Why cant some women get pregnant: Infertility | Office on Women’s Health
Infertility | Office on Women’s Health
What are the different types of assisted reproductive technology (ART)?
Common methods of ART include:
- In vitro fertilization (IVF) means fertilization outside of the body. IVF is the most effective ART. It is often used when a woman’s fallopian tubes are blocked or when a man produces too few sperm. Doctors treat the woman with a drug that causes the ovaries to produce multiple eggs. Once mature, the eggs are removed from the woman. They are put in a dish in the lab along with the man’s sperm for fertilization. After 3 to 5 days, healthy embryos are implanted in the woman’s uterus.
- Zygote intrafallopian transfer (ZIFT) or Tubal Embryo Transfer is similar to IVF. Fertilization occurs in the laboratory. Then the very young embryo is transferred to the fallopian tube instead of the uterus.
- Gamete intrafallopian transfer (GIFT) involves transferring eggs and sperm into the woman’s fallopian tube. So fertilization occurs in the woman’s body. Few practices offer GIFT as an option.
- Intracytoplasmic sperm injection (ICSI) is often used for couples in which there are serious problems with the sperm. Sometimes it is also used for older couples or for those with failed IVF attempts. In ICSI, a single sperm is injected into a mature egg. Then the embryo is transferred to the uterus or fallopian tube.
ART procedures sometimes involve the use of donor eggs (eggs from another woman), donor sperm, or previously frozen embryos. Donor eggs are sometimes used for women who can not produce eggs. Also, donor eggs or donor sperm is sometimes used when the woman or man has a genetic disease that can be passed on to the baby. An infertile woman or couple may also use donor embryos. These are embryos that were either created by couples in infertility treatment or were created from donor sperm and donor eggs. The donated embryo is transferred to the uterus. The child will not be genetically related to either parent.
Women with no eggs or unhealthy eggs might also want to consider surrogacy. A surrogate is a woman who agrees to become pregnant using the man’s sperm and her own egg. The child will be genetically related to the surrogate and the male partner. After birth, the surrogate will give up the baby for adoption by the parents.
Women with ovaries but no uterus may be able to use a gestational carrier. This may also be an option for women who shouldn’t become pregnant because of a serious health problem. In this case, a woman uses her own egg. It is fertilized by the man’s sperm and the embryo is placed inside the carrier’s uterus. The carrier will not be related to the baby and gives him or her to the parents at birth.
Recent research by the Centers for Disease Control and Prevention showed that ART babies are two to four times more likely to have certain kinds of birth defects. These may include heart and digestive system problems, and cleft (divided into two pieces) lips or palate. Researchers don’t know why this happens. The birth defects may not be due to the technology. Other factors, like the age of the parents, may be involved. More research is needed. The risk is relatively low, but parents should consider this when making the decision to use ART.
Why Can’t I Get Pregnant?
When you’re ready to start a family and you’re not getting pregnant, it can be frustrating and overwhelming. Especially if you’ve tried the conventional methods to maximize your chances: having frequent intercourse during your fertile window, tracking your temperature every morning and using tools like ovulation tracker apps and predictor kits.
You may start to wonder — is this a medical problem or do I simply need to be more patient? You’re not alone. One in 8 couples struggles to conceive. Chantel Cross, M.D., a reproductive endocrinologist and infertility specialist with the Johns Hopkins Fertility Center at the Johns Hopkins Health Care & Surgery Center — Green Spring Station in Lutherville, Maryland, explains what factors might be affecting your ability to get pregnant and when you might consider infertility treatment.
How is infertility defined?
Infertility is defined as the inability to become pregnant after one year of unprotected sex for women under 35 and six months for women 35 and older.
“The vast majority of people will become pregnant within the first 12 months of trying to conceive with regular unprotected intercourse,” says Cross. “After six months to a year of trying — depending on a woman’s age — we recommend that a couple comes in for an infertility evaluation. At that point, it’s more likely that there’s a problem preventing pregnancy.”
Medical Conditions Affecting Infertility
One or more factors may contribute to infertility. The most common problems include:
Fallopian tube obstruction
Blocked or scarred fallopian tubes that prevent sperm from reaching the egg are a frequent cause of infertility, especially among African Americans. A history of pelvic infection, sexually transmitted disease or endometriosis increases your risk for fallopian tube obstruction.
Irregular uterine shape
An irregularly shaped uterus can make it difficult for a fertilized egg to attach to the uterine wall. Abnormalities can be caused by uterine fibroids (noncancerous growths on the uterine wall) or scar tissue from surgery or infection. It could also be the way your uterus is shaped.
Sometimes women don’t ovulate regularly and consistently. Sporadic menstrual cycles can be caused by conditions such as polycystic ovary syndrome (PCOS), hormonal imbalances or obesity. Ovulation can also be impacted by excessive exercise, stress or low body weight.
In more than 30 percent of infertility cases, there’s a problem with sperm such as low sperm count or abnormal sperm movement or shape. Male factor infertility can be due to a number of reasons including trauma, medical conditions like diabetes and unhealthy habits such as heavy drinking and smoking.
The Impact of Stress on Fertility
It’s normal to feel anxious when you’re trying to conceive. But whether or not that impacts fertility is up for debate. What we do know is that managing stress is good for you, no matter what life stage you’re in.
Age Is a Major Factor for Women
You’ve probably heard the phrase “your biological clock is ticking.” This phrase refers to your fertile window. Women can’t conceive after their menstrual cycles stop, usually sometime in your 40s or 50s. Men produce sperm throughout their lives, but women are born with a set number of eggs that decreases as you age.
“At birth you have about two million eggs but naturally lose hundreds of thousands of them by the time you reach puberty,” says Cross. “Your body continues to lose eggs no matter what you do. And the rate at which women lose eggs accelerates around the age of 37.”
