Infertility is a condition that affects approximately 1 in every 6 couples and can be from either the man or the woman but for this article, we will focus on the woman.
When the cause of infertility exists within the female partner, it is referred to as Female Infertility and contributes to approximately 50% of all infertility cases.
Common Causes of Female Infertility
There are many reasons why women experience difficulty in conceiving. Let’s discuss below five common causes;
A woman’s age is the most significant factor influencing her fertility. As women age their fertility declines.
A woman’s fertility starts to decline in her early 30s, with the decline speeding up after 35. At 40 a woman only has a 5% chance of becoming pregnant in any month. This is because a woman is born with all the eggs she is going to have in her lifetime. As she ages her eggs age with her, decreasing in quality and number.
2. Polycystic ovarian syndrome (PCOS)
PCOS is a hormone imbalance which results in disrupted menstrual and ovulation cycles. It is the most common cause of infertility due to anovulation (no ovulation or egg is released). The name of the condition comes from the presence of tiny cysts on the outside of the ovaries. While many women have polycystic ovaries, not all women have the polycystic ovarian syndrome. Women with PCOS have additional symptoms including irregular periods, excess weight (particularly in the tummy area), excess hair on the face and body, acne and male pattern baldness. It is estimated that 30% of infertile women suffer from PCOS.
This is a condition in which the tissue that lines the uterus (endometrial tissue) grows in other parts of the body, usually in the pelvis. This stray endometrial tissue bleeds in the same way as the lining of the uterus during menstruation, except that the blood/tissue is trapped causing irritation and inflammation. Scar tissue can form resulting in adhesions which can stick pelvic structures together. Endometriosis can affect fertility by damaging the ovaries so that ovulation cannot occur. Similarly, damage and/or blockages to the inside of the fallopian tubes can impede the journey of the egg to the uterus. It can also have an impact on the lining of the uterus, affecting the implantation of a fertilised egg.
A woman’s weight is an important consideration in her fertility. Women who are underweight and/or have a low percentage of body fat (ie., athletes) can experience irregular menstrual cycles and issues with ovulation. Being overweight or obese can also interfere with normal menstruation and ovulation. In addition, overweight and obese women also have a higher risk of miscarriage and other pregnancy complications and a lower success rate with infertility treatments such as IVF.
5. Sexually transmitted infections (STIs)
If STIs such as chlamydia or gonorrhea is left untreated, it can lead to Pelvic Inflammatory Disease (PID) thus scarring in the fallopian tubes which can narrow them, blocking the path of the egg. If a fertilised egg becomes trapped in a blocked fallopian tube an ectopic pregnancy can occur (where the fetus develops outside the uterus). This is a serious, potentially life-threatening health condition that requires immediate medical attention. Studies suggest that one episode of PID decreases a woman’s chance of a successful pregnancy by 10%. After two or more episodes of PID, a woman’s risk of becoming infertile is about 50%.
If you’ve been unable to conceive after trying continuously for up to one year, seek help from your Doctor or Fertility Expert for evaluation and treatment of infertility.
Fertility tests may include:
1. Ovulation testing. An at-home, over-the-counter ovulation prediction kit detects the surge in luteinizing hormone (LH) that occurs before ovulation.
2. Hormone profile: A blood test for Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), Estradiol (E2), Progesterone and Prolactin.
3. Hysterosalpingography(HSG): To check Tubal Patency
4.Ovarian Reserve Testing. This testing helps determine the quality and quantity of eggs available for ovulation especially for women older than 35.
5. Pelvic Ultrasound to check for PID or uterine tumours or cysts.
6. Tests for STIs such as High Vaginal Swab and Urine MCS tests.
These will go a long way in determining the cause infertility and solving it.
Until next time, Fertility Blessings to you