CONDITIONS
Female Fertility
Understanding Female Fertility and Pregnancy Challenges
What is female fertility?
Female fertility refers to a woman’s ability to conceive and carry a pregnancy to full term. It involves various factors, including the release of a healthy egg from the ovaries, the presence of open and healthy fallopian tubes for fertilization, and a receptive uterine environment for the implantation of a fertilized egg. Hormonal balance, ovarian function, and overall reproductive health are essential in female fertility.
What causes female fertility problems?
The factors that can have an impact on female fertility include:
- Difficulties in ovulation, also known as releasing eggs or irregular menstrual cycles, can be caused by hormone-related disorders. These disorders incorporate polycystic ovary syndrome, elevated levels of prolactin hormone, and thyroid issues. Additionally, poorly managed diabetes and certain autoimmune diseases like lupus can also impact ovulation and menstrual regularity.
- Uterine or cervical disorders include various conditions, including the presence of abnormal growths within the uterus, such as polyps or fibroids.
- Endometriosis is a disease where the tissue that forms the lining of the uterus grows outside of the uterine cavity.
- Primary ovarian insufficiency, also known as early menopause, refers to the condition where the ovaries stop functioning and menstrual periods cease before the age of 40.
- Pelvic or uterine adhesions. These bands of scar tissue bind organs together and can happen after pelvic infection, appendicitis, or abdominal or pelvic surgery.
- Aging can decrease the likelihood of successful conception for women who delay trying to get pregnant. As women approach their 40s, they experience a faster reduction of eggs and a decrease in egg quality, reducing the chances of fertility.
What is the best way to boost fertility?
- Maintain a healthy weight: Being overweight or obese can cause women to produce too much oestrogen, which can interfere with ovulation, and being underweight can cause the body to stop making oestrogen, which can also impact ovulation.
- Moderate exercise: Participation in moderate exercise has been shown to improve both female and male fertility. It also helps regulate menstrual cycles. But participating in vigorous physical activity may decrease fertility in women who are at a normal weight.
- Avoid tobacco and too much alcohol. Both smoking and alcohol may have a negative impact on fertility.
- Consider taking multivitamins: Studies have found that B vitamins, including B1, B2, B6, B12, folic acid, and niacin, are linked to a decreased risk of ovulatory infertility. A lack of these vitamins may be connected to fertility issues. These nutrients are typically found in multivitamins and prenatal supplements.
- Working on managing stress
- Avoid environmental toxins: There are many toxins in the environment. These include pesticides, dry-cleaning solvents, and lead. They can harm fertility.
What is female infertility?
Female infertility refers to the inability of a woman to conceive and carry a pregnancy to full term, even after engaging in regular and unprotected sexual intercourse with a male partner for a year or longer.
An infertility diagnosis is usually made after:
- Six months of trying to conceive for women over 35 years old.
- One year of trying to conceive for women younger than 35 years old.
One in every fifteen Indian couples struggles with infertility. The issue is exacerbated by late marriages, demanding lifestyles, obesity, excessive consumption of fast food, smoking, and drinking.
What are the types of female infertility?
There are two types of infertility:
- Primary infertility refers to the difficulty of conceiving for someone who has never conceived a child before.
- Secondary infertility refers to the inability to conceive again after having had one or more pregnancies in the past.
How is female infertility diagnosed?
The doctor may recommend various tests to determine the cause of infertility.
- Blood tests to assess the hormonal levels and determine if hormone imbalance is the reason for infertility.
- Ultrasound scans are conducted to check the ovaries and uterus for structural abnormalities or conditions such as endometriosis or fibroids.
- Laparoscopy is a minimally invasive surgical technique that involves the use of a laparoscope, which is a fiber-optic tube equipped with a light source and video camera. This instrument is inserted through two or more small incisions, typically made near the belly button. Through this procedure, the surgeon can visually inspect the pelvic reproductive organs and the pelvic cavity.
- A hysterosalpingogram (HSG) can be utilized to check for blocked fallopian tubes by injecting dye into the uterus and fallopian tubes and taking an X-ray to observe the flow of the dye through the tubes.
What is a treatment for female infertility?
Treatment options for female infertility depend on the cause and may include timed intercourse, ovulation induction (using hormone treatment), surgery, and assisted reproductive technologies (ART) such as in-vitro fertilization (IVF).
