Infertility in Women

Dr Priya Sharma

Dr Priya Sharma

BDS (Bachelor of Dental Surgery), 6 years of experience

December 9, 2020 Womens Health 1025 Views

English हिन्दी Bengali Tamil

What is Infertility in Women?

Infertility in women is a condition where a female is unable to get pregnant after one year of trying, that is, having unprotected intercourse at least twice a week. Women who suffer from many miscarriages, and are unable to stay pregnant are also considered infertile. Women of the age above 35, who after trying for 6 months don’t get pregnant are also considered infertile. 

Infertility occurs in about 10% of women, and the chances of infertility increase as the age of a woman increases.

In this article, we will be discussing in detail infertility in women.

  • What are the Causes of Infertility in Women?
  • What are the risk factors associated with Infertility in Women?
  • What are the tests done to diagnose Infertility in Women?
  • What is the treatment for Infertility in Women?
  • How to prevent Infertility in Women?
  • Frequently asked questions (FAQ’s) about Infertility in Women

What are the Causes of Infertility in Women?

There are several causes of infertility occurring in women. A few common causes include:

1. Problems associated with the uterus

  • Polyps (abnormal growth of tissue) and fibroids (non-cancerous growth in the uterus) can form in the uterus at any time leading to infertility. ( Know more about- Uterine Fibroids )
  • Septate Uterus (the uterus gets a wedge of extra tissue called the septum) may be present at birth, causing infertility in women.
  • Adhesions (or scar tissue) may form in the uterus after certain surgical procedures like dilation and curettage.

( Know more about – Causes of Uterine cancer )

2. Problems associated with the fallopian tubes

  • Pelvic inflammatory disease (infection of a woman’s reproductive organs) is the most common cause of infertility associated with the fallopian tubes. This disease usually occurs due to sexually transmitted diseases like gonorrhea and chlamydia.

( Know more about – Symptoms of Blocked Fallopian tubes )

3. Problems due to the number and quality of eggs

  • A woman may not have a sufficient number of eggs left by the time they start nearing their menopausal (when the menstrual cycle stops) age. Therefore, a woman’s reproductive age is mostly in the 20’s and early 30’s. Pregnancies in the late ’30s are also possible but are complicated.
  • In a few cases, the eggs may have the wrong number of chromosomes and hence these eggs are unable to fertilize.
  • In cases of balanced translocation (a chromosomal defect where a part of the chromosome breaks off and attaches itself to some other location) all the eggs are affected, leading to infertility.

4. Problems associated with ovulation

A woman may not ovulate or release an egg regularly, resulting in infertility. This occurs in cases of:

  • Eating disorders
  • Hormonal disturbances
  • Thyroid disorders
  • Stress   (  Know more about- What is Anxiety ? )
  • Drugs or substance abuse
  • Pituitary tumors
  • Polycystic Ovary Syndrome (PCOS)- It is a condition causing an imbalance in the hormonal level affecting ovulation in a woman. This causes infertility.

( Know more about- What is PCOS? )

5. Endometriosis

It is a condition that occurs when the tissue which grows normally in the uterus starts growing in other locations. This extra growth requires surgical removal which may lead to the blockage of the fallopian tube and prevents the egg and the sperm from meeting.

Endometriosis also affects the uterine wall lining, preventing the implantation of a fertilized egg (an egg meets a sperm during intercourse to form a fertilized egg. This fertilized egg attaches to the uterus wall to form a fetus). Endometriosis may also cause damage to the egg or the sperm.

( Know more about- What are Endometriosis and its treatments ? )

6. Unexplained Infertility

The exact cause of infertility cannot be detected in about 20% of couples.

7. Multifactorial Infertility

There may be multiple male and female factors that may cause infertility.

As stated above, altered menses/ periods are caused due to PCOS in the majority of females. This is a major factor for delayed pregnancy or infertility in females. Also, the problems caused due to PCOS includes bladder and bowel problems, stomach ache and bloating, leg swelling, etc. In such cases, patients may be advised to get the treatment of PCOS by Ovarian Cyst Removal Surgery. There are many hospitals and doctors in India where Ovarian Cyst Removal Surgery is done. 

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What are the risk factors associated with Infertility in Women?

The risk factors for female infertility include:

  • Increase in age
  • Smoking
  • Heavy consumption of alcohol
  • Obesity
  • Underweight women
  • Sexually Transmitted Diseases (STD’s)
  • Irregular menstrual cycle
  • Hormonal disorders like Diabetes, Thyroid conditions, etc.
  • Endometriosis
  • Cysts, tumors, fibroids, or polyps in the uterus or ovaries
  • Polycystic Ovary Syndrome (PCOS)
  • Autoimmune disorders like Crohn’s disease (inflammatory condition of the digestive tract lining) , rheumatoid arthritis ( a condition where immune system attacks body’s own joints ), etc in females can cause infertility

( Know more about- What is Arthritis? Home remedies for Arthritis )

  • History of an ectopic pregnancy (a condition in which the fertilized egg implants outside the uterus and therefore does not survive)
  • Diethylstilbestrol Syndrome (DES syndrome) where the female has health problems like infertility or increased risk of cancer, due to exposure to Diethylstilbestrol (a synthetic form of estrogen hormone ) before birth. 
  • Pelvic Inflammatory Disease

( Know more about- What is Pelvic Inflammatory Disease and its treatments?)

  • Premature ovarian failure
  • Scarring because of a previous surgery
  • Use of certain medications like antipsychotic medications, long term use of nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen.
  • Taking drugs like cocaine and marijuana
  • History of radiation therapy or chemotherapy

( Know more about- What is Cervical Cancer? )

What are the tests done to diagnose Infertility in Women?

