Female Infertility: Causes and Treatment

The Doctor That Knows Aging Dr. Dov Rand

Female infertility is way more complicated and multifaceted than male one. After all, the female body should not only produce an egg cell of a high quality, but also create the favorable environment and conditions for conception and normal pregnancy. Any, even minor, failure in the reproductive tract of a woman can make conception problematic and frequently even impossible.

What is female infertility?

Generally speaking, this is the absence of pregnancy for more than a year provided that a woman has been sexually active, while having a regular sex with a healthy partner without the use of contraceptives.

There is absolute infertility (sterility) associated with irreversible pathological conditions that fully excludes the possibility of conception and relative infertility (that can be treated).

Infertility can also be primary (the woman has never had a single pregnancy) and secondary infertility (the inability of getting pregnant and to have a full term pregnancy after already giving a birth to a child before).

Around two percent of females worldwide are not capable to conceive (primary infertility) and nearly eleven percent of women are unable to become pregnant after giving birth to at least one child (secondary infertility).

Infertility in married couples occurs in 10-15% cases. Male and female infertility are almost equally common. When a couple faces infertility problems, medical examination is required for each of the partners.

In addition to physical health factor, family tribulation and mental or social distress can also lead to infertility.

The main causes of female infertility

The problems with maturation of egg come first. These problems are found in 39% of all cases. Most often, such endocrine disorders occur as a result of hormone deficiency. However, damage to ovarian functions themselves is sometimes to blame, for example, when a cyst appears as a result of inflammation or hormonal disorders.

Defects of the fallopian tubes, which can be damaged or clogged is the second reason (30%) of female infertility in the world. This can be caused by the adhesions following abdominal surgery, abortion or ectopic pregnancies, or by the inflammation of the fallopian tubes (inflammation of the appendages) and the uterus (endometritis). Normally, the union of an egg with a sperm cell occurs in the fallopian tube, and if it is blocked conception becomes impossible, meaning that the nucleus of both an oocyte and a sperm cell will not fuse to form a diploid cell.

Problems with the cervical canal is another cause of infertility. In healthy women, the cervical canal is completely filled with mucus, which is necessary so that sperm can easily overcome the cervix and get to the egg. If the mucus is too viscous or when there is not enough amount of it, if its chemical composition is disturbed, the unhindered passage of sperm into the uterus will be impeded.

This usually happens as a result of genital infections, deterioration of biological functionality of the mucus glands, erosion or inflammation of the cervix.

Immunological problems: substances that can damage and even destroy sperm cells appear in the mucus of the cervix. Also infertility can cause uterine defects: malformations, fibroids, fibromyomas, colpitis, lesions resulting from surgical intervention, condylomas, polyps of various localization and tumor-like formations – cysts.

Genital endometriosis leads to infertility in 40-50% of cases. Certain diseases that are not directly related to the endocrine tract can also lead to infertility. These are metabolic disorders, diseases of the thyroid gland, adrenal glands, pituitary gland, diabetes, some autoimmune diseases, when your immune system erroneously aggressively acts against your body, etc.  

It should also be borne in mind that the probability of pregnancy decreases with age, because of obesity or conversely due to significantly reduced weight, bulimia, anorexia, malnutrition, smoking, alcohol abuse and constant stress.

Factors of female infertility

Sometimes you can hear about the factors of infertility. Usually, they are grouped by subject. For example, by the anatomical principle (uterine, tubal, cervical), by the nature of the pathological processes in the body, by the presence of genetic abnormalities, by the state of the woman’s psyche or by the infertility of the partner.  

Diagnostics of female infertility

The first whom a woman who has problems with conception refers to is a gynecologist. During the appointment with a doctor, it is necessary to try to answer all the questions as clearly and fully as possible, since often the promptness of identifying the causes of the problem and the effectiveness of the medical examination and treatment depend on the correct answers.

In some cases, consultation and treatment with other specialists (endocrinologist, therapist, and neuropsychiatrist) may be necessary.

To accurately diagnose the causes of infertility, a variety of laboratory studies and instrumental diagnostics methods may be required, such as:

  • basal temperature curve (to assess the state of the ovaries and the presence of ovulation);
  • assessment of cervical mucus;
  • postcoital test (assessment of the activity of sperm cells in the secretions of the cervix and the determination of the presence of antibodies to sperm cells);
  • determining the amount of hormones in the blood and urine;
  • determination of the content of antibodies to sperm cells in the blood and cervical mucus of the patient.

It is necessary to exclude the presence of genital infections. When examining a patient, a comprehensive examination, including radiography of the lungs is performed, and in the event of a menstrual disorder radiography of the skull is carried out.

