International Women’s Day is a time to celebrate women around the world, but also to talk about the issues faced by women, including infertility. It is important to note that infertility is indiscriminate, regardless of gender. In this blog, we focus on female infertility, possible causes, and steps that can be taken to overcome it.
While there are many causes of female infertility, primary causes include:
If a woman ovulates infrequently or not at all, this is regarded as an ovulation disorder, for example:
• Polycystic ovarian syndrome (PCOS): This is one of the most common causes of infertility in women. PCOS often causes abnormal hair growth on the face or body, acne, obesity, and insulin resistance. PCOS can significantly affect a woman’s fertility.
• Premature ovarian failure – This is the loss of ovarian function before the age of 40. If a woman has premature ovarian failure, her ovaries are no longer producing any eggs.
If a woman’s fallopian tubes are damaged, either from surgery or a sexually transmitted infection, this can prevent the sperm from reaching the egg. Damaged fallopian tubes can also block the natural passage of the fertilised egg into the uterus.
PID is an infection of the female upper genital tract. This includes the womb, fallopian tubes and ovaries and is often caused by sexually transmitted infections (STI). PID can scar the fallopian tubes and cause a blockage that prevents the egg from travelling to the cavity of the womb.
Benign growths in the uterine muscle can grow inside the uterus, in the uterine wall or outside the uterus. Depending on the position and size, these benign growths can have an influence on fertility and may also prevent a fertilised egg from implanting in the cavity of the womb.
Many women struggle on a day-to-day basis with pain associated with endometriosis, a disorder that can affect a woman’s ability to conceive naturally. Endometriosis occurs when tissue from the lining of the uterus implants itself in other locations around the uterus such as ovaries. This can damage the ovaries or the fallopian tubes and cause fertility problems.
Some women have a sterilisation procedure where the fallopian tubes are blocked making it impossible for the egg to travel to the cavity of the womb.
Some medicines including medicines used for cancer therapy can sometimes cause ovarian failure.
Another important factor that can have an impact on fertility is age. As a woman ages, her fertility rates begin to drop. So the longer a woman waits to have children, the more she may reduce her chances of conceiving naturally.
You can have your fertility assessed at any time, and we offer comprehensive fertility assessment packages for those who would like to be empowered about their fertility.
We would recommend seeking immediate help if the following applies:
You are 35 to 40 years old and have been trying to conceive naturally for six months or more.
Your periods are very painful.
You are over 40.
You menstruate irregularly or not at all.
You have had multiple miscarriages.
You have been diagnosed with endometriosis or pelvic inflammatory disease.
You have known fertility problems.
You have undergone treatment for cancer.
If you are concerned about your fertility, you can discuss your situation at an initial consultation with a fertility specialist, who would be able to advise which tests are appropriate for you. The results from the tests would then be used to determine the next steps, which could be simple lifestyle changes or more complex treatments. Fertility tests include:
Ultrasound scan: This is an internal scan that assesses your uterus to check for any abnormalities and to look at your ovaries to determine the number of antral follicles (egg sacs).
An anti-mullerian Hormone (AMH) blood test: Women with a low AMH and lower antral follicular counts produce a lower number of eggs compared with women with higher levels. Most fertility specialists now use AMH routinely in fertility assessments.
HyCoSy test: This test is used in some cases to detect any possible blockages or abnormalities in the fallopian tubes which could be affecting conception. This is a scan procedure where a dye is inserted through the neck of your womb.
If you are concerned about your fertility, you are not alone, and there are advice and treatments available. It is also important to remember that it is equally important for your partner to be checked, should you have a male partner.