications, which will rely upon the reason for infertility. Numerous barren couples, however, do proceed to conceive a child without treatment.

After attempting to get pregnant for a long time, around 95 percent of couples eventually conceive.

Symptoms

  • The primary indication is the failure to get pregnant.
  • A menstrual cycle that is excessively long (35 days or more)
  • Or one that is excessively short (under 21 days). Unpredictable or missing can imply that you’re not ovulating. There might be no other outward signs or manifestations.

When to seek Medical Attention

When to look for help in some cases relies upon your age:

  • Up to age 35, most specialists recommend attempting to get pregnant for at least a year consistently before testing or treatment.
  • In case you’re somewhere in the range of 35 and 40 years, you should discuss your worries with your primary care physician within 6 months of trying.
  • In case you’re older than 40 years, your specialist might need to start testing or treatment immediately.
  • Your doctor may likewise need to start testing or treatment immediately in the situation that you or your partner has known infertility issues, or on the off chance that you have a past filled with unpredictable or difficult periods, pelvic incendiary infection, rehashed unsuccessful labors, earlier disease treatment, or endometriosis.

 

Factors Essential to Become Pregnant

Each of these factors is essential to becoming pregnant:

  • You need to ovulate. To produce babies, your ovaries must produce and release an egg, a process known as ovulation. Your health care provider can help evaluate your menstrual cycles and verify ovulation.
  • Your partner needs sperm. For most married individuals, this isn’t usually a problem unless your partner has a history of illness or surgery. Your doctor can run some simple tests to assess the health of your partner’s sperm.
  • You need to have regular intercourse. I guess this goes without saying. You need to have frequent sexual intercourse during your fertile time. Your doctor can help you better understand when you’re most fertile.
  • You need to have open fallopian tubes and a normal uterus. The egg and sperm meet in the fallopian tubes, and the embryo needs a healthy uterus in which to grow.

 

Moving forward,

The following steps are necessary for pregnancy to occur #female_infertility #infertility Click To Tweet

For pregnancy to occur, every step of the human reproduction process has to occur and occur correctly as well. The steps in this process are:

  • One of the two ovaries releases a mature egg.
  • The egg is picked up by the fallopian tube.
  • Sperm swim up the cervix, through the uterus and into the fallopian tube to reach the egg for fertilization.
  • The fertilized egg travels down the fallopian tube to the uterus.
  • The fertilized egg implants and grows in the uterus.

 

Unfortunately for some women, a couple of factors can obstruct this process at any step. Female infertility is caused by one or more of the factors below.

Causes of Fertility Problems in Women

Let’s look at some common fertility problems in women.

  1. Ovulation problems

This is one of the issues that result in infertility in ladies. It happens when the egg in the ovaries fails to develop, or it can happen when the ovaries fail to discharge matured eggs. The disappointment of the ovarian egg to create is otherwise called premature ovarian failure.

How might you recognize ovarian issues?

  • On the off chance that you find that you are having heavy menstruation than expected, this might be the explanation.
  • Now and then it might be finished or missing of the menstrual cycle.
  • Different manifestations are identified with breast becoming tender and experiencing swelling as well.

Ovulation issue, which means you ovulate rarely or not in the least, is said to be the cause of infertility in 1 of every 4 couples facing fertility problem. Issues with the regulation of regenerative hormones by the nerve center or the pituitary organ, or issues in the ovary, can cause ovulation issue.

  • Polycystic ovary syndrome (PCOS). PCOS causes a hormone imbalance, which affects ovulation. PCOS is associated with insulin resistance and obesity, abnormal hair growth on the face or body, and acne. It’s the most common cause of female infertility.
  • Hypothalamic dysfunction. Two hormones produced by the pituitary gland are responsible for stimulating ovulation each month — (FSH) and luteinizing hormone (LH). Excess physical or emotional stress, a very high or very low body weight, or a recent substantial weight gain or loss can disrupt the production of these hormones and affect ovulation. Irregular or absent periods are the most common signs.
  • Premature ovarian failure. Also called primary ovarian insufficiency, this disorder is usually caused by an autoimmune response or by premature loss of eggs from your ovary (possibly from genetics or chemotherapy). The ovary no longer produces eggs, and it lowers estrogen production in women under the age of 40.
  • Too much prolactin. The pituitary gland may cause excess production of prolactin (hyperprolactinemia), which reduces estrogen production and may cause infertility. Usually related to a pituitary gland problem, this can also be caused by medications you’re taking for another disease.