The quality of eggs stored in the ovaries also declines over time. “The eggs you’re born with are naturally paused in the process of dividing their DNA,” Cross explains. “They complete that process, or ripen, when you ovulate them 20 to 40 years later. The longer eggs are stuck in the mid-division stage, the more likely that process will go wrong — creating eggs with the wrong number of chromosomes. That results in not becoming pregnant, experiencing miscarriages or having babies with genetic syndromes due to chromosomal abnormalities.”
The bottom line: The quality and number of eggs a woman has decreases throughout her lifetime and egg loss accelerates around the age of 37, which makes it more difficult to become pregnant.
Do I Need Infertility Treatment?
If you’re having trouble conceiving, an infertility specialist may be able to help. The first step after 12 months of trying to conceive (six months if you’re 35 or older) is to schedule an infertility evaluation. This multipart assessment includes:
- Physical examination
- Pelvic ultrasound
- Blood work
- Semen analysis
- Evaluation of the uterus and fallopian tubes (by specialized x-rays or ultrasounds)
If you or your partner have a known medical condition that affects the uterus, fallopian tubes, sperm or ovulation, talk to your doctor to see if you should be evaluated sooner. For example, if you know that both of your fallopian tubes are blocked, you’ll need to see an infertility specialist even before trying to get pregnant.
What Causes Infertility in Women?
Infertility affects an estimated 10 percent of women. Studies have found that about a third of infertility cases are due to female infertility, another third to men, and the rest to issues affecting both partners or a cause that may remain a mystery.
Many factors can contribute to female infertility. Understanding them is the first step toward resolving them.
Female Infertility: Ovulation Problems
Problems with ovulation are the most common cause of female infertility. Without an egg being released — the very definition of ovulation — you can’t have a pregnancy. A lack of ovulation is frequently due to:
- Polycystic ovarian syndrome: An imbalance of hormones causes a disruption in the regular ovulation process.
- Primary ovarian insufficiency: With this condition that affects women under 40, your ovaries aren’t functioning as they should be during your fertile years.
Female Infertility: Blocked Fallopian Tubes
A blockage in your fallopian tubes can prevent a released egg from being fertilizing by sperm and from progressing on its journey toward your uterus. Blocked fallopian tubes can be traced to:
Female Infertility: Uterine Conditions
Infertility in women may be due to problems with the uterus itself or with unwanted growths within the uterus, such as uterine fibroids or polyps. Uterine fibroids, for instance, are typically benign but can grow on the uterine walls. Fibroids and other physical abnormalities of your uterus can make it difficult to conceive or carry a baby to term.
Female Infertility: Symptoms
Some common symptoms that may indicate female infertility include irregular menstrual periods, not having any periods at all, or extreme pain associated with your periods.
If you have any of these symptoms, if you know that you have a condition that can affect fertility like endometriosis or pelvic inflammatory disease, or if you have been trying unsuccessfully to get pregnant for one year (or for six months if you are 35 or older), it’s time to talk with your doctor. He or she can give you a physical exam, review your medical history, and perform tests to determine if you have female infertility.
Female Infertility: Diagnosing the Problem
Some of the more common tests used in the diagnosis of infertility in women are:
- Ovulation tracking. The first step in assessing your fertility is often tracking when you ovulate. To assess your ovulation, your doctor may instruct you to keep a record of your menstrual cycles, chart your body temperature, use a urine test kit, or have periodic blood tests; he or she even may monitor your follicle growth via ultrasound.
- Hysterosalpingogram. In this procedure, a liquid is injected into your cervix and an X-ray is used to track its flow to detect a blocked fallopian tube or uterine abnormality.
- Laparoscopy. A small surgical instrument called a laparoscope — a tube fitted with a small camera — is inserted in your abdomen so that the doctor can visualize any problems affecting your fallopian tubes or uterus.
- Hormone testing. Your doctor may order blood tests to check for abnormal levels of hormones that play a role in fertility issues.
- Ovarian reserve test. This simple blood test can give your doctor an idea of how many eggs you have and how healthy they are.
Female Infertility: Treatment
Advances in infertility treatments may help many women get pregnant. Options include:
- Medication, such as fertility drugs
- Surgery, such as removing endometrial growths or fibroids
- Artificial insemination
- Other assisted reproductive techniques such as in vitro fertilization (IVF)
Female Infertility: Reducing Your Risk
In many cases, you cannot control how fertile you are, but you can increase your chances of being able to have a healthy baby by:
Being unable to conceive can lead to a rash of emotions, including frustration. Infertility experts have developed many different treatment options. Talk with a doctor to see what might work best for you and your partner.
Infertility – NHS
Infertility is when a couple cannot get pregnant (conceive) despite having regular unprotected sex.
Around 1 in 7 couples may have difficulty conceiving.
About 84% of couples will conceive naturally within a year if they have regular unprotected sex (every 2 or 3 days).
For couples who have been trying to conceive for more than 3 years without success, the likelihood of getting pregnant naturally within the next year is 1 in 4, or less.
Some people get pregnant quickly, but for others it can take longer. It’s a good idea to see a GP if you have not conceived after a year of trying.
Women aged 36 and over, and anyone who’s already aware they may have fertility problems, should see their GP sooner.
They can check for common causes of fertility problems and suggest treatments that could help.
Infertility is usually only diagnosed when a couple have not managed to conceive after a year of trying.
There are 2 types of infertility:
- primary infertility – where someone who’s never conceived a child in the past has difficulty conceiving
- secondary infertility – where someone has had 1 or more pregnancies in the past, but is having difficulty conceiving again
Read more about how infertility is diagnosed.
Fertility treatments include:
- medical treatment for lack of regular ovulation
- surgical procedures such as treatment for endometriosis, repair of the fallopian tubes, or removal of scarring (adhesions) within the womb or abdominal cavity
- assisted conception such as intrauterine insemination (IUI) or IVF
The treatment offered will depend on what’s causing the fertility problems and what’s available from your local clinical commissioning group (CCG).
