Female infertility

Infertility is defined as trying to get pregnant (having regular unprotected sex) for at least 1 year without success. About 1/7 couples will experience difficulty getting pregnant and in around 25% of these, no cause will ever be identified. Women under 30 years old have about a 20% chance of getting pregnant naturally each month and this reduced to 5% in women aged over 40. The most common cause of infertility in women is problems with ovulation. Fertility is influenced by a number of factors and investigations begin with a full medical history and ultrasound scan before further treatments are considered.

Female infertility causes are varied and include the following:

• Problems with ovulation
• Problems with the uterus, fallopian tubes or cervix
• Infections
• Medicines and illicit drugs
• Sterilisation

Blocked fallopian tubes are a common cause of infertility, which occurs after inflammation of internal sex organs (uterus, fallopian tubes, and ovaries). Fallopian tubes may get blocked, become narrow, or bent, thus creating anatomical obstacles in the fallopian tubes that prevent the eggs from travelling and becoming fertilised by sperm.

Endocrinological infertility is caused by problems with ovulation – formation of a follicle and failing in the middle menstrual cycle due to altered endocrinological gland functions (hypothalamus, pituitary gland, adrenal gland and thyroid gland).

Inherited or acquired anatomical sex organ changes manifests as amenorrhea (absence of menstruation), various menstrual cycle disorders, abortions, damaged lining of the uterus, inflammation of lining of the uterus, chronic inflammation of the fallopian tubes and ovaries, and deformed uterine cavity. Finally, infertility can be caused by ondometriosis and PCOS, when ovulation cannot occur.

Immunological infertility occurs when a woman develops immunity against male sex cells by creating specific antisperm antibodies.

However sometimes, the cause of infertility remains unknown.

Infertility is defined as a couple who cannot conceive after 1 year of regular, unprotected sex. The cause of infertility could be with the woman, the man or sometimes with both.

Infertility tests (women):

• Transvaginal ultrasound is done in order to evaluate anatomical position of the inner sex organs, ovary condition and thickness of the lining of the uterus.
• If tubal factor infertility is suspected, HysteroSalpingo Contrast Sonography (HyCoSy) and other tests are done to investigate the condition of fallopian tubes.
• Patient’s close relatives’ (mother, sisters) history of pregnancies, birth complications and childhood and adolescence diseases, puberty disorders, first period and beginning of sex life.
• Vaginal analysis, laboratory (blood, urine) tests and special tests to determine chronic inflammation of sex organs are done.
• Oestrogen, gestagen, prolactin, pituitary gland secreted blood hormone levels, 17-ketosteroid levels in urine
• The examination of both partners starts simultaneously.

There are 3 main types of fertility treatment –

Medicines – There are several medicines which can be used, depending on the cause of infertility. Most of the medicines work by stimulating ovulation.

Surgery – There are surgical procedures which can be done to clear blockages to fallopian tubes, treat PCOS or endometriosis or remove fibroids/polyps/cysts.

Assisted conception – Commonly known as IVF or IUI, or egg and sperm donation.

• IVF – is when an egg is fertilised outside of the body in a laboratory and then placed in the womb. Usually, fertility medicines are taken as part of this treatment.
• IUI – is when sperm are inserted into the womb artificially. The sperm are first collected and the best quality ones are selected.
• Egg and sperm donation – Either eggs, sperm or both can be donated and placed in to the womb using IVF.

Patients can increase their chances of getting pregnant by making sure both they and their partner are in good health. Treating conditions like diabetes, asthma and obesity, maintaining a health body weight, stopping smoking, reducing or stopping alcohol consumption and reducing stress can all improve fertility.

Fertility specialists at Northway Clinic are well prepared to help to treat infertility and other diseases related to women’s health.