Female Infertility: Cause and Treatment

The worst news that a woman trying to conceive can receive is that she is infertile. In the United States, 10 per cent of the women face the nerve-racking problem of infertility, which is the inability to get pregnant naturally. This is not solely a curse for women as men can be infertile as well.

The Center for Disease Control (CDC) states that out of all instances when infertility causes distress to a couple; female and male infertility each account for one third of those instances. A combination of problems from both the man and the woman who are trying to conceive, account for the rest of the cases after accounting for 20 per cent of the cases, where the doctors are unable to identify any obvious cause of infertility.

Causes of Female Infertility

Cervical Issues – In some cases, an abnormal mucus production or a previous surgical procedure performed on that area can cause a blockade that prevents the sperm from passing through the cervical canal. There is a workaround for this problem – intrauterine inseminations. In this process, the sperm is placed inside the uterus artificially to help with fertilization. This procedure increases the number of sperms that reach the egg.

Damage to Fallopian Tubes – A damaged fallopian tube can prevent the egg from reaching the uterus where it can met by the sperms. The fallopian tubes are responsible for carrying the eggs from the ovaries to the uterus. A damage to the tube can be caused by pelvic surgeries, pelvic infections and endometriosis.

Uterine Problems – In this case, the structure of the uterus is not hospitable for the foetus. This is caused by the presence of polyps and fibroids. Polyps are the abnormal growths of tissue that are most commonly present in the uterus, nose or colon. They can be present in any organ that has blood vessels. Fibroids are specific to the uterus. They are also abnormal growths that affect 70 to 80 per cent of the women of African-American descent who are above the age of 50. The incidence among Indian women is about 25% as per a study conducted by the National Institute of Health.

Hormonal Causes – The hormonal causes involve problems with ovulation (when a matured egg is released from the ovaries). Because of some hormonal changes, this transfer of the mature egg does not take place. Blood tests to detect the hormone levels beside ovulation predictor kits and basal body temperature charts can be used to detect this ovulation problem.

Unexplained Reasons – As the name suggests, an unexplained infertility is when the causes are not clearly identifiable. This happens in 20 per cent of infertility cases. More advanced methods of investigation are required to analyse such other causes.

Diagnosing Infertility

Blood Tests – Can be used to detect a number of potential causes including improper hormonal levels.  The level of testosterone in men is also analysed through a blood test.

Laparoscopy – This procedure involves looking at the outside of the uterus, ovaries, and fallopian tubes by inserting a fiberoptic camera attached to a thin tube through an incision near the belly button. Laparoscopy helps doctors look for abnormal growths in the area. This happens in the case of endometriosis which is due to the formation of endometriotic tissues in other parts of the body apart from being present in the uterus.

Hysterosalpingography (HSG) – An HSG involves inserting a dye or saline into the cervix. Thereafter through X-ray or ultrasound, doctors can find out whether the fallopian tubes are open or blocked.

Semen Analysis – Is performed in the case of male infertility to determine the strength and number of the sperms.

Treating Female Infertility

In vitro fertilization (IVF) – IVF is a method of artificial insemination. In this case, the egg and sperm are combined outside the body and then placed in the uterus after the embryo forms. Since 1981, when the procedure was first introduced, it has been successfully used to give birth to over 200,000 babies.

Medical therapy – Special drugs can be given to women facing problems with ovulation. These drugs are also known to improve fertility. Gonadotropins can also be used in case of an unexplained infertility. Women with insulin resistance may receive additional drugs.

ICSI – Intracytoplasmic Sperm Injection or ICSI is done in case of male infertility. The sperm is injected directly into the egg in a dish and then placed in the uterus.

Egg donation – Egg donation involves the removal of oocytes from the ovary of a woman who has taken fertility drugs for ovarian stimulation. After the eggs have been extracted, in vitro fertilization is performed, using the sperm from the recipient’s partner.

Intrauterine insemination – This procedure involves placing the sperm in the uterus when the female is ovulating. The sperm is first rinsed with a special solution and then, using a thin plastic catheter, placed in the uterus through the cervix.

Hysteroscopy – Similar to laparoscopy, a hysteroscope is placed in the uterus through the cervix. Doctors can then use it to locate and remove scar tissue, treat endometriosis, open blocked fallopian tubes and remove ovarian cysts.

GIFT and ZIFT  In Zygote Intrafallopian Transfer or ZIFT, the fertilized eggs are placed in the uterus of the mother after IVF within 24 hours while in Gamete Intrafallopian Tube Transfer or GIFT, the sperm and eggs are mixed before insertion.

Women facing infertility need not panic as it can be treated in several ways. As a last resort, if none of the above mentioned treatments work, a couple can always go in for adoption or surrogacy. In surrogacy, the surrogate mother is inseminated with the sperm from the recipient’s partner. The surrogate mother then carries the baby and delivers it on behalf of the recipient.