Private treatment is also available, but it can be expensive and there’s no guarantee it will be successful.
It’s important to choose a private clinic carefully. You can ask a GP for advice, and should make sure you choose a clinic that’s licensed by the Human Fertilisation and Embryology Authority (HFEA).
Some treatments for infertility, such as IVF, can cause complications.
- multiple pregnancy – if more than 1 embryo is placed in the womb as part of IVF treatment there’s an increased chance of having twins; this may not seem like a bad thing, but it significantly increases the risk of complications for you and your babies
- ectopic pregnancy – the risk of having an ectopic pregnancy is slightly increased if you have IVF
Read more about how infertility is treated.
What causes infertility?
There are many possible causes of infertility, and fertility problems can affect either partner. But in a quarter of cases it is not possible to identify the cause.
Common causes of infertility include:
- lack of regular ovulation (the monthly release of an egg)
- poor quality semen
- blocked or damaged fallopian tubes
- endometriosis – where tissue that behaves like the lining of the womb (the endometrium) is found outside the womb
There are also several factors that can affect fertility.
- age – fertility declines with age
- weight – being overweight or obese (having a BMI of 30 or over) reduces fertility; in women, being overweight or severely underweight can affect ovulation
- sexually transmitted infections (STIs) – several STIs, including chlamydia, can affect fertility
- smoking – can affect fertility: smoking (including passive smoking) affects your chance of conceiving and can reduce semen quality; read more about quitting smoking
- alcohol – the safest approach is not to drink alcohol at all to keep risks to your baby to a minimum. Drinking too much alcohol can also affect the quality of sperm (the chief medical officers for the UK recommend adults should drink no more than 14 units of alcohol a week, which should be spread evenly over 3 days or more)
- environmental factors – exposure to certain pesticides, solvents and metals has been shown to affect fertility, particularly in men
- stress – can affect your relationship with your partner and cause a loss of sex drive; in severe cases, stress may also affect ovulation and sperm production
There’s no evidence to suggest caffeinated drinks, such as tea, coffee and colas, are associated with fertility problems.
Page last reviewed: 18 February 2020
Next review due: 18 February 2023
Getting Pregnant Can Be Harder Than It Looks
Nancy Karabaic and her husband Chris LaChat of Wheaton, Md., are self-professed “late bloomers.” They courted for five years before deciding to tie the knot, but they never expected the pattern to follow them into parenthood. It did. They tried to conceive a baby for a full three years before Karabaic finally got pregnant.
“It was a surprise because I fully expected, like every woman does, that when the birth control was gone, it would happen next month,” she says. The couple had even begun some initial infertility testing to make sure everything was OK, although Karabaic got pregnant shortly thereafter.
Their story is common. Maybe we all learned our lessons too well back in junior high, squirming uncomfortably in our desks as our sex ed teacher ominously warned how easy it was to get pregnant. Many of us certainly devoted enough effort trying to avoid it all these years until the time was right.
The fact is, however, that getting pregnant is often more difficult than we’ve assumed, especially the older we get.
“Many people think that human reproduction is a much more efficient process than it really is,” agrees Dr. Robert Stillman, medical director of Shady Grove Fertility Centers in the Washington, D. C., area.
So to avoid the surprises — and disappointments — that might come with failure in those first few attempts, here’s the lesson you probably never heard from your parents or teachers on how to get pregnant.
The Odds Are in Your Favor
First of all, rest assured that the odds are definitely with you. About 85 percent of all couples will get pregnant within a year, but it’s also wise to have some realistic expectations. The average time it takes to conceive, for instance, is about six months, and women under 35 should wait until they’ve tried for a year before they consider calling their doctor or a fertility specialist with concerns, says Dr. Stillman.
For older women, the picture changes. Not only could it take longer to conceive, but there are fewer chances of succeeding.
“Women 35 and older who think things aren’t quite right, maybe their menstrual cycle is off, should bring that to someone’s attention fairly quickly — within three months if they’re not pregnant yet,” says Dr. Michael Zinaman, director of reproductive endocrinology at Loyola University Medical Center in Chicago. “If things seem absolutely fine, then they should contact someone after six months.”
The problem is that many women nowadays who are postponing children until later in life for a variety of reasons often don’t realize until it’s too late about the reduced odds, says Dr. A.F. Haney, chairman of the division of reproductive endocrinology and infertility at Duke University Medical Center.
“There’s this Susan Sarandon effect — everyone sees a 42-year-old woman getting pregnant, and they think there’s no problem waiting,” Dr. Haney says. “They need to understand the biological realities that go along with those life choices — that by waiting, there’s an increasing risk they’ll stumble or be unsuccessful — and many people, had they known that information beforehand, might sequence things differently.”
Do Any Tricks Work?
Mustering the patience until you conceive is often easier said than done. Standing on your head after intercourse, hanging upside down by moon boots, hypnosis — they’re all examples of measures that couples might only reluctantly admit to.
A British study even shocked the medical community by claiming recently that a late afternoon roll in the hay is the optimum time for conception because that’s when female hormones that affect fertility and sperm count and potency are at peak levels.
So far, however, experts say there isn’t enough evidence to prove that any particular positions, time of day or activity after intercourse make a difference.
“Remaining supine for a couple of minutes is more than adequate,” Dr. Stillman says. As for that romantic little getaway? “There’s nothing wrong with maintaining romance, or even a sense of humor, while trying to conceive, but a candle at the head of your bed is probably as useful as a candle at the Four Seasons, and it’s a whole lot less expensive.”
The fact is, there’s still only one way to get pregnant — by a sperm fertilizing the woman’s egg, which can happen for only about 12 to 24 hours after ovulation — approximately 14 days before the end of a woman’s monthly cycle. Ovulation sometimes can be harder to predict if a woman’s cycles are irregular. And for women who are getting older, monthly cycles first get shorter, then longer the closer they get to menopause.
