Female Infertility: Causes Symptoms & Treatment

Infertility can be defined as trying to become pregnant with frequent, unprotected sex for at least a year with no results. About one-third of infertility cases are caused by female causes and one-third by both female and male factors. In other cases, the exact cause is uncertain or is a combination of male and female variables. Female infertility can be difficult to diagnose. Treatment options vary depending on the cause of infertility. 

Symptoms

The main indicator of infertility is the inability to become pregnant. A menstrual cycle that is excessively lengthy (35 days or more), too short (less than 21 days), irregular, or absent may indicate that you are not ovulating. There may be no other signs or symptoms.

The suitable age to seek assistance can differ:

• Most doctors advise attempting to conceive for at least a year before testing or treatment, up to the age of 35.
• If you're between 35 and 40, go to your doctor after six months of trying.
• If you're over 40, your doctor may recommend testing or treatment right away.
• If you or your partner have a history of irregular or painful periods, pelvic inflammatory disease, multiple miscarriages, cancer treatment, or endometriosis, your doctor may recommend starting testing or treatment as soon as possible.

Causes

For pregnancy to occur, all steps of the human reproduction process must happen properly. This method consists of the following steps:

• The egg is released from the ovary, which is picked up by the fallopian tube.
• For fertilization to take place, sperm swims up the cervix to reach the fallopian tube.
• The fertilized egg then goes to the uterus, where it grows after implantation.
• During fertilization, eggs and sperm combine to form a zygote.
• The zygote further develops into a morula, and once in the uterus, it develops into a blastocyst. The blastocyst burrows into the uterine lining, a process known as implantation.

A variety of conditions in women might interfere with this process at any stage. Female fertility ovulations are caused by one or more of the following reasons.

• Ovulation Disorders: The majority of cases of infertility are caused by irregular or no ovulation. Ovulation abnormalities can be caused by disorders with reproductive hormone regulation by the brain or pituitary gland, as well as difficulties with the ovary.
• Polycystic Ovarian Syndrome (PCOS): Polycystic ovarian syndrome (PCOS) results in a hormonal imbalance that inhibits ovulation. PCOS is linked to insulin resistance, obesity, abnormal hair development on the face and body, and acne. It's the leading cause of female infertility.
• Hypothalamic Dysfunction: The pituitary gland produces two chemicals that stimulate ovulation each month: follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Excess physical or emotional stress, a very high or very low body weight, or a recent considerable weight gain or loss can all alter hormone production and impact ovulation patterns. The most prevalent signs are irregular or absent periods.
• Primary ovarian insufficiency: Also known as premature ovarian failure, this normally occurs due to an autoimmune response or the premature loss of eggs from your ovary, which could be due to genetics or chemotherapy. The ovary no longer makes eggs, and it decreases estrogen production in women under 40.
• Prolactin Excess: The pituitary gland can produce prolactin (hyperprolactinemia) in excess, reducing estrogen synthesis and leading to infertility. This can also be triggered by medications you are taking to treat another ailment.

Damage to fallopian tubes (tubal infertility)

Damage or obstructions in fallopian tubes prevent sperm from reaching the egg or hinder the path of the fertilized egg into the uterus. Causes of fallopian tube injury or obstruction may include:

Pelvic inflammatory disease refers to an infection of the uterus and fallopian tubes caused by gonorrhea, chlamydia, or other sexually transmitted infections. 
Previous surgery in the abdomen or pelvis, such as for ectopic pregnancy, where a fertilized egg implants and develops outside the uterus, typically in a fallopian tube, may give rise to this condition.

Endometriosis

Endometriosis happens when tissue that normally grows in the uterus implants and grows outside of it. This excess tissue growth and its surgical removal can produce scarring, which can block fallopian tubes and prevent an egg and sperm from fusion.

Endometriosis can also prevent fertilized eggs from implanting correctly. The condition also appears to have an indirect effect on fertility, such as causing damage to sperm or eggs.

Uterine Or Cervical Causes

Several uterine or cervical conditions can interfere with egg implantation or increase the chances of miscarriage:
Benign polyps and tumors (fibroids or myomas) are common in the uterus. Some can obstruct the fallopian tubes or interfere with implantation, affecting fertility. However, many women with fibroids or polyps become pregnant.

