Infertility

The inability of women to conceive after a year of having unprotected sex, or the inability of women to sustain pregnancy is known as infertility.

Reasons to seek medical advise:

• You are in your late 30s and have been trying to get pregnant for six months or longer
• Your menstrual cycles are either irregular or absent
• You have painful periods
• You have a known history of fertility problems
• You have a history of pelvic inflammatory disease or endometriosis
• You have had multiple miscarriages
• You have been treated for cancer with drugs and radiation

Causes

Infertility can be present from birth (congenital) or can be acquired as you age. Some of the causes may include:

• Problems with ovulation: Certain conditions, like polycystic ovarian syndrome (ovaries secrete excessive amounts of male hormone testosterone) and hyperprolactinemia (production of high amounts of prolactin, a hormone that induces the production of breast milk), can prevent your ovaries from releasing eggs.
• Damaged fallopian tubes: Fallopian tubes carry the eggs from the ovaries to the uterus. Any damage to them can affect the fertilization of the egg by the sperm. Pelvic surgeries and infections can cause formation of scar tissue that can damage your fallopian tubes.
• Abnormalities of the cervix and uterus: Abnormal mucus production in the cervix, problems with the cervical opening, abnormal shape and presence of benign tumors in the uterus can all contribute to infertility.
• Premature menopause: Mostly caused by a condition known as primary ovarian insufficiency, premature menopause, occurs when menstruation stops before the age of 40. The exact cause of this condition is unknown, though various treatments for cancer and abnormalities with the immune system have been known to contribute to it.
• Adhesions: Bands of scar tissue can form in the pelvis after an infection or surgery.
• Other medical conditions: Diabetes, endometriosis, thyroid disorders, sickle cell disease or kidney diseases can affect the fertility of a woman.
• Medications: Certain medications have been known to cause temporary infertility. Stoppage of those medications can restore fertility in most of the cases.

Risk

According to the American Society for Reproductive medicine, if you are under the age of 35, you should seek a provider if you have been actively trying to conceive after 12 months of unprotected intercourse, and after 6 months of actively trying to conceive for women over the age of 35.

Your risk for infertility increases with age. You are at a greater risk if you smoke, consume excess alcohol, or are overweight, obese or underweight.

Diagnosis

Female infertility can be confirmed with the following tests:

• Blood tests measure your hormone levels;assessing for ovarian reserve and ovulation.
• Imaging studies such as a pelvic ultrasound may be done to assess your follicles.
• Hysterosalpingography involves obtaining an X-ray image after injecting a contrast material into your cervix which travels up to your fallopian tubes. This can help identify any blockages in your fallopian tubes.

Treatment

Your provider will suggest a treatment suitable for your problem. Fertility drugs may be recommended to stimulate and regulate ovulation in women who are infertile due to ovarian disorders.