Common signs of ovulation are increases in vaginal mucus discharge and abdominal discomfort on either side of the pelvis (called “mittelschmerz”), but most women usually aren’t attuned to those signs, says Dr. Zinaman.
To minimize the guesswork and help you get pregnant as quickly as possible, drug stores now carry a handy home test called an ovulation predictor kit, which range from about $15 to $40. Using a urine sample, the ovulation predictor kit measures the level of luteinizing hormone (LH) that increases significantly before ovulation, giving couples about a day or two’s notice of a woman’s most fertile period and maximizing the chances of conception. In addition, the maker of the Clearplan Easy ovulation predictor kit is introducing an even more high-tech gizmo that claims to give couples a six-day window of opportunity for conceiving. This handheld computer tests and records women’s LH and estrogen levels by reading a urine sample stick, and notifies them of low, high and peak fertility times. The device retails for about $200, plus $50 for a package of 30 test sticks.
These kits definitely beat the old-fashioned method of charting your temperature, which not only has the potential to drive women — and their spouse — nuts, but which isn’t even very effective because by the time you notice a temperature change, you’ve already ovulated and it’s too late to conceive. “It was kind of like watching a calendar, but not quite as tense because you know you have one or two days,” says Karabaic, who used one of these kits before getting pregnant. “It’s as obsessive as I got about tracking the best time to get pregnant because I knew that it would be counterproductive.”
Clearing Your Head
There are some relatively controllable factors that may be slowing down a couple’s ability to conceive. For women, they include being too overweight or underweight, eating disorders, excessive exercise, smoking and drinking. For men, smoking and drinking also can reduce sperm count, as can marijuana use and even hot tubs. However, there are also a lot of old wives’ tales out there, too. There’s no merit, for instance, to common folklore cautioning men that briefs hinder sperm production more than boxer shorts.
As for stress, the jury is still out. There are lots of examples of couples who had trouble conceiving until they cleared their heads and relaxed a little more — say, they decided to adopt a baby instead, take a trip, or became distracted with moving into a new house. There’s even some evidence that depression may cause physiological changes that hinder some women from getting pregnant, says Dr. Alice D. Domar, a clinical psychologist and director of the Mind-Body Program for Infertility at Beth Israel Deaconess Medical Center in Boston.
It’s also true that most individuals juggle a lot of stress in their lives and still manage to get pregnant. But while the mind-body connection continues to be explored, experts say that at the very least, noninvasive stress reduction techniques such as biofeedback and meditation can’t hurt. In fact, they’ll probably enhance one’s overall well-being, making the process of conception — and pregnancy — a whole lot more enjoyable.
“I’m convinced that for some people, it’s actually why they got pregnant,” Dr. Zinaman says. “You can definitely in your head stress yourself enough to throw out your ovulation in subtle ways. What’s more, pregnancy itself — or even going to an infertility doctor and starting treatment — can be stressful, so with some patients, anything they can do to make this a little more tolerable is going to help them in the long run.”
Infertility in Women | American Pregnancy Association
Infertility is a condition that affects approximately 1 out of every 6 couples. An infertility diagnosis is given to a couple that has been unsuccessful in efforts to conceive over the course of one full year. When the cause is lies with the female partner, it is referred to as female infertility. Female infertility factors contribute to approximately 50% of all infertility cases, and infertility in women accounts for approximately one-third of all infertility cases.
Female Infertility: Causes, Treatment and Prevention
What causes female infertility?
The most common causes of female infertility include problems with ovulation, damage to fallopian tubes or uterus, or problems with the cervix. Age can contribute to infertility because as a woman ages, her fertility naturally tends to decrease.
Ovulation problems may be caused by one or more of the following:
- A hormone imbalance
- A tumor or cyst
- Eating disorders such as anorexia or bulimia
- Alcohol or drug use
- Thyroid gland problems
- Excess weight
- Intense exercise that causes a significant loss of body fat
- Extremely brief menstrual cycles
Damage to the fallopian tubes or uterus can be caused by one or more of the following:
Abnormal cervical mucus can also cause female infertility. Abnormal cervical mucus can prevent the sperm from reaching the egg or make it more difficult for the sperm to penetrate the egg.
How is female infertility diagnosed?
Potential female infertility is assessed as part of a thorough physical exam. The exam will include a medical history regarding potential factors that could contribute to infertility.
Healthcare providers may use one or more of the following tests/exams to evaluate fertility:
- A urine or blood test to check for infections or a hormone problem, including thyroid function
- Pelvic exam and breast exam
- A sample of cervical mucus and tissue to determine if ovulation is occurring
- Laparoscope inserted into the abdomen to view the condition of organs and to look for blockage, adhesions or scar tissue.
- HSG, which is an x-ray used in conjunction with a colored liquid inserted into the fallopian tubes making it easier for the technician to check for blockage.
- Hysteroscopy uses a tiny telescope with a fiber light to look for uterine abnormalities.
- Ultrasound to look at the uterus and ovaries. May be done vaginally or abdominally.
- Sonohystogram combines ultrasound and saline injected into the uterus to look for abnormalities or problems.
Tracking your ovulation through fertility awareness will also help your healthcare provider assess your fertility status.
How is female infertility treated?
Infertility in women is most often treated by one or more of the following methods:
- Taking hormones to address a hormone imbalance, endometriosis, or a short menstrual cycle
- Taking medications to stimulate ovulation
- Using supplements to enhance fertility – shop supplements
- Taking antibiotics to remove an infection
- Having minor surgery to remove blockage or scar tissues from the fallopian tubes, uterus, or pelvic area.
Can infertility in women be prevented?
There is usually nothing that can be done to prevent female infertility caused by genetic problems or illness.
However, there are several things that women can do to decrease the possibility of infertility:
- Take steps to prevent sexually transmitted diseases
- Avoid illicit drugs
- Avoid heavy or frequent alcohol use
- Adopt good personal hygiene and health practices
- Have annual check-ups with your GYN once you are sexually active
When should I contact my healthcare provider?
