Female infertility

What is female infertility?

 

Female infertility is defined as the inability to conceive after one year of regular unprotected sexual intercourse for women under 35, or after six months for women over 35. It can also refer to the inability to carry a pregnancy to full term.

 

For a pregnancy to occur, a sequence of events must happen: the release of an egg from the ovaries, its successful travel through the fallopian tubes, and fertilisation by a sperm. The fertilised egg must then implant in the uterus for the pregnancy to develop. Any disruption in this sequence can lead to infertility.

 

Infertility doesn’t necessarily mean a woman can’t conceive; it may indicate challenges in achieving or maintaining a pregnancy due to underlying factors affecting reproductive health.

 

 

What are the most common causes of female infertility?

 

Several medical conditions and biological factors can contribute to infertility in women. The most common causes include:

 

Ovulation disorders

Conditions like polycystic ovary syndrome (PCOS), hormonal imbalances, and premature ovarian insufficiency can disrupt the release of eggs from the ovaries.

 

Endometriosis

Endometriosis is a condition where the tissue that lines the uterus grows outside it, causing pain, inflammation, scarring, and blockages that affect fertility.

 

Fallopian tube damage or blockage

Damage caused by pelvic inflammatory disease, endometriosis, or previous surgeries can block the fallopian tubes, preventing fertilisation.

 

Uterine abnormalities

Issues like fibroids, polyps, or congenital uterine malformations in the uterus can interfere with the implantation of the fertilised egg and increased the risk of miscarriage.

 

In some cases, no clear cause for infertility is found. This is referred to as unexplained infertility and accounts for about 10-20% of cases.

 

Is age also a factor in female infertility?

 

Age is one of the most significant factors in female infertility. Women are born with a limited number of eggs, and both the quantity and quality of these eggs diminish over time. Fertility begins to decline in the late 20s and early 30s, with a more pronounced drop after age 35. By the age of 40, the likelihood of natural conception is low.

 

As egg quality declines, the risk of chromosomal abnormalities also increases, which can lead to miscarriage or genetic disorders. Women in their late 30s or 40s who are trying to conceive are advised to seek fertility guidance early to evaluate their options.

 

How is female infertility diagnosed?

 

Diagnosing female infertility involves a comprehensive evaluation of a woman’s medical history, lifestyle, and reproductive health. The process may include:

 

Medical history and physical examination

Questions about menstrual cycles, sexual history, and present or previous medical conditions help guide further testing. In some cases, a physical examination can also include a pelvic examination.

 

Hormone testing

Blood tests measures hormone levels that regulate ovulation, such as follicle-stimulating hormone (FSH), luteinising hormone (LH), and anti-Müllerian hormone (AMH), which indicates ovarian reserve.

 

Imaging studies

A pelvic ultrasound can identify structural abnormalities in the ovaries, uterus, or fallopian tubes. Additionally, a hysterosalpingography is a specialised imaging test that uses X-rays and a contrast dye to assess whether the fallopian tubes are open and the uterine cavity is normal.

 

Laparoscopy

Laparoscopy is a minimally invasive technique that can be used to examine the pelvis for conditions like endometriosis.

 

 

What fertility treatments are available for female infertility?

 

Treatment is determined by the underlying cause of infertility, as well as the woman’s age and personal choice. Common fertility treatments include:

 

Medications

Drugs like clomiphene citrate can help stimulate ovulation in women with ovulation disorders. In some cases, injectable hormones may also be prescribed.

 

Intrauterine insemination (IUI)

IUI is a procedure that involves placing sperm directly into the uterus during ovulation to increase the chances of fertilisation.

 

In vitro fertilisation (IVF)

In IVF, eggs are collected from the ovaries and fertilised with sperm in a laboratory. The resulting embryos are then implanted in the uterus. IVF is an option for many causes of infertility, including blocked fallopian tubes, severe endometriosis, or unexplained infertility. In some cases, intracytoplasmic sperm injections is a technique used in conjunction with IVF, where a single sperm is injected directly into an egg to facilitate fertilisation.

 

Egg or embyo donation

For women with poor egg quality or premature ovarian failure, donor eggs or embryos can help achieve pregnancy.

 

Can surgery improve chances of conception?

 

Yes, surgical interventions can enhance fertility in specific situations when less invasive treatments have failed. Advanced procedures can address structural abnormalities and remove obstructions. Examples include:

 

Laparoscopy

Laparoscopy can be used to treat conditions like endometriosis or repair blocked fallopian tubes.

 

Hysteroscopy

Hysteroscopy is a procedure used to remove uterine abnormalities like fibroids or polyps to improve implantation and reduce the risk of miscarriage.

 

Tubal surgery

In cases of tubal blockage or damage, tubal surgery is used to repair or clear them.

