Infertility is the inability of a couple to get pregnant and give birth to a child after trying (frequent intercourse without contraception) for one year with no success.
Frequent intercourse without birth control usually results in pregnancy:
- For 50% of couples, within 3 months
- For 75% of couples, within 6 months
- For 90% of couples, within 1 year
When the cause of infertility in a couple is found to come from the female partner, it is known as female infertility or “female factor” infertility. Women who can get pregnant but are unable to stay pregnant are also known as infertile.
Infertility is not always a woman’s problem. Both women and men can be infertile. However, women’s issues cause about one-third of infertility cases.
How To Identify Signs and Symptoms of Infertility?
The main symptom of infertility is the inability to get pregnant. This can be due to problems with the menstrual cycle or ovulation, such as
- Menstrual cycle ≥ 35 days
- Menstrual cycle < 21 days
- Irregular or absent menstrual cycle (signs of not ovulating)
Steps to achieve successful pregnancy (fertilization) include:
Step-1 One of the two ovaries releases a mature egg.
Step-2 The egg is picked up by the fallopian tube.
Step-3 Sperm swims up the cervix, through the uterus, and into the fallopian tube to reach the egg for fertilization (conception).
Step-4 The fertilized egg travels down the fallopian tube to the uterus.
Step-5 The fertilized egg attaches (implants) to the inside of the uterus and grows.
Causes of Female Infertility
In women, several factors can disrupt the process of achieving pregnancy at any step. Female infertility is caused by the following:
Problems with the uterus: Conditions such as polyps, fibroids, septum (present at birth), or adhesions (due to a surgical procedure) inside the uterus cavity.
Problems with the fallopian tubes: Pelvic inflammatory disease, usually caused by certain bacterial infections, can damage the tubes leading to fallopian tube-related infertility. History of surgery to the tubes may also cause infertility.
Problems with ovulation: Few factors that affect ovulation include hormonal imbalances (PCOS (Polycystic Ovary Syndrome)), substance abuse, thyroid conditions, severe stress, tumors in the brain, etc.
Problems with egg number and quality: Women are born with a defined count of eggs. Chromosomal abnormalities in the egg may lead to infertility, or older age may affect the quality of the eggs.
Unexplained infertility: Some women have “unexplained” or “multifactorial” infertility where the cause is unknown and may be due to a combination of multiple factors.
Who Is at A Higher Risk of Female Infertility?
Many factors can increase the risk of female infertility in women. Some of the factors include:
- Age (above 35)
- Abnormal menstrual cycle
- Obesity or being underweight
- Structural problems in the female reproductive system
- Uterine fibroids
- Cysts and tumors
- Autoimmune disorders (lupus, rheumatoid arthritis, etc.)
- Sexually transmitted infections (STIs)
- Polycystic Ovary Syndrome (PCOS)
- Excessive substance use (heavy drinking and smoking)
- A past ectopic (tubal) pregnancy
Diagnosis of Female Infertility
Your doctor may advise some tests to diagnose female infertility. These tests include:
- An overall physical examination
- A Pap smear test
- Blood tests (hormonal tests)
- X-ray hysterosalpingogram (HSG) (To check for any blockages in the path from the cervix to fallopian tubes)
- Laparoscopy (a laparoscope (a tiny device) is inserted into the abdomen to look at the organs)
- Transvaginal ultrasound (An ultrasound wand is inserted into the vagina for a better view of organs like the uterus and ovaries)
- Saline sonohysterogram (SIS) (Looks at the lining of the uterus to assess for polyps, fibroids, or other structural abnormalities)
- Hysteroscopy (test done to view the inside of the uterus)
How Is Female Infertility Treated?
Infertility treatment depends on multiple factors such as the cause, your age, how long you have been infertile and personal preferences.
Treatments can restore fertility through medication or surgery or help you get pregnant with assisted techniques.
Some of the treatment strategies for infertility include:
Medications: Medications that can help regulate or stimulate ovulation are known as fertility drugs. Fertility drugs are the choice of treatment for infertile women who are infertile with ovulation disorders.
Surgery: Several surgical procedures to correct structural problems in the female reproductive system can improve female fertility.
Reproductive assistance: Intrauterine insemination (IUI) (artificially injecting sperm into the woman to achieve conception) and other assisted reproductive technologies, like In-vitro fertilization (IVF), are known to have a high success rate in achieving pregnancy.
