Infertility is cruel, devastating, and unforgiving! It denies women one of the few things that completes them – a child. Infertility can take over your life and make it seem unbearable.
Unfortunately, female infertility is still stigmatized and scowled at, even though it is fairly common. And more surprisingly, when a couple suffers from infertility, it is women who bear most of the blame.
Are you suffering from infertility and trying to make your way out of the hell-hole? Or are you beginning your baby-making journey and want to understand what infertility is? If you nodded along anxiously, Let us lend you a hand. Read our post below to learn more about infertility in women.
What Is Infertility?
Infertility means the incapability to get pregnant even after unprotected and frequent sex. Almost 85 out of 100 couples who are trying to conceive will do so within a year of trying. It is the remaining 15 that fall under the infertility category.
[ Read: Can Ovarian Cysts Prevent Pregnancy ]
Symptoms Of Infertility In Women:
When it comes to infertility, the most prominent symptom is the inability to get pregnant!
There are a few symptoms of female infertility that hint at a problem with your reproductive system before you start trying to make a baby. Here are a few of them:
Abnormal periods are an indicator that something is not right with your reproductive health. Watch out for more or less than average bleeding.
Irregular periods are also a symptom of infertility in women. Now, what exactly is irregular? Well, if the days between two cycles vary drastically, your periods may be termed irregular.
Some women even miss periods. Or some women experience a sudden halt in their periods. If you experience any of these two, you need to see a doctor.
If your monthly periods are painful, or you suffer from back or pelvic pain, you may have some underlying condition that may cause infertility.
Hormonal imbalance is a common cause of infertility in women. Some of the symptoms that can indicate a hormonal problem in your body include acne; change in sex drive, excessive body hair growth, loss of hair, and unwanted weight gain.
Causes Of Infertility In Women:
There are various reasons a woman may experience infertility. Here are some of the major causes of female infertility:
1. Ovulation Related Causes:
Every month, your ovary releases an egg, which is a prerequisite for falling pregnant. But sometimes, your ovulation process goes haywire and causes infertility. In fact, 25 out of 100 infertility cases in women are due to ovulation disorders!
Here are the major ovulation problems a woman can encounter:
Polycystic Ovary Syndrome (PCOS):
Do you suffer from irregular periods? You may have PCOS! Some women with this disorder often have difficulty getting pregnant. PCOS causes hormonal imbalance in the body due to changes in the pituitary gland and ovaries. PCOS also leads to ovulation problems. Some symptoms of PCOS include insulin resistance, weight gain, excessive growth of hair on the body, and acne.
The pituitary gland plays a significant role in female fertility. It produces certain hormones that stimulate ovulation every month. But sometimes, the hormones lose their rhythm and behave erratically. Some of the reasons for hypothalamic dysfunction are excessive stress – both mental and physical, obesity, low body weight, etc.
Premature Ovarian Insufficiency (POI):
What happens when the body considers itself its enemy? You end up with a problem like premature ovarian insufficiency. Women suffering from this problem lose the ability to produce eggs and estrogen even before they hit the age of 40. POI is an autoimmune issue where your body attacks the ovarian tissues. It can be due to genetics. If you are undergoing chemotherapy, you have a high chance of developing POI too.
Sometimes, your body produces a little too much of prolactin. An excess of the hormone can reduce estrogen in the body and cause infertility. It is a rare pituitary gland related problem, but it does happen! Sometimes, some medication too can cause excess prolactin in the body.
2. Tubal Infertility:
The second most common cause of infertility in women is damaged fallopian tubes. What happens when your fallopian tube is just not working the way it should? Well, without a properly functioning tube, there is no way for the sperm to make its way to the egg. And even if the sperm does make it to the egg and fertilize it, a blocked tube can prevent it from reaching the uterus!
Here are some factors that can cause fallopian tube damage or blockage:
Pelvic Inflammatory Disease (PID):
PID is a very common, but often undiagnosed sexually transmitted disease among women. It affects the uterus as well as the fallopian tubes. If you have ever suffered from an STD, you can end up with this painful disease and also suffer from infertility.
