Guide to Treating Infertility step 4. Diagnosis Establishing the cause
Treating Infertility -Diagnosis Establishing cause :- Once the diagnostic tests have been completed, your doctor will have a clearer idea of what is causing the difficulty with conceiving and will then start treating the condition with medication, or recommend a procedure that may assist you in becoming pregnant. Many couples who have difficulty conceiving may have a specific medical condition hindering the woman’s ability to become pregnant.
In 40% of cases the issue is attributable to the female, while in 40% of cases the issue is traced back to the male. In about 10% of cases, fertility problems are linked to both partners. The remaining 10% of infertility is unexplained, even after exhaustive testing.12,13 A woman’s age is a definite factor in how easily they will become pregnant. A woman is most fertile between the ages of 15 and There is a decrease in fertility, although not significant, for women aged between 30 to 35.15 However, between 35 and 40, the fertility rate drops by at least 30%.
Causes of female infertility
- problems with ovulation
- blocked fallopian tubes
- polycystic ovary syndrome
- cervical problems.
Problems with ovulation
As we have discussed, becoming pregnant is dependent on the release of a healthy egg that is capable of being fertilised by a healthy sperm. However, if your period is irregular or absent then your production and release of eggs may be affected. About 25% of women who are infertile will have problems with ovulation. Infrequent periods (oligomenorrhoea) or the absence of periods (amenorrhoea) are most often caused by a deficiency in one of the controlling hormones. These can be successfully treated with medication. Problems are also associated with extremely low body weight, being overweight, or a significant change in weight. In addition, ovulation problems can arise if the ovaries themselves are resistant to normal levels of hormones. Absent, damaged or diseased ovaries will also prevent ovulation.
Blocked fallopian tubes
The fallopian tubes are delicate structures of only about the same thickness as the lead of a pencil. Because of this, they can easily become blocked or damaged. This can interfere with the sperm reaching the egg, development of a proper embryo, and implantation in the uterus. Blockages may arise as a result of scarring due to infection or previous abdominal surgery.
addition, PID is associated with an increased risk of subsequentectopic pregnancy – when the fertilised egg implants in the fallopian tube, ovary or abdominal cavity (instead of in the uterus). Tubal infertility can sometimes be treated by surgery, but if this is not possible, or if surgery is unsuccessful, in vitro fertilisation (IVF) –
This is a major cause of infertility and occurs when the tissue that normally lines the inside of the uterus grows in other places of your body where it doesn’t belong, such as on the ovaries, fallopian tubes, outside surface of the uterus, bowel, bladder and rectum. The symptoms of endometriosis may include heavy, painful and long menstrual periods. Because this tissue still acts the same as that found in your uterus and responds to changes in your hormones during your menstrual cycle, the tissue breaks down and bleeds, causing pain before and after your period, scarring and adhesions (organs sticking together).A laparoscopy is used to identify endometriosis and there are several forms of treatment available, involving both medications and surgery.
Uterine fibroids or uterine myomas occur in up to 70-80% of women by the age of 50.16 A fibroid is a non-cancerous growth of the muscle in the uterus, as illustrated. These may require treatment if they are causing problems with fertility.
Polycystic ovary syndrome
Polycystic ovary (ovarian) syndrome (PCOS) is a condition in which the ovaries are enlarged, with a smooth but thicker than normal outer cover. Many small cysts cover this surface, which
are themselves harmless, but may cause infrequent or absent periods, resulting in infertility.
Polycystic ovaries are most easily seen by an ultrasound scan. The condition may be treated with medication or larger cysts may need to be surgically removed.
Cervical problems may be related to the consistency or not having enough cervical mucus.
‘Mucus hostility’ may arise as a result of a vaginal infection or the presence of antisperm antibodies in the mucus.