What is Infertility?
Infertility can take a toll on your life emotionally and may hamper your relationship with your spouse too. Most people will have a strong desire to conceive a child at some point during their lifetime. Understand what defines normal fertility, this helps you know when to seek medical help. Approximately 85 % of couples will achieve pregnancy within one year of trying. Infertility is defined when couples are unable to conceive a child, even though they’ve had frequent, unprotected sexual intercourse for a year or longer. Up to 15 per cent of couples are infertile. In over a third of these couples, male infertility plays a role.
Infertility can be caused due to factors affecting the female or the male partner.
Here are a few common reasons in women that lead to Infertility:
1) Advancing maternal age: Female age-related infertility is the most common cause of infertility today. For unknown reasons, as women age, egg numbers decrease at a rapid rate. And as ageing occurs, egg quality, or the likelihood of an egg being genetically normal, decreases as well.
2) Ovulation disorders: Normal and regular ovulation, or release of a mature egg, is essential for women to conceive naturally. There are many disorders that may impact the ability for a woman to ovulate normally.
3) Tubal occlusion (blockage): A history of sexually transmitted infections including chlamydia, gonorrhea, or pelvic inflammatory disease can predispose a woman to have blocked fallopian tubes. Tubal occlusion is a cause of infertility because an ovulated egg is unable to be fertilized by sperm or to reach the endometrial cavity.
4) Uterine fibroids: Fibroids are very common (approximately 40% of women may have them) and the mere presence alone does not necessarily cause infertility. The size and position of the fibroid determine its effects on your pregnancy.
5) Endometrial polyps: Endometrial polyps are finger-like growths in the uterine cavity arising from the lining of the uterus, called the endometrium. They can decrease fertility by up to 50% according to some studies.
6) Endometriosis: Endometriosis is a condition whereby cells very similar to the ones lining the uterine cavity, or endometrium, are found outside the uterine cavity. It is found in approximately 10-50% of reproductive-aged women and can be associated with infertility as well as pain during intercourse and/or menstrual periods.
Quick Facts About Infertility
- Infertility is a disease of the reproductive system that impairs the body’s ability to perform the basic function of reproduction.
- Infertility affects men and women equally.
- Twenty-five per cent of infertile couples has more than one factor that contributes to their infertility.
- In approximately 40 per cent of infertile couples, the male partner is either the sole cause or a contributing cause of infertility.
- Irregular or abnormal ovulation accounts for approximately 25 per cent of all female infertility problems.
- Most infertility cases — 85% to 90% — are treated with conventional medical therapies such as medication or surgery.
- It is possible for women with body weight disorders to reverse their infertility by attaining and maintaining a healthy weight.
- Men and Women who smoke have decreased fertility.
- The risk of miscarriage is higher for pregnant women who smoke.
Fertility treatments for females:
- Fertility drugs and hormones to help the woman ovulate or restore levels of hormones.
- Surgery to remove tissue that is blocking fertility (such as endometriosis) or to open blocked fallopian tubes.
In general, infertility is defined as not being able to get pregnant (conceive) after one year (or longer) of unprotected sex. Because fertility in women is known to decline steadily with age, some providers evaluate and treat women aged 35 years or older after 6 months of unprotected sex. Women with infertility should consider making an appointment with a reproductive endocrinologist—a doctor who specializes in managing infertility. Reproductive endocrinologists may also be able to help women with recurrent pregnancy loss, defined as having two or more spontaneous miscarriages.
Women need functioning ovariesexternal icon, fallopianexternal icon, and a uterusexternal icon to get pregnant. Conditions affecting any one of these organs can contribute to female infertility. Some of these conditions are listed below and can be evaluated using several different tests.
Disruption of ovarian function (presence or absence of ovulation and effects of ovarian “age”)
A woman’s menstrual cycleexternal icon is, on average, 28 days long. Day 1 is defined as the first day of “full flow.” Regular predictable periods that occur every 21 to 35 days likely reflect ovulation. A woman with irregular periods is likely not ovulating.
Ovulation can be predicted by using an ovulation predictor kit and can be confirmed by a blood test to check the woman’s progesterone level on day 21 of her menstrual cycle. Although several tests exist to evaluate a woman’s ovarian function, no single test is a perfect predictor of fertility. The most commonly used markers of ovarian function include follicle-stimulating hormone (FSH) value on day 3 to 5 of the menstrual cycle, anti-müllerian hormone value (AMH), and antral follicle count (AFC) using a transvaginal ultrasound.
Disruption in ovarian function may be caused by several conditions and warrants an evaluation by a doctor.
Female fertility is known to decline with
- About 1 in 5 (22%) couples in which the woman is 30-39 have problems conceiving their first child, compared to about 1 in 8 (13%) couples in which the woman is younger than 30. Fertility declines with age primarily because egg quality declines over time. In addition, older women have fewer eggs left and they are more likely to have health conditions that can cause fertility problems. Aging also increases a woman’s chances of miscarriageexternal iconand of having a child with a genetic abnormality.
- Excessive alcohol use.
- People with overweight or obesity or underweight.
- Extreme weight gain or loss.
- Excessive physical or emotional stress that results in amenorrhea (absent periods).