It is important to contact your healthcare provider if you experience any of the following symptoms:
- Abnormal bleeding
- Abdominal pain
- Unusual discharge
- Pain or discomfort during intercourse
- Soreness or itching in the vaginal area
Some couples want to explore more traditional or over the counter efforts before exploring infertility procedures. If you are trying to get pregnant and looking for resources to support your efforts, we invite you to check out the fertility product and resource guide provided by our corporate sponsor. Review resource guide here.
However, if you are looking for testing or options to increase your fertility chances of conception, you can find a fertility specialist with the search tool below:
More informative articles:
Compiled using information from the following sources:
1. RESOLVE: The National Infertility Association
2. American Society for Reproductive Medicine (ASRM)
Having a Baby After Age 35: How Aging Affects Fertility and Pregnancy
Carrier Screening: A test done on a person without signs or symptoms to find out whether he or she carries a gene for a genetic disorder.
Chromosomes: Structures that are located inside each cell in the body. They contain the genes that determine a person’s physical makeup.
Complications: Diseases or conditions that happen as a result of another disease or condition. An example is pneumonia that occurs as a result of the flu. A complication also can occur as a result of a condition, such as pregnancy. An example of a pregnancy complication is preterm labor.
Diagnostic Tests: Tests that look for a disease or cause of a disease.
Down Syndrome (Trisomy 21): A genetic disorder that causes abnormal features of the face and body, medical problems such as heart defects, and mental disability. Most cases of Down syndrome are caused by an extra chromosome 21 (trisomy 21).
Eggs: The female reproductive cells made in and released from the ovaries. Also called the ova.
Embryos: The stage of prenatal development that starts at fertilization (joining of an egg and sperm) and lasts up to 8 weeks.
Endometriosis: A condition in which tissue that lines the uterus is found outside of the uterus, usually on the ovaries, fallopian tubes, and other pelvic structures.
Fetus: The stage of human development beyond 8 completed weeks after fertilization.
Fibroids: Growths that form in the muscle of the uterus. Fibroids usually are noncancerous.
Folic Acid: A vitamin that reduces the risk of certain birth defects when taken before and during pregnancy.
Genetic Disorders: Disorders caused by a change in genes or chromosomes.
High Blood Pressure: Blood pressure above the normal level. Also called hypertension.
In Vitro Fertilization (IVF): A procedure in which an egg is removed from a woman’s ovary, fertilized in a laboratory with the man’s sperm, and then transferred to the woman’s uterus to achieve a pregnancy.
Menstrual Cycle: The monthly process of changes that occur to prepare a woman’s body for possible pregnancy. A menstrual cycle is defined as the first day of menstrual bleeding of one cycle to the first day of menstrual bleeding of the next cycle.
Miscarriage: Loss of a pregnancy that is in the uterus.
Multiple Pregnancy: A pregnancy where there are two or more fetuses.
Neural Tube Defects (NTDs): Birth defects that result from a problem in development of the brain, spinal cord, or their coverings.
Obstetrician–Gynecologist (Ob-Gyn): A doctor with special training and education in women’s health.
Oocyte Cryopreservation: A procedure in which eggs are removed from a woman’s ovaries and frozen for later use with in vitro fertilization (IVF).
Ovaries: Organs in women that contain the eggs necessary to get pregnant and make important hormones, such as estrogen, progesterone, and testosterone.
Preeclampsia: A disorder that can occur during pregnancy or after childbirth in which there is high blood pressure and other signs of organ injury. These signs include an abnormal amount of protein in the urine, a low number of platelets, abnormal kidney or liver function, pain over the upper abdomen, fluid in the lungs, or a severe headache or changes in vision.
Prenatal Care: A program of care for a pregnant woman before the birth of her baby.
Preterm: Less than 37 weeks of pregnancy.
Screening Tests: Tests that look for possible signs of disease in people who do not have signs or symptoms.
Sexually Transmitted Infections (STIs): Infections that are spread by sexual contact. Infections include chlamydia, gonorrhea, human papillomavirus (HPV), herpes, syphilis, and human immunodeficiency virus (HIV, the cause of acquired immunodeficiency syndrome [AIDS]).
Sperm: A cell made in the male testicles that can fertilize a female egg.
Stillbirth: Birth of a dead fetus.
Uterus: A muscular organ in the female pelvis. During pregnancy, this organ holds and nourishes the fetus. Also called the womb.
Vaccines: Substances that help the body fight disease. Vaccines are made from very small amounts of weak or dead agents that cause disease (bacteria, toxins, and viruses).
90,000 7 reasons why a woman cannot get pregnant
Many couples, even young and healthy ones, have problems with conception. Why is this happening? There are a number of reasons why a woman cannot get pregnant. You will be surprised how obvious and simple they are, MedicForum writes.
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Reason # 1: irregular schedule
Work causes a lot of problems in the life of a person, especially a woman.In particular, an irregular schedule can lead to a woman not getting pregnant. This is the conclusion reached by experts from Harvard University. They conducted a study and found that the body of a woman who has an irregular schedule or night work produces fewer eggs – by 28%.
Experts have noticed that there is an explanation for this. The fact is that such representatives of the fair sex experience malfunctions of the circadian rhythm, that is, violations of biological processes.This is why women cannot get pregnant.
Reason # 2: stress
Stressful situations in general can negatively affect the health of people. In women, this is also manifested in the fact that she cannot get pregnant. According to statistics, those women who are often exposed to stress suffer from infertility. This, by the way, is inevitably connected with work – it is she who most often becomes a provocateur.
Reason # 3: alcohol
According to Danish scientists, the probability of not getting pregnant is reduced by 18% with regular consumption of alcoholic beverages.If a woman is a drinker, then problems with conceiving a child are inevitable.