 

2. Endometriosis.

This is a condition that usually occurs when the tissues which are found within the internal lining of the uterus (known as endometrial tissue) grows on the outer part of your uterus instead.

The tissue usually grows in the abdominal-pelvic cavity which is not right. And oftentimes requires surgical procedures for the removal of the extra tissue.

Possible Symptoms Include:

  • You may experience unusual pain during your menstrual cycle.
  • Other symptoms may be related to pain when having sex.

Endometriosis can also affect the lining of the uterus, disrupting the implantation of the fertilized egg. The condition also seems to affect fertility in less-direct ways, such as damage to the sperm or egg.

 

3. Polycystic Ovarian Syndrome.

This issue happens in the ovaries zone whereby the little follicles framed in the ovaries fail to develop henceforth results to you encountering hormonal imbalance and abnormal ovulation.

Possible symptoms include.

  • The affected individual may experience irregular menstrual.
  •  Acne break may also be experienced.
  • You may also experience excessive weight loss.

 

 4. Damaged fallopian tube.

If your fallopian tube isn’t working admirably whereby on the off chance that it is blocked or harmed might be an extraordinary reason for infertility. This issue keeps the sperm from swimming into your eggs henceforth no fertilization happens at all in the uterus.

Harmed or blocked fallopian tubes prevent sperm from getting to the egg or square the entry of the prepared egg into the uterus. Reasons for fallopian tube harm or blockage can include:

  • Pelvic inflammatory disease, an infection of the uterus and fallopian tubes due to chlamydia, gonorrhea or other sexually transmitted infections
  • Previous surgery in the abdomen or pelvis, including surgery for ectopic pregnancy, in which a fertilized egg implants and develops in a fallopian tube instead of the uterus
  • Pelvic tuberculosis, a major cause of tubal infertility worldwide, although uncommon in the United States

 5. Hormonal problems.

Another reason for fertility issues in women is whereby your hormones continue changing consequently bringing about discharging of the ovule in the uterus.

This consequently makes the coating of the uterus thicken subsequently keeping the sperm from entering the uterus. Along these lines, no fertilization will occur.

 6. Early menopause.

This is another reason for infertility in women whereby they experience menopause before they hit the correct age. This generally happens because of the deficient supply of ovaries. In different cases, it happens to ladies who are athletic and have had low weight for the duration of their lives consequently can’t deliver enough eggs.

 7. Damaged ovaries.

If your ovaries have been harmed/damaged, it might be hard to conceive. This outcome to the failure of ovulation. A portion of the reasons for harm to ovaries includes having various medical procedures and repeated ovarian cysts which cause harm to the follicles henceforth they can’t develop.

 8. Congenital effects.

Most often, the occurrence of this problem is low, however, it may occur to some women whereby they are born with abnormalities in the uterine part, therefore, making it difficult for fertilization to take place at all.

 9. Environmental causes.

A lot of environmental factors that can lead to infertility. Some may be genetic such as damage to the DNA which makes it impossible to conceive. Other causes may be related to drug abuse that causes the body to become toxic.

10. Sexually transmitted diseases.

The sexually transmitted disease likewise influences the females’ reproductive system consequently making them unfit to imitate. A portion of the parts that are changed is the uterus which can’t enable any fertilization to occur.

11. Menopause.

As a woman, there is an expected age that your body can be fruitful, however on the off chance that you pass that age, you may have issues in getting pregnant. For a lady, you are prompted that the most recent age you can consider is 35 years as you approach 40 years you may encounter issues in getting pregnant as your body isn’t producing eggs for fertilization.

Unexplained infertility

Now and then, the reason for infertility is rarely found. A mix of a few minor factors in the two partners could cause unexplained fertility issues. Even though it’s disappointing to find no particular solution, this issue may address itself with time. Be that as it may, you shouldn’t defer treatment for infertility.