12-11-2024
Top Doctors

Female infertility

What is female infertility?

 

Female infertility is defined as the inability to conceive after one year of regular unprotected sexual intercourse for women under 35, or after six months for women over 35. It can also refer to the inability to carry a pregnancy to full term.

 

For a pregnancy to occur, a sequence of events must happen: the release of an egg from the ovaries, its successful travel through the fallopian tubes, and fertilisation by a sperm. The fertilised egg must then implant in the uterus for the pregnancy to develop. Any disruption in this sequence can lead to infertility.

 

Infertility doesn’t necessarily mean a woman can’t conceive; it may indicate challenges in achieving or maintaining a pregnancy due to underlying factors affecting reproductive health.

 

 

What are the most common causes of female infertility?

 

Several medical conditions and biological factors can contribute to infertility in women. The most common causes include:

 

Ovulation disorders

Conditions like polycystic ovary syndrome (PCOS), hormonal imbalances, and premature ovarian insufficiency can disrupt the release of eggs from the ovaries.

 

Endometriosis

Endometriosis is a condition where the tissue that lines the uterus grows outside it, causing pain, inflammation, scarring, and blockages that affect fertility.

 

Fallopian tube damage or blockage

Damage caused by pelvic inflammatory disease, endometriosis, or previous surgeries can block the fallopian tubes, preventing fertilisation.

 

Uterine abnormalities

Issues like fibroids, polyps, or congenital uterine malformations in the uterus can interfere with the implantation of the fertilised egg and increased the risk of miscarriage.

 

In some cases, no clear cause for infertility is found. This is referred to as unexplained infertility and accounts for about 10-20% of cases.

 

Is age also a factor in female infertility?

 

Age is one of the most significant factors in female infertility. Women are born with a limited number of eggs, and both the quantity and quality of these eggs diminish over time. Fertility begins to decline in the late 20s and early 30s, with a more pronounced drop after age 35. By the age of 40, the likelihood of natural conception is low.

 

As egg quality declines, the risk of chromosomal abnormalities also increases, which can lead to miscarriage or genetic disorders. Women in their late 30s or 40s who are trying to conceive are advised to seek fertility guidance early to evaluate their options.

 

How is female infertility diagnosed?

 

Diagnosing female infertility involves a comprehensive evaluation of a woman’s medical history, lifestyle, and reproductive health. The process may include:

 

Medical history and physical examination

Questions about menstrual cycles, sexual history, and present or previous medical conditions help guide further testing. In some cases, a physical examination can also include a pelvic examination.

 

Hormone testing

Blood tests measures hormone levels that regulate ovulation, such as follicle-stimulating hormone (FSH), luteinising hormone (LH), and anti-Müllerian hormone (AMH), which indicates ovarian reserve.

 

Imaging studies

A pelvic ultrasound can identify structural abnormalities in the ovaries, uterus, or fallopian tubes. Additionally, a hysterosalpingography is a specialised imaging test that uses X-rays and a contrast dye to assess whether the fallopian tubes are open and the uterine cavity is normal.

 

Laparoscopy

Laparoscopy is a minimally invasive technique that can be used to examine the pelvis for conditions like endometriosis.

 

 

What fertility treatments are available for female infertility?

 

Treatment is determined by the underlying cause of infertility, as well as the woman’s age and personal choice. Common fertility treatments include:

 

Medications

Drugs like clomiphene citrate can help stimulate ovulation in women with ovulation disorders. In some cases, injectable hormones may also be prescribed.

 

Intrauterine insemination (IUI)

IUI is a procedure that involves placing sperm directly into the uterus during ovulation to increase the chances of fertilisation.

 

In vitro fertilisation (IVF)

In IVF, eggs are collected from the ovaries and fertilised with sperm in a laboratory. The resulting embryos are then implanted in the uterus. IVF is an option for many causes of infertility, including blocked fallopian tubes, severe endometriosis, or unexplained infertility. In some cases, intracytoplasmic sperm injections is a technique used in conjunction with IVF, where a single sperm is injected directly into an egg to facilitate fertilisation.

 

Egg or embyo donation

For women with poor egg quality or premature ovarian failure, donor eggs or embryos can help achieve pregnancy.

 

Can surgery improve chances of conception?

 

Yes, surgical interventions can enhance fertility in specific situations when less invasive treatments have failed. Advanced procedures can address structural abnormalities and remove obstructions. Examples include:

 

Laparoscopy

Laparoscopy can be used to treat conditions like endometriosis or repair blocked fallopian tubes.

 

Hysteroscopy

Hysteroscopy is a procedure used to remove uterine abnormalities like fibroids or polyps to improve implantation and reduce the risk of miscarriage.

 

Tubal surgery

In cases of tubal blockage or damage, tubal surgery is used to repair or clear them.

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