Ectopic pregnancy is a heartbreaking phenomenon where you are pregnant, yet you are not! An ectopic pregnancy occurs when a fertilized egg implants itself in the fallopian tube. The only solution to this problem is surgery, which can damage the tubes and cause future infertility.
Most of us associate tuberculosis with the lungs. But the fact is, TB can impact any part of the body, including the pelvis! Pelvic tuberculosis is a big cause of infertility in women.
Do you suffer from uncommonly painful periods? You may have endometriosis (popularly referred to as Endo). Endo is a common cause of infertility and occurs when uterus tissues find other places to call home. These endometrial tissues can obstruct the sperm from meeting the egg and cause infertility. Sometimes, Endo can also damage the uterus lining and prevent the implantation of a fertilized egg. Some of the causes for endometriosis include:
The most common cause of endometriosis, retrograde menstruation causes the menstrual blood, along with the endometrial cells, to flow back through the fallopian tubes into the pelvic cavity instead of out of the body. These endometrial cells then cling on to the pelvic walls and the surface of pelvic organs, causing endometriosis.
Embryonic Cell Growth:
Embryonic cells are the source of cells that line the abdominal and pelvic cavities. Sometimes, a portion of the abdominal lining turns into endometrial tissue, causing endometriosis.
Surgical Scar Implantation:
Endometriosis is often the most common cause of secondary infertility in women (inability to get pregnant after having a successful first pregnancy). If you underwent a C-section during your last pregnancy, you could contract Endo. A surgery such as C-section can cause the endometrial cells to attach to a surgical incision, causing endometriosis.
Endometrial Cells Transport:
Another cause of endometriosis is Endometrial cells transport. When the blood vessels or the lymphatic system transport endometrial cells to other parts of the body, it too can cause Endo.
Immune System Disorder:
A wayward immune system too can cause endometriosis. Sometimes, a problem with the body’s immune system can lead to it attacking the endometrial tissue growing outside the uterus, causing endometriosis.
4. Uterine Or Cervical Causes:
There are some uterine or cervical disorders that can lead to infertility. Some of the major causes include:
Fibroids or Myomas:
It is common for women to develop fibroids or myomas in the uterus. But sometimes, these growths can cause infertility by blocking the fallopian tube and preventing implantation.
Scarring or inflammation of the uterus due to endometriosis can also cause infertility.
Many a time, a woman is born with uterine abnormalities that can cause infertility. Some women are even born without a uterus!
Some women have a narrow cervix, which too can make pregnancy difficult. Cervical narrowing is often an inherited disorder. But sometimes, it can also be due to trauma to the cervix.
Low-Quality Cervical Mucus:
Cervical mucus plays an important part in fertility. So, when the cervical mucus the body produces is not top-notch, it can also be a cause of infertility. Low-quality mucus can make it difficult for the sperms to travel up the cervix and reach the egg.
5. Unexplained Infertility:
One of the most heartbreaking aspects of infertility is unexplained infertility. Sometimes, doctors are unable to diagnose the cause of infertility. Some experts believe that unexplained infertility may be the culmination of many minute and overlooked factors affecting both the partners. But that is just a hypothesis. The good news is that most cases of unexplained infertility resolve themselves with time.
Some Other Factors That Can Cause Infertility:
Apart from the diseases and disorders mentioned above, there are other factors that too can cause infertility. Keep these points in mind if you are embarking on the ‘trying to conceive’ journey.
It may be unfashionable to say, but it is the truth. As a woman ages, the quality and quantity of her eggs take a nosedive. This decline starts from the mid-30s and can make pregnancy a difficult dream to achieve.
Are you a smoker? Well, that can be a primary reason for your inability to get pregnant! Women who smoke can end up damaging their reproductive system. Not just that, smoking also increases the risk of miscarriage and ectopic pregnancy. Smoking is also said to reduce the quality and quantity of your eggs.
If you are obese or very underweight, your chances of conceiving without too many difficulties can go down drastically. A woman with a healthy BMI is more likely to have a healthy reproductive system.
4. Sexual History:
Women who experience sexually transmitted diseases can also face fallopian tube damage. A sexual history of unprotected sex with multiple partners can cause STDs and infertility in the long run.