The doctor will first do a physical examination and then advise some tests to diagnose infertility in women. Some of these tests are:

  • Pap smear/ Pap test – It is done to check for cervical cancer.

( Know more about- What is a Pap smear? )

  • Pelvic examination- This is done to check the size, position, and shape of the uterus.
  • Pelvic ultrasound- This test produces images that help the doctor to analyze the structure of the female reproductive organs like uterus, vagina, fallopian tubes and ovaries.
  • Blood tests – Blood tests may be done to check the thyroid levels, prolactin levels, progesterone levels (a hormone produced during the menstrual cycle indicating ovulation).
  • Breast examination – It is done to check for any type of unusual milk production.
  • Laparoscopy – A small instrument with a camera known as a laparoscope is inserted into the abdomen to have a look at the pelvic reproductive organs in the female.
  • X-ray hysterosalpingogram (HSG) – In this procedure, a dye is injected into the cervix of the woman and the movement of the dye through the fallopian tube is observed. This is done to check if there are any blockages in the fallopian tubes.
  • Hysteroscopy – A hysteroscope (a thin, flexible tube with a camera at its end) is inserted through the cervix into the vagina in this procedure. The doctor moves it into the uterus and views the inside part of the uterus.

( Know more about- What is Hysteroscopy? )

  • Saline sonohysterogram (SIS) – This test is performed to check the lining for fibroids, polyps, and other structural abnormalities. Saline is filled in the uterus during this test, which allows the doctor to get a good view of the uterine cavity during the transvaginal ultrasound.
  • Follicle-stimulating hormone (FSH) test – It is a type of ovarian reserve testing that uses a combination of hormone tests for determining the chances of a woman conceiving.

( Know more about- What is Female Fertility Panel )

What is the treatment for Infertility in Women?

The treatment for infertility in women varies on the cause of infertility. The various treatment options for infertility in women include:

1. Medications

  • Certain hormonal medications may be prescribed to correct thyroid disorders.
  • Other hormonal medicines like Clomiphene citrate (Serophene, Clomid), letrozole, or gonadotropins (like Pregnyl, Humegon, Follistim) may be prescribed to solve ovulation disorders. Gonadotropins help in triggering ovulation when Serophene and Clomid don’t work. These medicines are also useful as they help in the release of multiple eggs from the ovaries instead of just one egg that is released during each menstrual period. This increases the chances of a woman getting pregnant.
  • Metformin can be prescribed for normal ovulation if a patient is suffering from polycystic ovarian syndrome (PCOS) or diabetes.

2. Artificial Insemination

  • Also known as Intrauterine insemination, the doctor inserts a sperm washed with a special solution inside a woman’s uterus when she is ovulating.

3. In-vitro Fertilization (IVF)

  • The egg of a woman and the sperm of a man is combined in a dish in the laboratory to form an embryo.
  • This embryo is then transferred into the uterus of a woman.

( Know more about- What is IVF? )

4. Intracytoplasmic sperm injection (ICSI)

  • The doctor injects sperm into the egg directly in a dish and then places it in the uterus.

5. ZIFT (zygote intrafallopian transfer) and GIFT (gamete intrafallopian tube transfer)

  • Like the IVF procedure, the above procedures also involve combining the retrieved egg with the sperm in a lab. This is then immediately inserted into the fallopian tubes.
  • In ZIFT, the fertilized eggs (known as zygotes) are inserted into the fallopian tubes within 24 hours.
  • In GIFT, the sperms and eggs are mixed together just before inserting them into the fallopian tube.

How to prevent Infertility in Women?

It is difficult to predict or prevent infertility in women. However, controlling certain risk factors can help in preventing infertility in women.

The following may help in reducing the chances of infertility:

  • Quitting smoking
  • Reduction in alcohol consumption
  • Maintenance of weight 
  • Exercising regularly
  • Regular check-ups with the Gynaecologist
  • Eating food rich in minerals and vitamins
  • Drinking plenty of water
  • Treatment of hormonal disorders, autoimmune disorders, ovarian or other underlying disorders as mentioned above.
  • Treatment of PCOS, Pelvic inflammatory disease, etc.

( Know more about- PCOS ( Polycystic Ovarian Syndrome) Diet chart )

Frequently asked questions (FAQ’s) about Infertility in Women

Q. How common is infertility?

10-14 percent of the Indian population which is 27.5 million couples are suffering from infertility in India.

Q. Is infertility only a women’s problem?

No. Infertility is a problem found both in males and females.  One third of the infertility is related to the female partner, one third is related to male partner and one third is related to both partners. Around 20 percent of the time, the cause is unexplained. 

Q. Can age affect chances of infertility in females?

Yes. Age is a major factor causing infertility in women. Studies show that at the age of 30 the chances of conceiving are 20 percent every month in females. The chance of conceiving reduces  to 5 percent every month, by the age of 40. 

Q. When should we see a doctor if we are trying to conceive for long?

If a woman is of less than 35 years of age and has been trying to conceive for more than a year, then the couple must see a gynecologist. If a woman is of more than 35 years of age, and is unable to conceive after more than 6 months of trying , then the couple must see a gynecologist. 

Q. Is IVF 100% successful?

No. The success rate of IVF is 50% below the age of 35. The chances of success goes down as the age advances.

We hope we have answered your questions regarding Infertility in Women.

If you have any other queries regarding Infertility in Women, contact a Gynaecologist immediately.

Our only aim is to provide you with information through this article and do not advise any medication or treatment to anyone. Only a qualified doctor can provide you with good advice and a treatment plan. 

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