Female infertility – Common fertility issues affecting women
Typical, isn’t it? You spent your youth trying to avoid getting pregnant and now, when you’ve finally decided you want a baby, it’s not working. Sure, it’s fun trying, but as the months slip by, the anxieties build up and you start to worry whether it’s ever going to happen. Here, we’ll go through the many different things can cause female infertility. Many of these can be successfully treated and the latest medical techniques mean that your chances of having a baby are better than ever, so don’t despair as you scroll through!
The impact of age on female infertility
A woman’s age is the main factor determining how fertile she is. It’s not just grey hairs and wrinkles that mark the passing of time, a woman’s fertility decreases and drops off markedly around a decade before the menopause. For older women, their age alone is likely to contribute to infertility in women. Fertility over 40 can be a challenge.
For this reason, it’s a sensible idea for women to find out when their mother’s menopause began. This will give a good indication of when your fertility is likely to start on a downward spiral.
If a woman is under 35, she has time on her side. While it can be frustrating to be told to keep trying when you’re ready to start a family, you can feel more confident that there’s plenty of time for fertility treatment in your future.
Trying to conceive between the ages of 35 and 44 doesn’t mean you’ve left it too late – it’s getting more and more common for women not to have children until this point in their lives. But looking great for your age doesn’t mean your eggs are in tip-top shape too. Women in their late 30s and 40s tend to ovulate less and sadly, have an increased risk of miscarriage. Time is more important to women and couples in this age group and they may be ready to diagnose what’s causing their female infertility as soon as possible.
Over the age of 45, the chance of falling pregnant is much lower and miscarriage rates shoot up, although that’s not to say that women do have children at this time in their lives. If IVF doesn’t work for women in this age group, using eggs from a younger donor is a promising option.
Problems with ovulation
Around 20 per cent of all female infertility is related to ovulation – the release of eggs from the ovaries. If a woman is having regular periods, then ovulation is probably happening as it should, but bleeding every month doesn’t necessarily mean you are releasing eggs. Confusing, isn’t it? There’s a whole host of reasons why you may be having ovulation problems.
If you seek advice from a doctor on your fertility, you’ll find that a blood test to analyse progesterone levels – an indicator of whether you’re ovulating – is the first thing he or she does. If this is found to be low, you’ll have further samples taken to check for other issues.
Lots of finely-tuned conditions in the body can fall out of balance, leading to ovulation problems, or amenorrhoea causing female infertility. The brain’s hypothalamus controls ovulation by releasing gonadotrophin-releasing hormone (GRH), follicle stimulating hormone (FSH) and luteinising hormone (LH). These form a pathway that can be disrupted by serious stress or being severely underweight, a condition known as hypothalamic amenorrhoea.
Excessive exercise and low body weight might make you look good, but they also cause loss of oestrogen, which is stored in those love handles (body fat). To ovulate properly, a woman needs to have at least 22 per cent body fat.
Other hormones effect ovulation too. Raised prolactin levels contribute to female infertility by suppressing ovulation. Women normally produce this in vast quantities during preganancy and breast-feeding – nature’s ingenious way of ensuring you don’t have too much on your plate! But various drugs, stress, lots of exercise and other conditions can cause this hormone to rocket. Raised testosterone causes problems too
The good news is that if female infertility is being caused by ovulation problems, this can often be fixed with medication, without resorting to IVF.
Now onto the physical nuts and bolts of your insides. Besides ovulation problems, there are several gynaecological issues that cause infertility in women. These include problems with the thyroid gland which helps manage the body’s hormones. Although it’s in your neck, well away from your private parts, an underactive or overactive thyroid can disrupt normal levels of hormones vital for conception.
Female Infertility: Polycystic ovarian syndrome (PCOS)
Scary-sounding polycystic ovaries (PCO) and polycystic ovarian syndrome (PCOS) are far more common than you’d think. Victoria Beckham has PCOS, along with 5-10 per cent of women of reproductive age. While PCO means that 1 in 3 women has tiny, usually harmless cysts in her ovaries, PCOS can cause female infertility.
This female infertility-causing syndrome is another case of those pesky hormones getting out of balance and women may notice other symptoms such as weight gain (not for Victoria, obviously), excess hair growth and irregular cycles. Women with PCOS tend to have a higher chance of miscarriage but they can be helped to conceive naturally with the use of hormone-balancing drugs without moving immediately to IVF.
It’s easy to be anaemic without knowing about it, but it essentially means that your blood’s low on oxygen. Women who experience heavy periods are especially susceptible, and although it can be easily treated once diagnosed with iron supplements, it can also cause female infertility in women.
If you’ve got endometriosis, you’ll probably already know about it. Although some women don’t experience symptoms, many suffer from uncomfortable periods, pelvic pain, fatigue and bloating. Lovely. For reasons yet to be understood, it’s been linked to female infertility.
Cells that should line the womb grow in other parts of the pelvic area, but continue to break down and bleed in the same way causing scarring and discomfort. Minor surgery to clear patches of these cells might be the best way forward, and hormonal therapy may also work prior to starting fertility treatment.
The fallopian tubes that lead from the ovaries to the womb need to be healthy in order to conceive naturally. Women sometimes lose one tube from complications such as an ectopic pregnancy (where an embryo develops in the tube rather than in the womb), but sometimes the opposite tube compensates. Ongoing problems result in infertility in women.
Blockage or damage to a woman’s tubes may mean she is advised to move straight to IVF. However, fertility treatment in this circumstance has very high odds, assuming nothing else is wrong. Alternatively, surgery may be able to correct the tubes.
If there are blockages at the ovary end of the tube, fluid can pool here instead of draining out into the peritoneal cavity. If it enters the womb, it can worsen conditions for IVF-implanted embryos, causing female infertility. This condition is known as a hydrosalpinx. It may correct itself over time or the tube may have to be treated or removed with surgery.
Adhesions are clumps of fibrous scar tissue that cause separate surfaces inside the womb and pevic area to bind together. It can be caused by endometriosis, pelvic infections or previous surgery.
With these are fairly common and often cause no issues, more tightly bound adhesions in the wrong place can affect the fallopian tubes, ovaries and surface of the womb. In the most serious cases, most of the womb can be bound together, destroying the cavity needed for a successful pregnancy. This is called Asherman’s syndrome – an unusual cause of female infertility. Keyhole surgery can help to break the adhesions apart.
Uterine abnormalities and fibroids
Uterine abnormalities such as polyps and fibroids contribute to female infertility and are found in around 5 per cent of women. Simple surgery can usually remove these growths to allow for a normal pregnancy.
Fibroids tend to occur more in women over the age of 30 and for some reason, are more common in women of African origin. Larger fibroids in awkward places within the womb can quite severely affect fertility but having them removed through surgery may be best to ensure a healthy pregnancy.
Dealing with infertility
Most fertility clinics will carry out some simple tests and scans to give you an indication of how likely you are to conceive. See our General infertility article for more on this. InterTrust Fertility clinics boast all the latest medical technology and approachable, expert health professionals who will help ease you through the difficult times and hopefully towards a successful pregnancy. We will take care of you and ensure you receive the best, most affordable treatment option for treating female infertility.
Topic: Female Infertility