1. When a Woman Is Considered to Be Infertile?
Infertility is the inability to get pregnant after a year of having sexual intercourse without protection. For women after the age of 35, infertility is considered the period after six months of trying to conceive. Women who get pregnant, but are not able to maintain the pregnancy until the end, may also be infertile.
Infertility does not affect only women. Just in one-third of the cases, infertility results because of women’s problems. Another one-third of infertility cases result from male problems, while in one-third of infertility cases there are unknown problems causing it.
2. What Causes Infertility in Women?
The main cause of infertility in women is ovulation problems. Normally, with every menstrual cycle, during ovulation an egg is released in order to be fertilized. In cases when there are problems with ovulation, there is no egg to be fertilized. Signs that show problems with ovulation include irregular menstrual periods and absent menstrual periods. The main causes of infertility in women include:
- Polycystic Ovarian Syndrome
- Primary ovarian insufficiency
- Pelvic inflammatory disease
- Blocked fallopian tubes
- Uterine abnormalities
- Uterine fibroids, etc.
There are a lot of factors that can lead or increase the chances of infertility in women, such as:
- Excess alcohol use
- Poor diet
- Athletic training
- Being overweight or underweight
- Sexually transmitted infections, etc.
With age the possibility of a woman to get pregnant decreases. This is all due to a smaller number of eggs left, the ovaries are less able to release the eggs, the eggs are not as healthy, etc.
3. How Is Infertility Diagnosed?
Diagnosing the real cause of infertility will take some time. It is a long end emotional process until all the possible tests are done. Sometimes it is very difficult to diagnose the real cause of infertility. Diagnosing infertility in a couple should start with tests for both partners. Possible examinations that can help diagnose infertility in women include:
- Physical examination
- A good anamnesis especially about the sexual life
- Ovulation monitoring – which can be performed at home by women themselves. Monitoring ovulation includes monitoring and writing down the morning body temperature for couple of months, using a home ovulation test kit or monitoring the cervical mucus for a couple of months. Ovulation can also be monitored with ultrasounds of the ovaries.
- Hysterosalpingography – is performed in order to diagnose or rule out any physical block that may stop the egg and sperm to get meet each other and get fertilizes into the Fallopian tubes.
- Laparoscopy – is performed in order to check the ovaries, the Fallopian tubes and uterus for any physical problem or possible diseases. Laparoscopy is usually performed in cases with endometriosis when scarring tissue is found.
4. How Is Infertility Treated?
Treatment for infertility can be long, expensive and not always successful. There are many treatment possibilities all depending from the cause of infertility. Treatment options include:
- Medicine – like clomiphene citrate which is used to cause ovulation by stimulating the pituitary gland, human menopausal gonadotropin (hMG) in cases when there are problems with the pituitary gland, Follicle-stimulating hormone (FSH), Gonadotropin-releasing hormone (Gn-RH) analogs for women who do not ovulate regularly every month, Bromocriptine in cases when there are high levels of prolactin, etc.
- Surgery – in cases with uterine abnormalities, endometriosis, uterine fibroids, etc.
- Artificial insemination – also known as intrauterine insemination (IUI). The procedure consists of injecting specially prepared sperms.
- Assisted reproductive technology – is a group of different methods that try to help an infertile couple get pregnant. The eggs are removed from the woman’s body, mixed with the male sperm to make an embryo which is later inserted into the woman’s uterus. Common methods of assisted reproductive technology include:
- in vitro fertilization
- zygote intrafallopian transfer
- gamete intrafallopian transfer
- Intracytoplasmic sperm injection, etc.
The best treatment for a specific case is selected based on: the period that a couple has been trying to get pregnant, the age of both men and women, test results, possible chronic conditions and overall health of both partners, etc.