The best kept secret is the joy of having a baby. Anticipation about expanding your family bring feelings of joy. But when conception doesn’t happen right away, it’s easy to start worrying about fertility.
Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. World Health Organization (WHO). International Classification of Diseases, 11th Revision (ICD-11) Geneva: WHO 2018.
It is known to affect millions of people of reproductive age worldwide – and has an impact on their families and communities.
Estimates suggest that between 48 million couples and 186 million individuals live with infertility globally which is a significant number.
In the female reproductive system, infertility may be caused by a range of abnormalities of the ovaries, uterus, fallopian tubes, and the endocrine system.
While the definition above states that you should consult a doctor after one year of trying, another study reveals that you should seek help sooner.
Women who are 35 and above should be evaluated after trying for only six months since age-related decline in fertility is more rapid. While a fertile 30-year-old women has about a 20% chance of getting pregnant during each cycle, by age 40 those chances drop to about 5%.
What Causes Infertility in Women?
In the female reproductive system, infertility may be caused by a range of abnormalities of the ovaries, uterus, fallopian tubes, and the endocrine system.
Infertility can be primary or secondary.
- Primary infertility is when a pregnancy has never been achieved by a person.
- Secondary infertility is when at least one prior pregnancy has been achieved.
Most cases of female infertility are caused by problems with ovulation. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.
Ovulation issues are often caused by polycystic ovarian syndrome (PCOS). PCOS is a hormone imbalance problem which can interfere with normal ovulation. PCOS is the most common cause of female infertility. Primary ovarian insufficiency (POI) is another cause of ovulation issue. POI occurs when a woman’s ovaries stop working normally before she is 40. POI is not the same as early menopause as some women tend to misunderstand.
Less common causes of fertility problems in women include:
- Blocked fallopian tubes due to pelvic inflammatory disease, endometriosis, or surgery for an ectopic pregnancy
- Physical problems with the uterus
- Uterine fibroids, which are non-cancerous clumps of tissue and muscle on the walls of the uterus.
What Increases A Woman’s Risk of Infertility?
There are many things that can change a woman’s ability to have a baby.
These include:
- Age
- Smoking
- Excess alcohol use
- Stress
- Poor diet
- Being overweight or underweight
- Sexually transmitted infections (STIs)
How Do Doctors Find Out If You Have Fertility Problems?
Doctors will do an infertility check-up which involves a physical examination and which includes pelvic examination. Both partners’ health and sexual history will be evaluated in detail. Most of the time, further testing is required.
To make it simple, in women, the first step is to find out if she is ovulating each month. There are a few ways to do this. A woman can track her ovulation at home by:
- Writing down changes in her morning body temperature for at least 3months continuously
- Writing down the nature of cervical mucus-colour, consistency, amount and odour
- Using a home ovulation test kit (available at any pharmacy)
Doctors can also check ovulation with blood tests. Or they can do an ultrasound of the ovaries. If ovulation is normal, there are other fertility tests available which is done by a specialist.
Some common tests of fertility in women include:
- Hysterosalpingography
This is an x-ray of the uterus and fallopian tubes to looks for obstruction in Fallopian tubes and if the uterine cavity is normal. - Laparoscopy
A minor surgery to see inside the abdomen. The doctor does this with a small tool with a light called a laparoscope o check the ovaries, fallopian tubes, and uterus for disease and physical problems.
How Do Doctors Treat Infertility?
Infertility can be treated with medication, surgery, artificial insemination or assisted reproductive technology. Most commonly, these methods are combined to achieve optimal result.
Most couples don’t think about their fertility and its related issues until they start planning a family. Evaluation and treatment of infertility is important for women especially for those above the age of 35 if you are planning to complete your family soon.
You can talk to our doctors and avoid fertility related issues sooner. It is advisable to not wait until illness strikes to make healthy lifestyle choices and one also should not wait until you see a series of negative pregnancy test before seeking help.