Timed intercourse
Timed intercourse is often the first choice for many couples trying to conceive, especially when the male has good sperm count and motility, the female has healthy fallopian tubes, and both partners can have intercourse. The couple tracks the woman’s ovulation cycle and has intercourse during her fertile window.
Ovulation induction
Irregular or missing menstrual cycles typically indicate irregular or absent ovulation. Ovulation can be stimulated using various medications, either in tablet or injectable form. Clomiphene citrate (Clomid, Serophene) is an oral medication that can enhance the release of hormones from the brain, thereby promoting ovulation.
Alternatively, injectable forms of hormones can be administered to encourage the ovaries to mature and release an egg, effectively stimulating ovulation. Blood tests and ultrasound examinations closely monitor the response to these hormones.
Surgery
Female infertility can be caused by obstructions within the reproductive organs. Some of the problems that can be addressed through surgery include:
- Fibroids: These are non-malignant tumours that grow inside the uterus.
- Polyps: Small protrusions that grow out of the lining of the uterus.
- Endometriosis: The growth of endometrial tissue outside the uterus, which can block the fallopian tubes.
- Ovarian cysts fluid-filled sacs that develop either within an ovary or on its surface.
Currently, most reproductive surgeries are performed using keyhole surgery techniques. This involves the use of a laparoscope through the abdomen or a hysteroscope through the cervix and into the uterus. However, in some instances where keyhole surgery is not feasible, open surgery (a surgical incision in the abdomen) may be necessary.
Assisted reproductive technologies (ART)
IVF (in-vitro fertilization) and ICSI (intracytoplasmic sperm injection) are forms of assisted reproductive treatment (ART) in which eggs are fertilized with sperm outside the body. IVF is used to treat female infertility and unexplained infertility, while ICSI is used when male infertility is the cause. In IVF, mature eggs are collected from ovaries and fertilized by sperm in a lab. Two to five days later, an embryo is transferred to the woman’s uterus using a slender tube inserted through the cervix. With ICSI, a single sperm is injected into a mature egg. If multiple embryos are obtained, they can be cryopreserved for future use. Cryopreservation is a widely used method for long-term storage of cells or tissues at an extremely low temperature such as −80°C or even lower.
Can female infertility be prevented?
Most types of female infertility cannot be predicted or prevented. However, lifestyle modifications can help control some of the risk factors that contribute to infertility.
- Reducing alcohol consumption.
- Quitting smoking.
- Maintaining a healthy weight.
- Developing a good exercise routine.
- Preventing and treating sexually transmitted diseases
- Eating a diet rich in fruits and vegetables.
- Trying to sleep at least seven hours per night.
- Regular checkups with gynaecology doctor
In summary, dealing with female infertility can be a difficult and emotional experience for many women and couples. Factors like age, hormonal imbalances, and anatomical issues can all play a role in infertility. Fortunately, there are many effective treatments available to help address this issue. It is important for women dealing with infertility to work closely with their gynaecologist to determine the cause and consider appropriate treatment options. These options may include lifestyle changes, medications, surgery, or assisted reproductive technologies.
References
- Mayo Clinic. Healthy Lifestyle Getting Pregnant. Female fertility: Why lifestyle choices count. Available from: https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/female-fertility/art-20045887#:~:text=Female%20fertility%20is%20being%20able,by%20fertility%20concerns%20or%20problems. Accessed on May 16th, 2024
- Your fertility. Understanding how to improve your chance of having a baby. Available from: https://www.yourfertility.org.au/everyone/age. Accessed on May 16th, 2024
- https://fertility.womenandinfants.org/services/women
- Medical terms and definitions during pregnancy and birth. Available from: https://www.betterhealth.vic.gov.au/health/servicesandsupport/medical-terms-and-definitions-during-pregnancy-and-birth. Accessed on May 17th, 2024
- Forbes Health. 6 Expert-Backed Ways To Boost Fertility. Available from: https://www.forbes.com/health/womens-health/ways-to-boost-fertility/. Accessed on May 17th, 2024
- The rising problem of infertility in India. Available from: https://www.deccanherald.com/science/the-rising-problem-of-infertility-in-india-1105245.html. Accessed on May 17th, 2024