• Problems with the uterus that exist at birth, such as an abnormally shaped uterus, might make it difficult to get or remain pregnant.
• Cervical stenosis is a narrowing of the cervix that can be caused by a hereditary abnormality or cervix damage.
• Sometimes the cervix is unable to create the appropriate mucus to allow sperm to pass through it into the uterus.

Unexplained Infertility

Sometimes, the cause of infertility is never identified. A combination of minor issues in both partners may result in unexplained fertility issues. Although it is annoying when you get no particular solution, this problem will resolve itself over time. However, you should not postpone infertility treatment.

Risk Factors

Certain factors may raise your risk of infertility, including:

• Age: The quality and quantity of a woman's eggs drop with age. In the mid-30s, the rate of follicle loss accelerates, resulting in fewer and lower-quality eggs. This makes conception more difficult and increases the chances of miscarriage.
• Smoking: Smoking not only damages your cervix and fallopian tubes, but it also raises your chances of miscarriage and ectopic pregnancy symptoms. It is also thought to age your ovaries and reduce your egg count prematurely. Stop smoking before starting fertility therapy.
• Weight: Obesity or being greatly underweight can interfere with ovulation. Reaching a healthy body mass index (BMI) can improve the frequency of ovulation and the likelihood of getting pregnant.
• Sexual history: Sexually transmitted illnesses like chlamydia and gonorrhea may cause damage to the fallopian tubes. Having unprotected sexual contact with several partners raises your risk of getting a sexually transmitted infection, which may lead to fertility issues later on.
• Alcohol: Excessive alcohol use can negatively impact fertility.

Treatment

Once your healthcare professional has diagnosed infertility and found the cause, they will suggest different treatments. Treatment options vary depending on the underlying problem. Some of the therapies include:

• Surgery: If infertility is caused by a structural issue, obstruction, or scarring, your doctor may be able to correct it surgically.
• Fertility Medication: It can help with hormonal abnormalities and ovulation issues. Certain hormonal drugs can also cause ovulation and help you release an egg.
• Antibiotics: They can help clear an infection from your reproductive organs.
• Fertility Awareness: Other ways your provider may test your fertility include tracking ovulation by examining your cervical mucus and measuring your basal body temperature. 

Some people will need specialized therapies such as intrauterine insemination (IUI) or assisted reproductive technologies (ART), such as in vitro fertilization (IVF).

Prevention

For females thinking about getting pregnant soon or in the future, the following tips may be helpful:

• Maintain a Healthy Body Weight: Overweight and underweight women are more likely to develop ovulation issues. If you're trying to reduce weight, exercise moderately. Strenuous, vigorous exercise lasting more than five hours per week has been linked to decreased ovulation.
• Quit Smoking: Tobacco use has numerous harmful consequences for fertility, as well as your overall health and the health of the fetus. If you smoke and are thinking about getting pregnant, stop right away.
• Avoid Alcohol: Heavy alcohol consumption may cause diminished fertility. And any amount of alcohol can have an impact on the health of a developing fetus. If you plan to become pregnant, avoid alcohol and do not drink while pregnant.
• Reduce Stress: Some studies have found that stress can lead to inferior outcomes in infertility treatment. Before attempting to get pregnant, try to lower your stress levels.

Conclusion

Infertility can be quite stressful. If you've been trying to conceive for 12 months without success or six months if you're over 35, contact your healthcare practitioner. A healthcare provider can assist in determining the reason and recommending a treatment plan. Try to maintain a positive mindset. Most people can conceive with the right treatment.

Frequently Asked Questions (FAQ's)

What are the three primary causes of infertility?

Common reasons for infertility are lack of regular ovulation (the monthly release of an egg), poor-quality sperm, and blocked or damaged fallopian tubes.
 
Who is at risk for infertility?

Women's fertility decreases gradually with age, particularly around their mid-30s. It decreases rapidly beyond the age of 37. Infertility in elderly women is most often caused by a decrease in the number and quality of eggs, as well as fertility-related health problems. Men over the age of 40 may not be as fertile as younger men.
 
How is women's infertility managed?

Infertility can be treated with medication, surgery, intrauterine insemination, or assisted reproductive technology. Often, medicine and intrauterine insemination are used together.