What is Female Infertility?
The inability to conceive a child after at least one year of attempting is known as infertility. Due to certain reasons and factors, such as tubal disease, advanced maternal age, pelvic endometriosis, ovarian dysfunction and male infertility, a woman fails to become pregnant. According to the recent data, about 20 percent of couples based in US have to face infertility problems. In addition, getting treatments for improving fertility is a costly affair and can be really demoralizing.
Causes and Factors
There is a broad range of problems that can cause infertility. Male infertility accounts for 30% of cases. The diagnosis and treatment of male infertility is based on the results of individualized history of the patient, combined with the results of a semen analysis. A semen analysis, is a test in which the male sperm is analyzed for count, motility, morphology, and forward progression. If any of these parameters are abnormal, it may lead to inability to fertilize the egg. Depending upon the severity of these abnormalities, treatments range from intrauterine insemination where the sperm is washed and placed in a concentrated amount up into the uterus, or intracytoplasmic sperm injection, in which the female partner undergoes ovarian hyperstimulation, an egg retrieval, then the sperm are individually placed into or injected into the egg to better stimulate fertilization to occur. Both of these treatments have been very successful for solving the issue of male infertility. .
Female infertility is slightly more complicated because there are a number of issues that can cause this condition. The main reason for female infertility is often ovarian dysfunction, either due to aging or anovulation. Over the past decades, women have been waiting much longer to reproduce even though the timing of the biological clock has not changed. This leads to issues of egg quality, which make it more difficult to conceive and also more difficult to complete a successful pregnancy. As the incidence, of obesity increases in the U.S., we have seen a rise in the number of cases of polycystic ovarian syndrome. This is a metabolic disorder, which causes abnormalities in the hormonal milieu which contribute to the inability of the female patient to produce an egg on a timely monthly basis. The eggs that these women are able to produce are often of poor quality and can cause a higher risk of miscarriage as well. These women often have other endocrine abnormalities such as increased testosterone levels, and hyperinsulinemia which can also play a role in making the process of achieving a successful pregnancy more difficult. The diagnosis of ovarian dysfunction can be made by obtaining a thorough history of the female's menstrual cycles, obtaining a cycle day 3 FSH level, and performing a pelvic ultrasound to examine the size, character, and ovarian reserve. Treatment is based on the type and degree of ovarian dysfunction. This treatment can range from minimal controlled ovarian hyperstimulation with hormone tablets such as clomid, to superovulation and in vitro fertilization.
Another common cause of infertility in women is pelvic factor. The pelvis is the area where the ovaries, tubes and uterus are located. It is where natural reproduction takes place. In order for this process to progress smoothly, the tubes need to be in pristine condition, the pelvis needs to be free of toxic implants such as endometriosis and the anatomy of the pelvis needs to be normal. Tubal disease can be caused by different factors such as a history of sexually transmitted diseases, abortions or previous uterine surgery, appendix rupture, and pelvic tuberculosis. Also women could have elected to have their tubes ligated in the past. The main way to diagnose tubal disease is by performing a hysterosalpingogram in which dye is injected into the uterus and then examined as it exits the fallopian tubes. The best treatment for tubal disease is to bypass the fallopian tubes altogether and undergoing in vitro fertilization. In in vitro fertilization, the female takes hormones which are naturally produced every month to stimulate egg production, but in higher quantities, once these eggs are mature, she undergoes an egg retrieval. The eggs and sperm are combined in a petri dish and then the embryos which are created are placed inside the uterus three to five days following fertiization. This procedure has been extremely successful at solving the issue of tubal factor.
Endometriosis is another important cause of infertility in women. It is caused by endometrial lining implanting into the pelvic area causing progressive irritation and inflammation with each menstrual cycle. It provides an inhospitable environment for the creation and successful implantation of embryos. It can further block the fallopian tubes restricting the egg to move freely from the ovaries into the uterus. Endometriosis can be treated surgically by undergoing a laparoscopy. It can also be circumvented by in vitro fertilization which bypasses the toxic environment of the pelvis. In some cases, women who have endometriosis, lack B-integrin protein, which may severely limit their chances of a successful implantation. This protein can be evaluated for by undergoing an endometrial biopsy a week following ovulation, in the window of implantation. The treatment for missing this protein is to undergo 3-6 months of gonadotropin agonist therapy.
Besides, these factors, various kinds of hormonal disorders in the hypothalamus or pituitary can also cause infertility in women. Anything which causes stress to the body such as excessive exercising, anorexia nervosa, and medical situations like failure of kidney can diminish the fertility rate in women.
Due to the complexity of the etiology of fertility, the best way to start the process of solving this issue, is to consult a fertility physician, so that the appropriate diagnostic tests and treatment may be performed.
Maximizing Fertility
There are several procedures that can be instituted to help maximize fertility outcomes in women undergoing in vitro fertilization therapy. Assisted hatching is a procedure in which a small hole is made in the shell of the embryo before it is placed into the womb which has been shown to increase the rates of implantation around 10-15%. Also intracytoplamic sperm injection (ICSI), has been shown to increase fertilization rates around 10-15% over natural fertilization, and provides more reassurance that fertilization will take place during the IVF cycle. When a donor shares some of her eligible eggs to a woman who can’t produce her own, it is called egg donation. Depending on the age of the egg donor, success rates with in vitro fertilization can be as high as 75-80%.
Recurrent Miscarriage:
There are various reasons for recurrent miscarriage, not all of which are currently known. Women who have suffered more than two consecutive miscarriages, should seek professional consultation. Etiologies may include but are not limited to advanced maternal age, inherited thrombophilia, uterine abnormality, chromosomal abnormalities, and possible immunological reasons. Diagnosis consists of a thorough laboratory evaluation of these possible conditions as well as a radiologic evaluation of the uterine cavity. Treatments depend on the origin of the diagnosis, however, successful outcomes can result when the appropriate treatment is instituted.
Cryopreservation:
Due to advances in reproductive technology, we now have the ability to freeze, eggs, sperm, and embryos. Sperm is the easiest reproductive tissue to freeze and has a long history of proven success when thawed. The successful implantation of frozen embryos depends largely on the quality of the embryo at the time that it was frozen. Cryopreserving eggs, has just recently come about, and new advances are being made every year in the perfection of the techniques which will enhance the overall success of this procedure. All of these therapies, are a wonderful option for men and women suffering from cancer who may require removal of their pelvic organs or chemotherapy, and radiation therapy. Cryopreservation of eggs, may one day be implemented in young women who wish to prolong their reproductive potential into later ages.
Red Rock Fertility Center:
Infertility is no doubt a disheartening condition for both the female and the male patient. Residents of Las Vegas can find many great treatment centers or clinics in their neighboring areas and get adequate solutions for their problems. The Red Rock Fertility Center provides high quality solutions and individual attention to those couples in need.
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