A glass or two of alcohol a day is not something to worry about. But heavy drinking can cause ovulation problems as well as endometriosis.
When Should You See A Doctor?
Many women are baffled by their apparent inability to get pregnant. But the question is when is the right time to see a doctor? Should you try for a few more months or head to a physician now? Well, that depends on your age.
Women in their early thirties or even younger can go a year without worrying too much. If a year or more of unprotected sex has yet not led to a pregnancy, you should consider going to a doctor.
Six months of unprotected sex without getting pregnant and you are between 35-40? That should raise a red flag or two! Get an appointment with your doctor and discuss your concerns.
If you are above 40 years of age, you should talk to a doctor even before you start trying for a baby.
See a doctor immediately if you have any of the symptoms of infertility mentioned in this article like irregular or painful periods, PID, miscarriages, or endometriosis.
Diagnosing Infertility In Women:
The first thing you need to do when you are suffering from infertility is to learn to trust your doctor. He is the expert, with years of experience helping women become pregnant!
Once you are at your doctor’s, he will run you through a gamut of questions to gauge if you have a fertility problem. In many cases (especially if you are in your twenties or early thirties) he may ask you to go back and try without assistance for a few more months.
But if you are over 35 and have been trying for more than six months, your doctor will get down to business immediately.
Firstly, you doctor will need to know the exact cause of your inability to conceive. So, be ready for a plethora of tests!
Some of the female infertility tests you can expect to undergo include:
1. Ovulation Testing:
These days, you can buy an ovulation prediction kit to figure out if you are ovulating! If all these tests come back negative, your doctor may prescribe a blood test for progesterone to determine if you ovulate. The doctor can also use ultrasonography to check the quality and quantity of your eggs if you do ovulate.
2. Hysterosalpingography (HSG):
As mentioned before, tubal abnormalities are a leading cause of women infertility. If your ovulation tests come back all clear, your doctor will ask you to take an HSG. During an hysterosalpingography, an X-ray contrast dye is injected into your uterus via the vagina to check if your fallopian tubes are healthy and undamaged. If the Xray shows abnormalities, you may require more tests. But for some women, HSG itself works as a treatment by flushing out obstructions and clearing up the fallopian tube. Some women who undergo HSG end up getting pregnant within three months of the test. But HSG can be painful, really painful. Do talk to your doctor about management before you go for this particular test.
If your HSG shows some fallopian tube issues, your doctor will ask you to go for a laparoscopy. A laparoscopy is used to check out the state of your fallopian tubes, ovaries, and uterus. Apart from fallopian tube defects, laparoscopy can also help diagnose endometriosis and scarring as well as other reproductive issues.
4. Ovarian Reserve Testing:
If you are over 35, your doctor may prescribe the ovarian reserve test to determine the quality and quantity of your eggs. The test includes some blood and imaging tests. Though older women are more likely to suffer from this particular problem, many younger women report premature ovarian reserve depletion too.
5. Hormone Testing:
Hormones can make or break your health, including your fertility. It is no wonder then that hormonal tests form a big chunk of fertility tests! Your doctor may order blood work to check out your ovulatory, thyroid, and pituitary hormones.
6. Imaging Tests:
Some of the image tests involved in diagnosing infertility include pelvic ultrasound, hysterosonography, and hysteroscopy.
Genetic testing is the last line of defense, generally reserved for couples who have gone years without conceiving.
Treating Infertility In Women:
Infertility is heartbreaking but is definitely not the end of the road! With medical science coming of age, millions of women with infertility go on to become mothers, great ones at that!
Infertility is a complex issue so it is obvious that treating it too will involve complexities. How your particular case is treated depends on your age, the length of your infertility journey, and your budget!
Some of the female infertility treatment options your doctor may explore include:
1. Fertility Drugs:
As mentioned before, ovulation-related issues are the biggest cause of infertility in women. That is why almost all women seeking treatment for infertility go through a course or two of fertility drugs.
Fertility drugs can induce or regulate ovulation by working like natural hormones.