Risk factors

Certain factors may put you at higher risk of infertility, including:

  • Age. As already established, the quality and volume of a woman’s eggs begin to decline as she advances in age. In the mid-30s, the rate of follicle loss speeds, resulting in less and weaker quality eggs. This makes childbearing more difficult and increases the risk of miscarriage.
  • Smoking. Besides being a threat to your lungs, and causing severe damage to your cervix and fallopian tubes, smoking increases your risk of miscarriage and ectopic pregnancy. It’s also thought to age your ovaries and drain your eggs prematurely. If you smoke, you can consider stopping smoking before beginning fertility treatment.
  • Weight. Being overweight or significantly underweight may affect normal ovulation. Getting to a healthy body mass index (BMI) may increase the frequency of ovulation and the likelihood of pregnancy.
  • Sexual history. Sexually transmitted infections such as chlamydia and gonorrhea can damage the fallopian tubes. Having unprotected intercourse with multiple partners increases your risk of a sexually transmitted infection that may cause fertility problems later.
  • Alcohol. Stick to moderate alcohol consumption of no more than one alcoholic drink per day.

Prevention

In case you’re a lady pondering getting pregnant soon or later on, you may improve your odds of having typical fertility if you:

  • Maintain a normal weight. Overweight and underweight women are at increased risk of ovulation disorders. If you need to lose weight, exercise moderately. Strenuous, intense exercise of more than five hours a week has been associated with decreased ovulation.
  • Quit smoking. Tobacco has multiple negative effects on fertility, not to mention your general health and the health of a fetus. If you smoke and are considering pregnancy, quit now.
  • Avoid alcohol. Heavy alcohol use may lead to decreased fertility. And any alcohol use can affect the health of a developing fetus. If you’re planning to become pregnant, avoid alcohol, and don’t drink alcohol while you’re pregnant.
  • Reduce stress. Some studies have shown that couples experiencing psychological stress had poorer results with infertility treatment. If you can, find a way to reduce stress in your life before trying to become pregnant.
  • Limit caffeine. Research suggests that limiting caffeine intake to less than 200 milligrams a day shouldn’t affect your ability to get pregnant. That’s about one to two cups of 6 to 8 ounces of coffee per day.

Diagnosis

Hysterosalpingography

If you’ve been unable to conceive within a reasonable period, seek help from your health care provider for testing and treatment of infertility.

Fertility tests may include:

  • Ovulation testing. An at-home, over-the-counter ovulation prediction kit detects the surge in luteinizing hormone (LH) that occurs before ovulation. A blood test for progesterone — a hormone produced after ovulation — can also document that you’re ovulating. Other hormone levels, such as prolactin, also may be checked.
  • Hysterosalpingography. During hysterosalpingography (his-tur-o-sal-ping-GOG-rush-fee), X-ray contrast is injected into your uterus and an X-ray is taken to detect abnormalities in the uterine cavity. The test also determines whether the fluid passes out of the uterus and spills out of your fallopian tubes. If abnormalities are found, you’ll likely need further evaluation. In a few women, the test itself can improve fertility, possibly by flushing out and opening the fallopian tubes.
  • Ovarian reserve testing. This testing helps determine the quality and quantity of eggs available for ovulation. Women at risk of a depleted egg supply — including women older than 35 — may have this series of blood and imaging tests.
  • Another hormone testing. Other hormone tests check levels of ovulatory hormones as well as thyroid and pituitary hormones that control reproductive processes.
  • Imaging tests. A pelvic ultrasound looks for uterine or fallopian tube disease. Sometimes a hysterosonography (his-tur-o-Suh-NOG-rush-fee) is used to see details inside the uterus that can’t be seen on a regular ultrasound.

Though Depending on your situation, rarely your testing may include:

  • Other imaging tests. Depending on your symptoms, your doctor may request a hysteroscopy to look for uterine or fallopian tube disease.
  • Laparoscopy. This minimally invasive surgery involves making a small incision beneath your navel and inserting a thin viewing device to examine your fallopian tubes, ovaries, and uterus. A laparoscopy may identify endometriosis, scarring, blockages or irregularities of the fallopian tubes, and problems with the ovaries and uterus.
  • Genetic testing. Genetic testing helps determine whether there’s a genetic defect causing infertility.