Reason # 4: fast food
Fatty, junk food often causes health problems. This is especially true for women who want to get pregnant. Obesity occurs very often when eating fast food. But it’s not only that. The trans fats found in fast food can trigger ovarian disease. Sperm production is also negatively affected.Therefore, if a woman and a man want to have a child, then it is better to stick to a healthy diet.
Reason # 5: carbonated drinks
Perhaps everyone knows about the dangers of carbonated drinks. But not everyone knows how this affects the state of a woman’s health. As a rule, with regular soda consumption, a woman cannot get pregnant due to artificial sweeteners that are added to drinks. The quality of the eggs is significantly reduced, therefore, the likelihood of a successful conception is extremely small.
Reason # 6: appendix or tonsils
It may sound rather strange, but scientists have found that there is a definite connection between the above organs and the likelihood of getting pregnant. It is known that women who had their appendix removed had a much higher chance of getting pregnant – by 34%. And for those who were deprived of their tonsils by surgeons – by 49%. If there was not both, then by 43%.
Reason # 7: wrong man
Of course, every woman wants to marry for love, to have a child from a loving and beloved man.But not everyone succeeds, even if there are strong and mutual feelings between the spouses. The fact is that some women choose the wrong partner and run the risk of contracting one of the types of herpes. Most often, it cannot be detected in the blood, and this is what becomes the reason for the inability to get pregnant.
90,000 Causes of infertility in women
If a woman is faced with a problem of conception, it is only natural to ask what is causing this? Next, you will find out what can affect reproductive function, and whether you need to seek medical help to get pregnant?
- MYTH: infertility is more often caused by problems in women than in men.
- TRUTH: infertility occurs with the same frequency in both women and men. In about 1/3 of couples, infertility is observed in a man, in 1/3 in a woman, and in 1/3 in both partners. 1
Is this my fault?
Difficulties with the onset of pregnancy are observed quite often. On average, 9% of the total population face this problem. 2
There are many factors that can cause infertility, so you should not focus on “whose fault it is.”
- Approximately 1/3 of infertile couples are caused by a female factor 1
- In 1/3 of infertile couples, the cause is male factor 1
- In 1/3 of infertile couples, the cause is a mixed (male and female) factor 1
Infertility is not a permanent condition, and it does not mean that you will never have children. You just may need the help of a specialist to achieve your goal – pregnancy.
What are the causes of female infertility?
After you and your partner undergo a fertility test, your doctor will be able to make a diagnosis that explains the causes of infertility.
Unfortunately, in some cases it is not possible to determine a specific factor, therefore a diagnosis of “infertility of unknown etiology” can be made. In some cases, the doctor may recommend the passage of more advanced and modern methods of infertility treatment – assisted reproductive technologies (ART).
- With increasing age, reproductive function begins to decline
- A healthy 30-year-old woman is approximately 20% likely to become pregnant every month 3
- However, a healthy 40-year-old woman has approximately 5% chance of becoming pregnant per month 3
- As you age, the likelihood that you will need ART procedures to get pregnant increases
- Problems with ovulation occur in approximately 25% of cases associated with infertility 4
- In order for a woman to become pregnant safely, ovulation (the release of an egg from the ovary) must take place every month
- Ovulation may not occur if a woman has irregular or no periods, or if the woman is overweight or underweight
- Medication is usually prescribed to treat ovulation problems 4
- 25-35% of cases of female infertility are associated with obstruction or functional insufficiency of the fallopian tubes 6
- The fallopian tubes are extremely sensitive to damaging factors
- Obstruction of the fallopian tubes may result from a previous infection or surgery on the abdominal organs
- An obstruction of the fallopian tubes can prevent the passage of sperm to the egg.If fertilization has occurred, then the impassability complicates the development of the embryo and its passage into the uterine cavity
- Obstruction of the fallopian tubes in some cases can be cured by surgery. In case of failure of surgical treatment, an in vitro fertilization (IVF) procedure may be required
- 30-50% of women with endometriosis suffer from infertility 7
- Endometriosis – a disease in which the endometrium (the tissue lining the uterine cavity) is found in the ovaries, fallopian tubes, on the outer surface of the uterus, and in other parts of the body 1
- Endometrio may cause painful, heavy, irregular periods, scarring and adhesions 5
- Laparoscopic intervention will help diagnose endometriosis
- Medicines and / or surgical methods are used to treat endometriosis.After therapy, it is possible to switch to ART
- Approximately 5-10% of fertility problems are due to fibroids (fibroids or leiomyomas)
- These are benign neoplasms consisting of muscle and connective tissue that develop in and around the tissues of the uterus
- They can change the shape of the uterus or fallopian tubes or lead to obstruction of the fallopian tubes
- These tumors can obstruct the movement of sperm to the egg or prevent the implantation of an embryo in the uterus
- The exact cause of the development of fibroids is unknown, and the severity of any symptoms is usually due to their location, size and number
- Treatment of fibroids is carried out using drugs and / or surgical methods.After therapy, it is possible to switch to ART
- 70-80% of women with PCOS may experience infertility 9
- PCOS leads to an increase in ovarian volume, as well as the growth of numerous small cysts on the thickened surface of the ovaries 4
- This can lead to irregular periods, which in turn affects fertility 4
- Ultrasound is used to diagnose PCOS
- Drugs and / or surgery are the most commonly used treatments for PCOS.After therapy, it is possible to switch to ART
- From 3% to 8% of cases of female infertility can be associated with pathology of the cervix 10
- Glands located in the cervix secrete a secretion (mucus) that helps the sperm move through the genital tract 11
- Some women do not produce enough secretion, it may be too dense and viscous, or contain antibodies (protein molecules) that inhibit sperm activity 11
- Problems with cervical mucus can be eliminated with the help of drug therapy / either by transferring sperm directly to the uterus by insemination / or using IVF, which will ensure conception outside the female body
- Sexually transmitted infections (STIs) such as chlamydia or gonorrhea can cause pelvic inflammatory disease (PID) 5
- PID cause tubal obstruction and increase the risk of ectopic pregnancy 8.12
- An ectopic pregnancy develops when the embryo is implanted outside the uterus 12
- Treatment of obstruction of the fallopian tubes is possible with the help of surgical intervention, in case of failure, VRT may be required
- Menopause is a natural process that women go through when fertility ends and menstruation stops
- Some women develop early menopause before age 40
- If a woman has an early menopause, then for the onset of pregnancy it is necessary to resort to assisted reproductive technologies (ART), including the use of donor eggs
Do oral contraceptives cause my infertility?
