Female infertility is a condition in which a woman’s capacity to become pregnant and give birth is hampered or reduced in some way. This is commonly detected after one year of attempting to get pregnant for heterosexual couples (man and woman) (but maybe diagnosed sooner depending on other factors).
Female infertility, often known as “female factor” infertility, occurs when the reason for infertility is discovered to be the female partner.
What causes female infertility?
Getting pregnant can be a complicated process. Many things can go wrong during pregnancy resulting in infertility. The following list includes only some of the common causes of infertility in females.
Failure to Ovulate: The most common cause of female infertility is the failure to ovulate, occurring in 40 percent of women with infertility issues. Ovarian or gynaecological issues, ageing, diminished ovarian reserve, endocrine disorders, lifestyle and environmental factors can all contribute to not ovulating.
Problems with Menstrual Cycle: Menstrual irregularity and problems are one of the major causes of female infertility. Female infertility can be caused by issues with the menstrual cycle, which is the process that prepares the female body for conception. The menstrual cycle has multiple stages, and issues with any of them might make it difficult to get pregnant or result in infertility.
Damage to fallopian tubes: Damage to fallopian tubes is another major female infertility cause. These organs transport fertilised eggs from your ovaries to your uterus, where the baby grows. Scars from vaginal infections, endometriosis, and pelvic surgery can cause damage to the tubes. This can make it difficult for sperm to reach an egg in the tube. The egg is fertilised here before moving down to the uterus to implant.
Hormonal problems: You might not be able to conceive because your body isn’t undergoing the normal hormonal changes that lead to the release of an egg from the ovary and the thickening of the uterine lining.
Cervical problems: A disease in certain women prevents sperm from going through the cervical canal.
Uterine issues: Polyps (a growth or tumour) and fibroids may prevent you from becoming pregnant. Uterine polyps form when the endometrium, the uterine lining, grows too many cells. The uterine wall is where fibroids grow. Other uterine defects can pose problems as well.
Infertility that’s “unknown“: The actual causes of infertility difficulties are never determined for roughly 20% of couples.
Symptoms of infertility in female
The symptoms of infertility in females differ with the person. Changes in the menstrual cycle and ovulation in women may be an indication of an infertility-related condition. Among the signs and symptoms are:
- Abnormal periods
- The bleeding is more or less strong than usual
- Irregular periods. Each month, the number of days between periods fluctuates
- No periods. You’ve never had a period before, or your periods have abruptly stopped
- Painful periods. Backache, cramps, pelvic discomfort
Hormonal imbalance is another major cause of female infertility.
Symptoms in this situation may also include:
- Changes in the skin, including increased acne
- Sex drive and desire changes
- Loss of hair or thinning hair
- Weight gain
Diagnosis of female infertility
A woman will get a general physical exam, during which the doctor will inquire about her medical history, medications, menstrual cycle, and sexual behaviours.
She’ll also have a gynaecological exam and a battery of tests:
To investigate and remove undesirable tissue, your gynaecologist may insert a small tube with a camera inserted into the abdomen.
Blood test:
A blood test can be used to determine hormone levels and whether or not a woman is ovulating.
Hysterosalpingography:
Hysterosalpingography involves injecting fluid into a woman’s uterus and taking X-rays to see if the fluid moves appropriately out of the uterus and into the fallopian tubes.
Imaging tests:
A pelvic ultrasound examines the uterus and fallopian tube disease. A sonohysterogram, also known as a saline infusion sonogram, or hysteroscopy is sometimes used to view details inside the uterus that a normal ultrasound can’t show.
Laparoscopy:
Laparoscopy involves inserting a thin, flexible tube with a camera into the belly and pelvis to allow a doctor to examine the fallopian tubes, uterus, and ovaries. This can reveal symptoms of endometriosis, scarring, obstructions, and some uterine and fallopian tube anomalies.