Treatment

Infertility treatment relies upon the cause, your age, to what extent you’ve been an infertile and individual preference. Since infertility is an unpredictable issue, treatment includes noteworthy money related, physical, mental and time duties.

Albeit a few ladies need only a couple of treatments to reestablish fertility, it’s conceivable that few distinct sorts of treatment might be required.

Medicines can either endeavor to reestablish fertility through prescription or medical procedures or assist you with getting pregnant with modern methods.

Fertility restoration: Stimulating ovulation with fertility drugs

Fertility drugs manage or animate ovulation. Fertility drugs are the principal treatment for ladies who are barren because of ovulation issues.

Fruitfulness sedates by and large work like the normal hormones — follicle-animating hormone (FSH) and luteinizing hormone (LH) — to trigger ovulation. They’re additionally utilized in ladies who ovulate to attempt to animate a superior egg or an additional egg or eggs. Ripeness medications may include:

  • Clomiphene citrate. Clomiphene (Clomid) is taken by mouth and stimulates ovulation by causing the pituitary gland to release more FSH and LH, which stimulate the growth of an ovarian follicle containing an egg.
  • Gonadotropins. Instead of stimulating the pituitary gland to release more hormones, these injected treatments stimulate the ovary directly to produce multiple eggs. Gonadotropin medications include human menopausal gonadotropin or hMG(Menopur) and FSH (Gonal-F, Follistim AQ, Bravelle). Another gonadotropin, human chorionic gonadotropin (Ovidrel, Pregnyl), is used to mature the eggs and trigger their release at the time of ovulation. Concerns exist that there’s a higher risk of conceiving multiples and having a premature delivery with gonadotropin use.
  • Metformin. Metformin (Glucophage, others) is used when insulin resistance is a known or suspected cause of infertility, usually in women with a diagnosis of PCOS. Metformin helps improve insulin resistance, which can improve the likelihood of ovulation.
  • Letrozole. Letrozole (Femara) belongs to a class of drugs known as aromatase inhibitors and works similarly to clomiphene. Letrozole may induce ovulation. However, the effect this medication has on early pregnancy isn’t yet known, so it isn’t used for ovulation induction as frequently as others.
  • Bromocriptine. Bromocriptine (Cycloset), a dopamine agonist, may be used when ovulation problems are caused by excess production of prolactin (hyperprolactinemia) by the pituitary gland.

Risks of fertility drugs

Using fertility drugs carries some risks, such as:

  • Pregnancy with multiples. Oral medications carry a fairly low risk of multiples (less than 10 percent) and mostly a risk of twins. Your chances increase by up to 30 percent with injectable medications. Injectable fertility medications also carry the major risk of triplets or more (higher-order multiple pregnancies).

By and large, the more embryos you’re bearing, the greater the danger of untimely labor, low birth weight and later formative issues. Now and again modifying meds can bring down the danger of products, if an excessive number of follicles create.

  • Ovarian hyperstimulation syndrome (OHSS). Injecting fertility drugs to induce ovulation can cause OHSS, which causes swollen and painful ovaries. Signs and symptoms usually go away without treatment and include mild abdominal pain, bloating, nausea, vomiting, and diarrhea.

On the off chance that you become pregnant, be that as it may, your indications may most recent a little while. Once in awhile, it’s conceivable to build up an increasingly extreme structure of OHSS that can likewise cause quick weight increase, extended excruciating ovaries, liquid in the guts and brevity of breath.

  • Long-term risks of ovarian tumors. Most studies of women using fertility drugs suggest that there are few if any long-term risks. However, a few studies suggest that women taking fertility drugs for 12 or more months without a successful pregnancy may be at increased risk of borderline ovarian tumors later in life.

Ladies who never have pregnancies have an expanded danger of ovarian tumors, so it might be identified with the fundamental issue instead of the treatment.

Since progress rates are normally higher in the initial barely any treatment cycles, reconsidering prescription utilize like clockwork and focusing on the medications that have the most achievement have all the earmarks of being fit.