MYTH: Taking oral contraceptives for several years increases the risk of developing infertility.
TRUTH: Studies have not found an association between infertility and the use of contraceptives for a long period of time.
Like many women, you may have used oral or other hormonal contraceptives for several years to prevent unwanted pregnancies. When you decide to become pregnant, it is logical that the inability to implement these plans immediately causes you a lot of excitement.
However, studies have not demonstrated an association between infertility and the use of contraceptives for an extended period of time. 13
Uncertainty is certainly frustrating, but you shouldn’t worry or think about contraception as a potential cause of failure.
Seeking medical care
The assumption of infertility can be extremely painful. Being overwhelmed with feelings about your future is completely normal, and you may need additional support from loved ones.
You should talk to your doctor about your reproductive health if:
- You know you have any of the conditions listed above
- You are under 35 and trying to get pregnant within 1 year 3
- You are over 35 and trying to get pregnant within 6 months 3
Methods for the study of reproductive function in women
Influence of the reproductive cycle on female reproductive function
To learn more
90,000 Infertile women on the rise – News – IQ Research and Education Portal – National Research University Higher School of Economics
The diagnosis of “infertility” is being made to married couples more and more often.The spread of this phenomenon is associated with the fashion for postponing childbearing to a later age, celibacy, illiterate sexual behavior and the growth of female diseases. At the same time, in vitro fertilization and other assisted reproductive technologies are not available for all childless couples, said Rosalia Fakhrislamova , a postgraduate student at the Institute of Demography, National Research University Higher School of Economics .
The number of registered diseases for the first time diagnosed with infertility was 78 thousand in Russia in 2012.However, this statistic is corrected by two points. Firstly, there is a latent morbidity that will bypass all calculations: some women, for various reasons, are not examined, they are not diagnosed. Secondly, the very “mathematics” of morbidity is not easy.
The rise in the prevalence of some pathologies may be partly due to simple improvements in diagnostics. In some patients, the first signs of abnormalities are revealed. And in others, long-existing diseases are discovered and identified, and this, in fact, is already statistics of “yesterday”.The increase in the number of diagnoses of “infertility” is undoubtedly associated not only with the upgrade of diagnostics, but also with social aspects, behavior, Rosalia Fakhrislamova is convinced.
Modern women, primarily educated city dwellers, in realizing their life plans, postpone childbearing to all later ages. Meanwhile, over the years, fertility declines and the likelihood of permanent childlessness increases (see the article “Postponing motherhood increases the risk of childlessness”).
There are also ideological opponents of motherhood – child-free, who, however, sometimes reconsider their beliefs (see.the article “Child-free are a reserve of late motherhood”). Some women are childless simply because they have not married. Physiological infertility can be the result of negligent sexual behavior: caught genital infections can provoke pathologies, and unwanted pregnancies often end in abortions and reproductive failures.
As a result of the action of various factors over the past twenty years, since 1995, the number of officially recorded cases of infertility has increased several times, the researcher emphasizes.
The report of Rosalia Fakhrislamova with the telling title “The new demographic challenge of Russia: the problem of female infertility” is an attempt to give a comprehensive picture of the phenomenon. The work is based on four databases at once: the population censuses of 2002 and 2010, official health statistics and the 2011 Sample Survey of the Reproductive Health of the Russian Population (conducted jointly by Rosstat and the Ministry of Health; 10,010 women aged 15-44 were interviewed; coverage – 60 regions; see . about it).This “synchronization of clocks” allows you to give a more accurate picture of the phenomenon.
Reproductive health deteriorated sharply
About 5% of the population is infertile due to “unavoidable factors”: anatomical, genetic, endocrine, according to the World Health Organization.
A sample survey of the reproductive health of the population of Russia confirms this statistic. Almost 5% of respondents who have ever been married reported that they or their partners were diagnosed with infertility.Among infertile women, 36% had problems with ovulation, 30% had obstruction of the fallopian tubes, and 18% had endometriosis (abnormal proliferation of the uterine lining). Almost a third of women could not get pregnant due to pathologies in their partner.
The figures obtained from the analysis of the population censuses are also comparable with the WHO statistics. At the same time, for later generations, the incidence of infertility is increasing, Fakhrislamova noted. In women born in 1930-1960s who were married (official or civil), the level of infertility did not exceed 4%.And among women born in 1970, this figure is already close to 6%, the researcher calculated.
Experts began to notice the deterioration of the reproductive health of Russian women of different ages already in the 2000s. And although in 2012 compared with 2002 the level of cervical pathologies (erosion, etc.) per 100 thousand women decreased by 76%, at the same time another morbidity increased: menstrual disorders – by 44%, complications of pregnancy, childbirth and the postpartum period – by 30%, female infertility – by 58%.
Thus, 227 women of fertile age (18-49 years old) out of 100 thousand women in 2012 were diagnosed with infertility (Figure 1). Compared to 1995, when the minimum indicator was recorded (52 cases of infertility per 100 thousand women), the incidence increased by almost 4.4 times.
This process was influenced by both medical and behavioral factors, including a shift in childbirth, Fakhrislamova said. It is also likely that couples, not wanting to be treated with traditional methods for a long time, have become more likely to receive conclusions about infertility from doctors and turn to assisted reproductive technologies (IVF, surrogacy, germ cell donation).
Figure 1. Number of registered diseases with newly diagnosed infertility (per 100,000 women 18-49 years old), 1990-2012.
