Infertility in Women – Incidence, Causes and Available Treatments
Pregnancy is a biological miracle involving several requirements to be met for success. A female ovum must be released from the ovaries. A sperm must attach to the egg for fertilization. The fertilized egg must then travel through the fallopian tube to the uterus, and implantation in the uterus must occur for pregnancy to be achieved.
The inability to become pregnant is a result of a dysfunction in one or more of these steps. Infertility is defined as the inability to conceive and get pregnant after one year of attempting to do so despite frequent, unprotected sex.
According to the CDC, 10-12 percent of women in the U.S between the ages of 15 and 44 have difficulty becoming pregnant or staying pregnant. This quantifies as approximately 6 million women.
For those with infertility issues, there are safe and effective treatments available that can improve the chances of conceiving. While no method is guaranteed, there is a good success rate with fertility methods in current times. Much of the success rate does depend on the level of inhibitory factors or medical issues involved.
Major Causes of Infertility
The uninhibited coordination of the steps involved in the process of becoming pregnant, such as ovulation, fertilization, and implantation, is critical to achieving conception. If there is a problem with one or more steps, infertility issues often occur.
Infertility can occur in both men and women. In men, infertility issues result from dysfunctional sperm production, insufficient sperm count, and issues with sperm motility. These can be caused by environmental factors, cancer, other health-related diseases, or genetics.
For women, infertility results from ovulation dysfunction, cervical/uterine abnormalities, organ damage, and ovarian deficiencies. These can be the result of hormonal imbalances and disorders, tumors and polyps, inflammation, cancer, or genetics.
A major cause of infertility in either men or women is poor lifestyle habits. Men and women who live an unhealthy lifestyle that includes alcohol abuse, smoking, drug abuse, sedentary lifestyle with a lack of exercise that often results in obesity will often have issues with infertility.
Thus, it makes sense to address these controllable factors as the first steps when considering treating infertility. Other uncontrollable factors such as age or genetic factors can then be considered.
Available Treatment Options For Infertility
If you have trouble conceiving and you’re concerned you may be infertile, it’s important to consult a doctor. The specialists may include a general obstetrician-gynecologist, a urologist, or a reproductive endocrinologist.
As a specialist in infertility, a reproductive endocrinologist will be able to determine a prognosis, diagnosis, and treatment protocol.
The following are the available treatment options for infertility depending on the dysfunction:
- Improve Nutrition
- Control Weight – Significantly overweight or even significantly below ideal body weight can affect ovulation
- Quit Smoking
- Reduce Alcohol Consumption
- Exercise Regularly
- Ovulation Stimulation (clomiphene or letrozole)
- Gonadotropin Therapy (considered in cases of failure of clomiphene)
- Metformin (consideration in cases of PCOS)
- Dopamine agents (in cases of hyperprolactinemia)
- Laparoscopy to determine possible causes of infertility (such as endometriosis)
- Intrauterine Insemination
- In Vitro Fertilization
The general plan for treatment of infertility is to attempt noninvasive measures, which include lifestyle changes and subsequent medication treatment with ovulation-inducing medications. The medication treatment will be based on the specific reasons identified for infertility. For example, patients with PCOS can be treated with metformin to control their insulin resistance better. In association with lifestyle changes, this helps to improve weight loss and can also lead to increased spontaneous menstrual activity, which can lead to possible spontaneous ovulation.
If medication treatment fails, surgical treatment may be considered. Laparoscopic surgery for resection of areas of endometriosis or scar tissue can be considered.
In vitro fertilization is a technique with a high success rate, yet the cost is often prohibitive, and there is also a high rate of multiple pregnancies.
As a woman ages, the risk of infertility increases. According to the National Institute of Health, a healthy woman in her 30s is half as fertile as a healthy woman in her 20s. This is always something to consider when planning pregnancy.
With several other major causes and risk factors of infertility, it’s important to do all that you can in your control to ensure that your body is healthy and that you are at your optimum weight for conception.
It is important to remember that approximately 60% of infertility is due to a female factor, and 40% is due to a male factor. Often a combination of both male and female factors affects the ability of any couple to conceive.
Overall, there have been significant advancements in the treatment of infertility, and a multitude of options are available for women with this condition. The success rates for achieving pregnancy in women with infertility are higher than they’ve ever been previously. It’s important for women to know that they should seek evaluation by their obstetrician or a reproductive endocrinologist if they have any difficulties achieving conception.