Infertility Problems with Women

The inability to become pregnant after 1 year of sexual activity without contraception. Infertility occurs in 10 to 15% of all couples. Female fertility depends on normal functioning of the reproductive tract and the production of hormones necessary for normal sexual development and functioning. About 40 to 50% of all infertility is attributed to the female.

FREQUENT SIGNS AND SYMPTOMS

Inability to conceive.

CAUSES

  • Anatomic abnormalities of the reproductive system.
  • Emotional stress.
  • Repeated weight gain/weight loss cycle.
  • Hormone dysfunction, especially thyroid disorders.
  • Vaginitis.
  • Disorders of the cervix, such as infection, laceration or tearing from previous childbirth or narrowing of the cervical opening for any reason.
  • Amenorrhea (lack of menstrual periods) caused by strenuous exercise programs or nutritional disorders (bulimia or anorexia nervosa).
  • Chemical changes in the cervical mucus.
  • Ovarian cysts.
  • Endometriosis.
  • Smoking.
  • Tumors.
  • The use of some medications, including oral contraceptives (e.g., Depo-Provera). A large number of women cannot conceive for many months after discontinuing use.
  • Intrauterine device (IUD) (possibly).
  • Disorders probably not related to infertility include: a tilted uterus; small fibroid tumors of the uterus; or inability to achieve sexual orgasm.

RISK INCREASES WITH

  • Stress.
  • Diabetes mellitus.
  • Marital discord and infrequent sexual intercourse.
  • Smoking.
  • Genital disorders.
  • Drugs of abuse, such as heroin.

PREVENTIVE MEASURES

  • Obtain treatment for any treatable disorder that causes infertility.
  • Avoid preventable causes of infertility.

EXPECTED OUTCOME

  • Some fertility problems are minor and reversible. Approach treatment with optimism.
  • Research into this area is offering new options to couples.

POSSIBLE COMPLICATIONS

  • Psychological distress, including feelings of guilt, inadequacy and loss of self-esteem.
  • Treatment costs are high and often not covered by insurance.
  • The unknown and possible long-term effects of medications used to increase fertility.
  • Excessive bleeding due to anticoagulant medications

TREATMENT
GENERAL MEASURES

  • Diagnostic tests may include laboratory blood tests; pelvic examination; hysterosalpingogram (s-ray study of the genital tract); postcoital test (PCT), which is a study of the cervical mucus performed 2 to 12 hours after intercourse; endometrial biopsy to rule out luteal phase defect (a defect in hormone production) and possibly others.
  • Surgical diagnostic procedures, such as laparoscopy (use of a small lighted telescope) to examine reproductive organs.
  • Psychotherapy or counseling, if marital problems exist.
  • Surgery to correct any reproductive system abnormalities, your ovulation pattern. Have intercourse just before ovulation, which can be determined from the chart.
  • Don’t use a lubricant during sexual relations. Lubricants may interfere with sperm mobility.
  • Your partner should withdraw his penis quickly from your vagina after ejaculation. If left in, it reduces the number of sperms that can swim toward the egg.
  • After your partner’s ejaculation, place pillows under your buttocks to provide an easier downhill swim of the sperm.
  • Maintain a positive attitude. Worry and tension may contribute to infertility.
  • Alternate pregnancy methods include in-vitro fertilization (IVF) in which eggs from the female are harvested, impregnated with sperm from the male, and implanted in the uterus; GIFT or ZIFT (gamate or zygote intrafallopian transfer) which are implant procedures involving female egg and male sperm; and intracytoplasmic sperm injection (ICSI), whereby a single sperm is injected into a single egg and the resulting zygote is transferred to the uterus.

Exercise moderately. Over exercising may contribute to infertility.

DIET

Eat a normal, well-balanced diet. If you are overweight, try to achieve your ideal weight.