Fertility restoration: Surgery

Several surgical procedures can correct problems or otherwise improve female fertility. However, surgical treatments for fertility are rare these days due to the success of other treatments. They include:

  • Laparoscopic or hysteroscopic surgery. These surgeries can remove or correct abnormalities to help improve your chances of getting pregnant. Surgery might involve correcting an abnormal uterine shape, removing endometrial polyps and some types of fibroids that misshape the uterine cavity, or removing pelvic or uterine adhesions.
  • Tubal surgeries. If your fallopian tubes are blocked or filled with fluid (hydrosalpinx), your doctor may recommend laparoscopic surgery to remove adhesions, dilate a tube or create a new tubal opening. This surgery is rare, as pregnancy rates are usually better with IVF. For hydrosalpinx, removal of your tubes (salpingectomy) or blocking the tubes close to the uterus can improve your chances of pregnancy with IVF.

Reproductive assistance

The most commonly used methods of reproductive assistance include:

  • Intrauterine insemination (IUI). During IUI, millions of healthy sperm are placed inside the uterus close to the time of ovulation.
  • Assisted reproductive technology. This involves retrieving mature eggs from a woman, fertilizing them with a man’s sperm in a dish in a lab, then transferring the embryos into the uterus after fertilization. IVF is the most effective assisted reproductive technology. An IVF cycle takes several weeks and requires frequent blood tests and daily hormone injections.

Coping and support

Managing female infertility can be physically and genuinely debilitating. To adapt to the high points and low points of fruitlessness testing and treatment, think about these systems:

  • Be prepared. The uncertainty of infertility testing and treatments can be difficult and stressful. Ask your doctor to explain the steps for your therapy to help you and your partner prepare. Understanding the process may help reduce your anxiety.
  • Seek support. Although infertility can be a deeply personal issue, reach out to your partner, close family members or friends, or a professional for support. Many online support groups allow you to maintain your anonymity while you discuss issues related to infertility.
  • Exercise and eat a healthy diet. Keeping up a moderate exercise routine and eating healthy foods can improve your outlook and keep you focused on living your life despite fertility problems.
  • Consider other options. Determine alternatives — adoption, donor sperm or egg, or even having no children — as early as possible in the infertility treatment process. This can reduce anxiety during treatments and disappointment if conception doesn’t occur.

Preparing for your appointment

For an infertility assessment, you’ll likely observe a regenerative endocrinologist — a specialist who spends significant time in treating the issue that keeps couples from considering.

Your primary care physician will probably need to assess both you and your accomplice to distinguish potential causes and medications for barrenness.

What you can do

To prepare for your appointment:

  • Chart your menstrual cycles and associated symptoms for a few months. On a calendar or an electronic device, record when your period starts and stops and how your cervical mucus looks. Make note of days when you and your partner have intercourse.
  • Make a list of any medications, vitamins, herbs or other supplements you take. Include the doses and how often you take them.
  • Bring previous medical records. Your doctor will want to know what tests you’ve had and what treatments you’ve already tried.
  • Bring a notebook or electronic device with you. You may receive a lot of information at your visit, and it can be difficult to remember everything.
  • Think about what questions you’ll ask. List the most important questions first to be sure that they get answered.

Some basic questions to ask include:

When and how frequently would it be a good idea for us to have sex if we want to imagine?

  • Are there any way of life transforms we can make to improve the odds of getting pregnant?
  • Do you suggest any testing? Assuming this is the case, what kind?
  • Are drugs accessible that may improve the capacity to consider?
  • What symptoms can the prescriptions cause?
  • Okay, clarify our treatment alternatives in detail?
  • What treatment do you suggest in our circumstance?
  • What’s your prosperity rate for helping couples in accomplishing pregnancy?
  • Do you have any handouts or other pieces of literature that we can have?
  • What sites do you suggest visiting?

Don’t hesitate to ask your doctor to repeat information or to ask follow-up questions.

What to expect from your doctor

Some potential questions your doctor or other health care provider might ask include:

  • To what extent have you been attempting to get pregnant?
  • How regularly do you have sex?
  • Have you at any point been pregnant? Assuming this is the case, what was the result of that pregnancy?
  • Have you had any pelvic or stomach medical procedures?
  • Have you been treated for any gynecological conditions?
  • At what age did you first begin having periods?
  • All things considered, how long go between the start of one menstrual cycle and the start of your next menstrual cycle?
  • Do you experience premenstrual indications, for example, breast delicacy, stomach swelling or squeezing?
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