Conducting hysterosalpingography (radiographs of the uterus and fallopian tubes) allows you to identify abnormalities and tumors of the uterus.

Carrying out ultrasound test allows you to examine the conditions of the fallopian tubes, uterus and ovaries.

Surgical invasive procedures may be required for correct diagnosis: for example, diagnostic curettage to remove tissue by either scooping or scraping for further evaluation of pathological conditions, hysteroscopy and laparoscopy are endoscopic methods that are very effective and are often used for both diagnosis and treatment of infertility.

Female Infertility Treatment

The infertility treatment program is outlined after receiving all the relevant data, test results and establishing infertility’s causes.

At the same time, medical experts first make an attempt to restore the reproductive capacity of patients, and if natural conception is unreachable, then they recourse to the use of assisted reproductive technologies.

The patient weight should be normalized. For the correction of endocrine infertility, hormone therapy is carried out (the effectiveness of therapy and the onset of pregnancy can occur in 70-80% cases).

In case of violation of the patency of the fallopian tubes, it is restored using laparoscopy (in this case, the efficiency is 30-40% and IVF is very likely).

With anatomical defects of the uterus, reconstructive surgeries are performed (pregnancy occurs in 15–20% cases).

If it is impossible to cure an existing defect (for example, the absence of the uterus or defects of its development), you may consider the option of surrogate motherhood program.

If endometriosis is the cause of infertility, then a course of treatment is carried out (including laparoscopy), the probability of pregnancy is 30-40%.

If there are immunological problems, then artificial insemination is usually performed with the husband’s sperm (efficiency is up to 40%).

If the causes of infertility are not established, it is usually resorted to artificial insemination methods.

Such methods include:

  • intrauterine insemination with donor sperm or husband’s sperm;
  • IVF method;
  • intracytoplasmic sperm injection (ICSI method);
  • surrogacy.

 

It should be noted that the probability of pregnancy decreases sharply after 37 years. Start infertility treatment as early as possible to make sure you have healthy and blissful children.

The Network of Reproductive Medical Centers “Mother and Child” (ISO 9001-2015 Certified Health Care Provider) offers practically all types of infertility treatment in full compliance with the international principles of health care ethics, namely – Respect for autonomy, Beneficence, Non-maleficence and Justice. Medical centers “Mother and Child” employ highly qualified fertility specialists in reproductive endocrinology, andrology, urology and immunology, who are members of the European Society of Human Reproduction and Embryology (ESHRE), the American Society for Reproductive Medicine (ASRM), the Ukrainian Association of Reproductive Medicine (UARM)  and the Russian Association of Human Reproduction (RAHR). The overwhelming majority of doctors at “Mother and Child” centers hold both Doctor of Medicine (M.D.) and Doctor of Philosophy (Ph.D.) academic degrees.

The Network of Reproductive Medical Centers “Mother and Child” offers the following professional services, techniques, tests and procedures in connection with infertility treatment for males and females:

  • In vitro fertilization (IVF)
  • Intracytoplasmic sperm injection (ICSI)
  • Laparoscopy
  • Hysteroscopy
  • Controlled ovarian hyperstimulation
  • Ovulation induction
  • TESE
  • TESA
  • Follicle-stimulating hormone (FSH) test
  • Polycystic ovary syndrome treatment with clomiphene
  • Gamete intrafallopian tube transfer (GIFT)
  • Zygote intrafallopian transfer (ZIFT)
  • Fluorescence in situ hybridization (FISH) technique
  • Intrauterine insemination (IUI) treatment
  • Pre-implantation genetic diagnosis (PGD)
  • Pre-implantation genetic screening (PGS)
  • Next generation sequencing (NGS) method
  • Polymerase chain reaction (PCR) technique
  • Non-invasive prenatal test (NIPT)
  • Minimally invasive urological surgery
  • Clustered regularly interspaced short palindromic repeats (CRISPR)
  • Eggs and sperm cells vitrification
  • Frozen embryo transfer (FET)
  • Pharmacological treatment of infertility
  • Professional psychological support

Contact the exclusive representative of the Network of Reproductive Medical Centers “Mother and Child” IVF Group Surrogacy Services now to schedule an appointment with renowned fertility specialists!

The IVF Group Surrogacy Service is a highly mobile and committed multilingual team of ambitious marketing specialists, experienced domestic and foreign lawyers, and proficient social workers that has been closely cooperating for more than a decade with internationally recognized medical specialists from throughout the world in practically all fields of affordable and accessible infertility treatment. The IVF Group Surrogacy Group while on the same page with the practical use of modern assisted reproductive technologies, academic and scientific achievements in the field of infertility treatment combined with hard and dedicated work is proud of giving chances to people to experience the joy of happy motherhood and fatherhood.