Female infertility is the inability to conceive, even after having frequent intercoursefor around an year, in case the infertility is a resultant of female related factors. This condition affects lakhs of couples in India and around the world.
In fact, almost one-third of total infertility cases are caused due to female related problems.
Before going into the causes, we first need to understand the process of successful fertilization. In general, to conceive these factors are essential: the female needs to ovulate, her partner should have healthy sperms, the couple should have regular intercourse, and the female needs to have open fallopian tubes and a normal uterus. Further, each of the following steps should have taken place correctly. First, ovary delivers a mature egg. Second, the fallopian tube collects the egg. Third, the sperm reaches the egg for fertilization. And fourth, the fertilized egg moves to the uterus and grows there. Now, in a female, there can be many reasons that may disrupt this process at any step, which then may result in female infertility.
The prominent causes of female infertility are as listed below:
Female’s age: An advancing maternal age is related to a deterioration in egg quality and functioning. We are increasingly getting cases of female infertility in older age women, in their late thirties or forties.
Ovulation problems: These occur when a female is not able to release a mature egg, required to get pregnant naturally. It could be due to many reasons such as polycystic ovary syndrome (PCOS), hypogonadotropic hypogonadism, Hypothalamic dysfunction,Premature ovarian failure, prolactin excess, and ovarian insufficiency.
Fallopian tube blockage: Also called tubal occlusion, it leads to infertility since an ovulated egg is not able to get fertilized by a sperm or reach the endometrial cavity. It could be in one or both tubes, and in the latter case, IVF may be needed. While in the former case, laparoscopy or hysteroscopy may remove the blockage.
Endometriosis: This takes place if the tissue that otherwise grows in the uterus implants and grows in other locations. This may block fallopian tubes or affect the uterus lining or may affect the egg and sperm as well.
Uterine or cervical causes: These may also impact fertility such as benign polyps or fibroids in the uterus, endometriosis inflammation inside the uterus, uterine abnormalities by birth, like in its shape or a narrowing of the cervix.
Prevention of female infertility is certainly possible in many cases. If we understand the risk factors, that may lead to female infertility beforehand, and try to avoid them,there is a big chance that a couple will conceive easily without any medical intervention. These risk factors are as follows:
So prevention tips could be maintaining a normal weight, quitting to smoke/take drugs/heavy alcohol/too much coffee and lowering overall mental stress, keeping up good personal hygiene and health practices and going for annual check-up with your gynaecologist once you get sexually active.
The first part of the diagnosis is usually a careful physical examination. Then, the female’s history is understood in detail with respect to parameters such as menstrual cycle, for how long is she trying to conceive, frequency of intercourse, any past pregnancies/miscarriages, any history of sexually transmitted infections, any other medical conditions, prior surgeries, and family medical history.
Based on this diagnosis, some tests may be done to evaluate the exact cause infertility in the female. Some of them are as mentioned below:
Blood tests: These could be for hormones (like estradiol or FSH), connected with ovary health, TSH for thyroid function or prolactin, for menstrual health.
Hysterosalpingogram: Undertaken to determine the fitness of fallopian tubes, uterine filling and uterine cavity.
Ultrasound: A Transvaginal ultrasound could be done to check the composition of uterus, fallopian tubes and ovaries.
Endometrial Biopsy: This test could be done to inspect the uterus lining.
Laparoscopy: This procedure could be done to view the exteriors of uterus, ovaries, and fallopian tubes for any growth or blockage.
Our doctors generally recommend that if the female’s age is below 35, try to conceive for at least one year, without any tests or treatment. Between 35 to 40 years of female’s age, we might suggest the patient to do the same for six months. On the other hand, if the female’s age is 40 plus, we might begin the tests and treatment straight away.The tests may also begin immediately in case the female has known fertility problems, or irregular periods, pelvic inflammation, miscarriages or endometriosis.
Depending on the cause diagnosed for female infertility, specific treatments are available at our modern and latest fully equipped facilities. Some of the suggested treatments are as listed here:
Medication – This could be suggested to resolve ovulation problems. It is prescribed through pills or injections.
Laparoscopy – This might be a treatment for patients with tubal or pelvic diseases and helps reconstruct reproductive organs.
Hysteroscopy – It could be suggested to remove polyps and fibroids or open up blocked tubes.
In vitro fertilization (IVF) – An embryo, earlier fertilized in a dish, is placed in the uterus.
ICSI (intracytoplasmic sperm injection) – A sperm is artificially injected into the egg and then placed inside the uterus.
GIFT (gamete intrafallopian tube transfer) and ZIFT (zygote intrafallopian transfer) – Here an egg is retrieved, combined with the, and then put in the female body.
Insemination – Here a sperm is washed and placed into the uterus, bringing it closer to the tubes and egg.
Egg donation – Here eggs are taken from a donor for a female whose ovaries are problematic but uterus is normal. Eggs are fertilized and then placed in the healthy uterus.