21 Jul What Causes Infertility in Women?
Infertility is the inability to conceive a child or carry a pregnancy to delivery. For women, the timing of evaluation is based on age:
- under age 35 – after 12 months of unprotected intercourse.
- 35-40 – after six months of trying.
- over 40 – after three months of unprotected intercourse.
Women who do not have regular menstrual cycles or have risk factors for infertility. The American Society for Reproductive Medicine (ASRM) estimates that 15 percent of couples will need fertility testing and treatment to conceive. This can be due to female infertility, male infertility, or a combination of both.
- Percent of women aged 15-49 with impaired fecundity: 13.1%
- Percent of married women aged 15-49 with impaired fertility: 16.2%
- Percent of married women aged 15-49 that are infertile: 8.8%
- Percent of women aged 15-49 who have ever used infertility services: 12.7%
What is Female Infertility?
Female infertility can arise anywhere along the complex pathway that starts in the brain and ends in a successful pregnancy.
For a successful fertility diagnosis, a woman’s system must be able to do the following:
- The ovary needs to release a mature egg (ovulation), which is a complex process directed by hormones from the brain and the ovary.
- The egg needs to be picked up by the fimbriae of the fallopian tube to be brought into the genital tract.
- In the fallopian tube, the egg must be fertilized by sperm within 24 hours to make an embryo.
- The resulting embryo must travel to the uterus and implant for pregnancy to occur.
Causes of Infertility in Women
The three main categories for the causes of infertility in women are:
- Issues with ovulation (oligo-ovulation or anovulation)
- Structural problems of the reproductive system (fibroids, polyps, Müllerian anomalies, tubal factors)
- Unexplained infertility, which is the diagnosis for 1 in 5 infertile couples (meaning no definitive cause is identified after initial testing)
Fertility Testing for Women
Once a woman has decided to seek evaluation, Fertility Specialists Medical Group will consult with the patient regarding her reproductive and health history, as well as any symptoms of conditions that could impact fertility.
Beyond the physical examination, the most common fertility tests for women include:
- Ovarian reserve testing measures the number of eggs a woman has. A blood test measures the anti-Müllerian hormone (AMH), which can be drawn at any point in the menstrual cycle or even while on the birth control pill. Also, an antral follicle count (AFC) can be performed via transvaginal ultrasound by examining the ovaries and assessing the group of eggs that are made hormonally receptive to each cycle.
- Hysterosalpingogram (HSG) is an outpatient imaging test that checks to see if the fallopian tubes are open and anatomically normal in appearance. The HSG is not particularly good at assessing the uterus.
- Transvaginal ultrasonography, performed by inserting an ultrasound probe into the woman’s vagina, allows the fertility specialist to view the uterus and ovaries and examine them for cysts, fibroids, or other abnormalities.
- Saline infusion sonohysterography (SHG) is used to detect uterine abnormalities such as polyps. It involves filling the uterus with saline (a salt solution) before performing a transvaginal ultrasound.
- Advanced fertility tests if necessary: hysteroscopy and laparoscopy
Fertility Treatment for Women
The recommended course of treatment for female infertility will vary for each woman based on individual circumstances, including age, duration of infertility, and overall health.
With continuing advances in reproductive medicine, many couples can overcome their fertility problems and conceive one or more children. Infertility can cause emotional distress. If you’re struggling with it, you need not lose hope — schedule a consult today with the leading fertility team in San Diego.