Some of the popular fertility drugs in use today are:
Clomiphene citrate (Clomid, Serophene) is taken orally. It can help your body ovulate by stimulating the pituitary gland.
If your doctor thinks that your case requires something more powerful than clomiphene citrate, he may prescribe gonadotropins. These injectable hormones work directly on the ovaries to produce more eggs.
Metformin is used to treat many PCOS cases because it helps improve insulin resistance, and help you ovulate.
Letrozole (Femara) is often used to induce ovulation, but its primary use is for the treatment of breast cancer. That is why it is not commonly used for treating ovulation-related infertility.
Fertility drugs are used widely these days, but they do not come without a price. There are some issues that can complicate the situation when you are using fertility drugs. Fertility drugs can increase your chances of conceiving multiples (twins or more).
One of the more serious issues with fertility drugs is ovarian hyperstimulation syndrome (OHSS), which can lead to swollen and painful ovaries. Mild abdominal pain, bloating, nausea, vomiting, and diarrhea are all symptoms of OHSS. Remember that the extended use of fertility drugs can cause the growth of ovarian tumors in some women.
If your doctor thinks that you require something more invasive than pills for treating infertility, he may recommend surgery. There are numerous surgical procedures that can help restore your fertility. But surgery as a treatment for female infertility option is losing its popularity with the advent of several other, less invasive, options.
Laparoscopic or Hysteroscopic Surgery:
If you have problems such as an abnormal uterinephysiology,polyps, fibroids, or adhesions, a laparoscopic surgery may be in the offing.
If your fallopian tube issue is what’s keeping you from getting pregnant, surgery can come to your rescue.
3. Assisted Reproductive Procedures:
The most popular assisted reproductive procedures include:
Intrauterine Insemination (IUI):
During IUI, millions of sperm are inserted directly into the uterus during ovulation.
In Vitro Fertilization (IVF):
IVF is becoming increasingly popular these days, thanks to its high success rate. An IVF procedure involves removing healthy eggs from a woman, fertilizing them with her partner’s sperm in a lab. The fertilized embryo is then transferred into the uterus.
There are some offbeat measures that can help you achieve your ultimate dream – having your baby!
Some of the other options you can try are:
If your body is not making eggs at all or if the quality of your eggs is not viable in making a baby, you can opt for donor eggs.
If you are incapable of carrying a child to term, you can opt for surrogacy. In surrogacy, you and your partner create a baby in a lab (with your egg and your partner’s sperms). The fertilized egg is then placed in the surrogate’s uterus who carries the baby to term. If this is the path you want to walk, do consider getting a good lawyer.
Adoption is not a treatment for fertility. But it does give you’re the ultimate reward – a baby!
Tips For Dealing With Infertility:
Infertility can sap you of energy, leaving you broken and empty. But if you want to win the battle, you need to prepare for it. Here are some tips to help you deal with infertility better:
1. Do Your Research:
Be your advocate when it comes to infertility treatment. But for that, you need to be aware of all that infertility entails. So read up as much as you can about infertility even before you see your doctor.
2. Seek Support:
It can be a lonely battle when one is dealing with something as painful yet invisible as infertility. You can feel alone and depressed. That is why it is important to seek help to navigate this difficult phase in your life. Talk to your friends and family. If that does not appeal to you, seek out online support groups that can help you vent while remaining anonymous.
3. Watch Your Weight:
If you want to conceive you need to be a healthy weight. A healthy BMI will not just help you beat infertility but will also ensure a healthy pregnancy. So, watch what you are eating and do exercise regularly.
4. Quit Smoking:
Now is the best time to quit smoking because smoking is not just bad for your fertility but also for your overall health.
5. Decrease Alcohol Consumption:
Cut down on your alcohol consumption to give your fertility a boost.
6. Manage Your Stress Levels:
The last thing a woman suffering from infertility wants to hear is ‘stop worrying, and you’ll get pregnant’. But the fact remains that stress can impact your fertility. So, try and manage your stress levels as much as you can.
Infertility is a lonely battle. But it is a battle that can be won! So, don’t lose hope. Hold onto the vision of your baby – the ultimate prize!
Source: Mon Conjunction