Infertility in women
The term infertility is used when a couple has been trying to conceive through frequent intercourse for at least 1 year without success. Female infertility, male infertility, or both are quite common 10-15% of couples have problems with fertilization and successful delivery
Infertility in third cases is caused by female factors, and third cases are caused by male factors. The reason for the remaining third is unknown or related to problems of both members of the couple
Determining the cause of infertility in women can be difficult, but there are many treatments available Treatment depends on the underlying cause Medical intervention is not always necessary, and many infertile couples can eventually conceive without treatment.
The following factors are necessary to get pregnant:
- presence of ovulation Pregnancy requires the ovaries to produce and release an egg, a process called ovulation. Your doctor may evaluate your menstrual cycle and confirm ovulation
- Partner must have sperm For most couples, this is not a problem unless the partner has had a specific illness or surgery in the past Your doctor can perform simple tests to check the health of your partner's sperm
- It is necessary to have regular intercourse Regular sex with a partner is necessary during the fertile period The doctor will tell you which period is best for fertilization during the menstrual cycle
- It is necessary to have a patency of the fallopian tubes and a normal uterus. The egg and sperm meet in the fallopian tubes, after which the embryo needs a healthy location, i.e. the uterus, where it can grow.
In order to start pregnancy, it is necessary for all parts of the human reproductive system to work properly. Stages of pregnancy:
- One of the ovaries produces and releases a mature egg.
- The egg is transferred to the fallopian tube
- Sperm ascends the cervix and travels through the uterus to the fallopian tube to reach an egg for fertilization.
- The fertilized egg travels through the fallopian tube to the uterus
- The fertilized egg matures and begins to grow in the uterus
There are many factors that can disrupt any stage of this process in women Infertility in women is caused by one or more of these factors
Ovulation problems Ovulation problems, which mean infrequent or no ovulation, represent 25% of the causes of infertility in couples. The condition may be caused by dysregulation of reproductive hormones by the hypothalamus or pituitary gland. The problem may be in the ovary itself
- Polycystic ovary syndrome During this disease, complex changes develop in the hypothalamus, pituitary gland, and ovaries, resulting in hormonal changes that affect ovulation. The syndrome is associated with acne, insulin resistance, obesity, and abnormal facial and body hair growth. This syndrome is the most common cause of infertility in women
- dysfunction of the hypothalamus Two hormones take part in ovulation stimulation every month: follicle stimulating hormone and malutheinizing hormone. These hormones are specifically produced in the pituitary gland during the menstrual cycle Excessive physical or emotional stress, too high or low weight, rapid weight loss or gain may be the reason for the violation of the normal ovulation rhythm. The main manifestation of this problem is irregular or missed menstruation
- Premature ovarian failure This disease is caused by an autoimmune response in which the body mistakenly attacks the ovarian tissue The condition is also caused by the premature loss of eggs from the ovary, caused by a genetic problem or an environmental factor such as chemotherapy. As a result, the inability of the ovary to produce an egg develops Estrogen production also decreases before the age of 40
- Prolactin excess In rare cases, the pituitary gland produces too much prolactin (hyperprolactinemia), resulting in decreased estrogen production and infertility. The cause of the problem is mainly a pituitary disease, although the condition is sometimes caused by medications used for other diseases
Damage to the fallopian tubes
When the fallopian tubes are damaged or blocked, the sperm cannot reach the egg or the fertilized egg cannot reach the uterus. Causes of fallopian tube damage or obstruction:
- Uterine or fallopian tube infection caused by chlamydia, gonorrhea, or sexually transmitted infections
- Past abdominal or pelvic surgery, such as surgery for an ectopic pregnancy In an ectopic pregnancy, the fertilized egg grows and begins to develop in the fallopian tube instead of the uterus.
- Pelvic tuberculosis, the leading cause of fallopian tube infertility worldwide
Endometriosis Endometriosis develops when tissue that normally grows in the uterus grows and develops elsewhere. Additional tissue growth and its surgical removal may cause scarring, blocking the fallopian tube and preventing the union of the egg and sperm. The condition also damages the lining of the uterus, making it difficult for a fertilized egg to implant. In rare cases, endometriosis causes infertility by direct damage to the sperm or egg
Cervical and Uterine Problems Some cervical and uterine problems affect fertility During pathologies of these organs, there are problems with the implantation of the fertilized egg and cases of miscarriage
Benign polyps and tumors (fibroids or myomas) are common in the uterus. Some can affect fertility by compressing the fallopian tubes or disrupting implantation. However, most women with polyps and tumors are usually able to get pregnant
Scarring in the uterus caused by endometriosis or inflammation also prevents implantation of the embryo.
Congenital pathologies of the uterus, such as an abnormally shaped uterus, subsequently cause problems in conceiving or maintaining a pregnancy.
Narrowing of the cervix can also be the cause of an inherited malformation Sometimes harassment is caused by direct injury
In some cases, the cervix is unable to produce the proper mucus for sperm movement. As a result, the sperm cannot reach the uterus
Unexplained Infertility In some cases, the cause of infertility cannot be determined. It is possible that at this time, mild fertility problems in both partners lead to unexplained infertility Although the lack of an exact explanation for the exact cause can be a source of great concern for the couple, in some cases, the condition corrects itself over a period of time.
The main symptom of infertility is the absence of pregnancy Menstrual cycles that last a long time (35 days or more), are short (less than 21 days), are irregular, or are missed may indicate problems with ovulation, which is associated with infertility in women. There may be no other symptoms at all
When to consult a doctor The time to seek medical help depends partly on the age of the patient.
If the patient is between the ages of 30-35 or younger, doctors advise that the woman try to conceive for at least 1 year before undergoing any tests or treatments.
35-40-year-old women, after 6 months of trying to get pregnant, it is necessary to consult a doctor
After the age of 40, the doctor may directly request a test or some treatment
The doctor may directly request tests or treatment in the following cases: if your partner has fertility problems, if the patient has a history of irregular or painful menstrual periods, pelvic inflammatory disease, recurrent abdominal pain, cancer therapy or endometriosis