Other tests include:
- Ovarian reserve testing is used to determine the effectiveness of the eggs following ovulation.
- Genetic testing is performed to identify if a genetic issue is interfering with fertility.
- The uterus, fallopian tubes, and ovaries are imaged using pelvic ultrasonography.
- A chlamydia test can reveal whether or not antibiotic therapy is required.
- Thyroid function tests are recommended since they may impact hormonal balance.
Treatments for female infertility
Treatment for female infertility depends on your age, causes, how long you’ve been infertile and your personal preferences. Since infertility is a complicated condition to be treated with the utmost care, the treatment involves physical, psychological, financial, and time commitments. Treatments can either be to restore fertility through medication or surgery, or they can assist you in getting pregnant using advanced techniques.
Medication:
You may be prescribed clomiphene citrate (Clomid, Serophene), gonadotropins (such as Gonal-F, Follistim, Humegon, and Pregnyl), or letrozole if you have ovulation problems.
When Clomid or Serophene fail to function, gonadotropins can help. These medicines can also help in conception by encouraging numerous eggs to be released from your ovaries.
If you have unexplained infertility or other treatments have failed to help you get pregnant, your doctor may recommend gonadotropin.
If you have insulin resistance or PCOS (Polycystic Ovarian Syndrome) another type of medication that may help you ovulate naturally is metformin (Glucophage).
Surgical Options:
Surgery is used to remove adhesions (scar tissue) or endometriosis, which restrict the fallopian tube or prevent it from picking up an egg. Advanced procedures have improved the ability to do so, generally via a minimally invasive laparoscopic approach or microsurgical reconstruction of the fallopian tubes or uterus.
A microsurgical repair can be used to reverse tubal sterilisation and has a high success rate when compared to in vitro fertilisation. In vitro fertilisation is the most practical approach when the fallopian tubes are severely damaged or unlikely to respond to surgical treatment.
In-vitro fertilisation (IVF):
In-vitro fertilisation (IVF) occurs when sperm and unfertilized eggs are combined in a petri dish and fertilised. After that, the embryo is implanted in the uterus to start a pregnancy. The embryo may be frozen for future use.
Intrauterine Insemination (IUI):
Ovulation induction and artificial insemination (IUI) can both be used simultaneously. IUI is a “low-tech” assisted reproductive technology (ART) procedure in which cleaned sperm is placed into the uterus and fallopian tubes, where fertilisation takes place.
Furthermore, this procedure avoids hostile cervical mucus and helps in the treatment of sperm count and motility issues.
Intracytoplasmic Sperm Injection (ICSI)
During an IVF process, a single sperm is injected into an egg to achieve fertilisation. For males with low sperm counts, the chances of conception increase dramatically.
GIFT (Gamete Intrafallopian Tube Transfer) and ZIFT (Zygote Intrafallopian Transfer)
GIFT (Gamete Intrafallopian Tube Transfer) and ZIFT (Zygote Intrafallopian Transfer). These methods, like IVF, include extracting an egg, mixing it with sperm in a lab, and then inserting it into the fallopian tubes right away.
In ZIFT, your doctor injects fertilised eggs (called zygotes at this stage) into your fallopian tubes within 24 hours. The sperm and eggs are combined before being implanted in GIFT.
Egg Donation:
The ovary no longer releases eggs in rare cases of early ovarian failure because the egg supply has been depleted. Although there is no cure for this ailment, it is critical to recognise it. To cope with this diagnosis, some people will seek counselling and advice.
If the woman cannot conceive with her own eggs, donated eggs may be considered.
Outlook
There are more options than ever before for couples who are having reproductive issues or who want to have children later in life. The world’s first IVF baby, Louise Joy Brown, was born in 1978. By 2014, more than 5 million people had been born as a result of IVF.
Fertility treatment is becoming more accessible to more people as new technology becomes available, and success rates and safety are always improving. Fertility therapy can be pricey, but there are programmes available to assist with this.
