Infertility affects millions of couples around the world. Many couples struggle for years to get pregnant, regardless of age, ethnicity, religious background or financial status. The ability to conceive and sustain a pregnancy is a complex process that relies on several factors for success. Infertility is defined as a condition that affects the ability to successfully achieve conception.
Many people mistakenly assume that the woman has the underlying condition that leads to problems with fertility. Female infertility, in which the infertility is a direct result of the woman only, accounts for only one-third of infertility cases. Of the remaining cases, male infertility is responsible for one-third of all cases, and combined fertility conditions or unknown causes make up the other one-third.
Female infertility occurs when the woman has an underlying condition that prevents her body from conceiving and successfully maintaining a pregnancy. Female infertility includes not only the inability to get pregnant, but also the inability to have a viable pregnancy. Repeat miscarriages that occur during the first and second trimester are forms of infertility.
There are numerous conditions that can affect a woman’s ability to conceive. The most common factor in female infertility is a condition that interferes with ovulation. Ovulatory dysfunction is a hormonal disorder that prevents the ovaries from releasing eggs regularly. This condition can occur as a result of many possible underlying causes, including obesity, poor nutrition, pituitary tumors and hormonal imbalance.
Blocked fallopian tubes prevent the egg from traveling to the uterus after it has been released from the ovary. Blocked fallopian tubes can occur for unknown reasons; however, this usually occurs as a result of endometriosis or pelvic inflammatory disease.
Congenital abnormalities in the structure of the woman’s uterus can interfere with her ability to carry a baby to full term, and may lead to repeat miscarriages. Another common cause for recurring miscarriages is the presence of fibroids within the uterus.
Advanced maternal age is a common cause for infertility that affects couples in their mid-thirties and older. Once a woman reaches the age of 35, ovulatory function declines dramatically. This results in a decreased ability for the ovaries to release eggs. Advanced maternal age can also have a negative effect on the quality of the eggs that are released. Many eggs may have genetic defects that result in a miscarriage even if the egg is successfully fertilized.
Unexplained infertility accounts for roughly 10 percent of infertility cases. Unexplained infertility does not mean that there is no cause for infertility; it means that the underlying cause has not yet been detected. Fortunately, most couples will eventually discover an underlying cause that can be addressed in hopes of successfully conceiving. Sometimes all that is needed is more time. Many couples who have been diagnosed with unexplained infertility have successfully conceived and delivered a baby after many years of trying.
Factors that can put women at risk for female infertility include advanced maternal age, alcohol and tobacco use, high stress levels, being overweight, being underweight, poor nutrition and an overall unhealthy lifestyle.
Most doctors will prefer to use the least invasive method to help couples conceive. The most common type of non-surgical infertility treatment is hormone therapy. This involves the use of medications to help induce ovulation and prepare the woman’s body for successful implantation of a fertilized egg. Theses medication cycles are often used several times, if necessary, before advancing to more invasive, surgical techniques.
Assisted reproductive technologies, such as Intrauterine Insemination (IUI) is often used in conjunction with hormone therapy to maximize the chances of conception.
In addition, most doctors will instruct women on the importance of maintaining a healthy lifestyle. This includes moderate exercise, a nutritious diet, limiting stress, employing relaxation techniques and avoiding alcohol and cigarettes.
Women of advanced maternal age may wish to skip non-surgical treatments and instead opt for more aggressive infertility treatment because of the decline in fertility and the limited time factor involved.
There are a variety of surgical treatments that can be used to treat underlying conditions in the woman’s body that may interfere with a successful pregnancy. This includes surgical procedures to unblock fallopian tubes, repair structural abnormalities of the uterus, remove uterine fibroids and to scrape away excess scar tissues from prior surgeries. Laparoscopic procedures, in which a thin camera is inserted into the uterus, can be performed to detect unknown causes of infertility.
Couples who have been unable to conceive should schedule an appointment with their physician after 12 months of trying. Women over the age of 35 may wish to schedule a visit with their doctor even sooner. The American society of Reproductive Medicine recommends that women over the age of 35 should seek medical advice after 6 months of trying to conceive.
During your visit, your doctor will give both you and your partner a detailed health history questionnaire. It will include general health questions, as well as questions about your sexual history. You will both be asked to provide details about the number of sexual partners you had in the past, past birth control methods, any history of sexually transmitted diseases, your recreational drug use, etc. It is important to answer all questions honestly, as this will help your doctor recognize possible factors that may be contributing to your infertility.
You will have your weight and blood pressure checked. Your doctor will likely inquire about your eating habits, any fluctuation in weight, whether or not you smoke or drink alcohol and your emotional health. Blood tests will be ordered to check your hormone levels and for any possible underlying conditions.