Source: Healthcare in Russia. 2013: Stat. Sat / Rosstat. – M., 2013.
Is infertility not fatal?
If we take in absolute terms, in 2012, 78 thousand women were diagnosed with infertility (Figure 2). For comparison: in 2005, 53 thousand such diagnoses were made.This statistics includes both primary infertility (inability to get pregnant, communicate, give birth to a live child), and secondary (when a woman cannot give birth to the next child).
Figure 2. The number of registered diseases with the newly diagnosed infertility, thousand people, 1990-2012.
Source: Healthcare in Russia. 2013: Stat. Sat / Rosstat. – M., 2013.
Today, it is possible to treat infertility when the patient becomes fertile, and to overcome the situation – in this case, children appear in a couple due to assisted reproduction.So, in 2011, according to the Russian Association for Human Reproduction, by the number of cycles of such reproduction – almost 56.9 thousand – Russia took the third place among European countries. Nevertheless, these services are not available to the majority of the population due to high financial, territorial and psychological costs, Fakhrislamova comments.
Dynamics of infertility depends on stereotypes of behavior
Based on the 2002 census, the researcher identified two periods of the dynamics of female infertility.For married women born in the 1930s and 1960s, these indicators decreased. On the other hand, among women born after 1965, the proportion of infertile ones increased (Figure 3).
The first period is characterized by the improvement of the system of protection of mothers and children, comments Fakhrislamova. The increase in the proportion of infertile in the second period is probably due to the “aging of motherhood”, more frequent change of sexual partners, which affects the prevalence of infections. “The revealed negative picture suggests that the main problem lies in social, behavioral reasons,” the author of the report believes.
Figure 3. The proportion of childless women in registered and unregistered marriages, born in 1930-1960.
Source: R. Fakhrislamova’s calculations based on the results of the 2002 All-Russian Population Census.
90,055 Infertile women – almost 8% 90,056
For more accurate statistics, the researcher selected women aged 40-44 on the basis of a Sample Survey of the Reproductive Health of the Russian population.94.4% of them have ever been pregnant. 5% have never been pregnant and 0.6% have never had sexual intercourse. If we add here women who had a pregnancy, but did not have live births, then the total of infertile women 40-44 years old will be about 8%, Fakhrislamova calculated. At this age, this is already the final childlessness.
Of the women who did not have a single pregnancy, almost 40% were not pregnant due to the absence of a partner, the author of the work adds.
The respondents were asked what, in their opinion, is the reason for the impossibility of getting pregnant at a given point in time.The answers were analyzed in two groups of women: “there was a pregnancy” and “never was.” Although in both groups the majority of women chose the option “the respondent has no partner / is not sexually active” (40% among those who had a pregnancy and 26% among those who did not), some peculiarities were revealed. Among women who have never been pregnant, the proportion of women with various kinds of gynecological problems is higher than among those who were pregnant.
Thus, the problem of infertility is becoming more and more urgent.However, given the inaccessibility of assisted reproductive technologies, it is necessary to rely on the prevention of diseases and timely treatment of pathologies. The attitude to one’s own health should be somewhat different – more responsible, Fakhrislamova sums up.
Childfree reserves for late motherhood
Delaying motherhood increases the risk of childlessness
Childlessness increasingly predetermines beliefs
Abortion is no longer a method of family planning
Test-tube babies are changing the concept of kinship
Treating infertility is easier than convincing child-free
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90,000 Why can’t I get pregnant?
Many women turn to a gynecologist for help with infertility. Moreover, different women define this problem in different ways. Some wait 3-4 years and only then go to the doctor, while others start to worry after 2-3 months of trying to get pregnant. Sometimes women come to my office who are not planning a pregnancy at the moment, but just want to make sure that everything is fine with them and they can have children.
In the medical literature, infertility is defined as the absence of pregnancy after 12 months of regular intercourse without the use of contraception.
Causes of infertility
Infertility is a problem that affects both partners. Although many patients mistakenly believe that infertility is a purely female problem. Of course it is not. Infertility is divided into 2 categories:
primary and secondary.In men, primary infertility means that none of his partners got pregnant, secondary infertility – when at least one of his partners was pregnant. There are many reasons for male infertility, for example, varicocele, lack of sperm in the semen; obstruction of the vas deferens, etc. The main test for male infertility, or, conversely, fertility, is a spermogram, or sperm analysis for the number of sperm, their motility, morphology, etc.
Female infertility is also subdivided into primary and secondary.Primary infertility – when a woman has never had a pregnancy; secondary infertility – when there was a pregnancy in the past, and it does not matter if this pregnancy ended in childbirth, abortion or ectopic pregnancy.
Female factor is the cause of infertility in 40% of cases. In 15% of cases, the reasons for the couple’s infertility cannot be determined (infertility of unexplained genesis), in 20-30% of the couple, more than one disorder is detected, male infertility is about 20%.
Let’s dwell in more detail on the causes of female infertility
Problems with ovulation
First, let’s figure out what is ovulation .In a normal menstrual cycle, the female ovary (female reproductive gland) secretes an egg (ovulates) every 24 to 35 days. Ovulation usually occurs 12-14 days before the start of the next menstrual cycle, with the greatest chance of getting pregnant either on the day of ovulation or 2-4 days before ovulation. An ovulation problem occurs when the egg is not mature or viable. This happens when the ovaries do not produce mature follicles and no egg is released.
Lack of ovulation is the most common cause of female infertility.In turn, the absence of ovulation is caused by various disorders in the female body.
Complex hormonal processes regulate the coordinated work of the brain and ovaries. If one of the links of this fragile chain is disturbed, then the correct signal from the central nervous system does not enter the ovaries, and ovulation does not occur. This can be due to head trauma, swelling, certain medications, and various chemical disorders. Hormonal disorders can affect the hypothalamus (a part of the brain) and the pituitary gland (an endocrine gland located next to the hypothalamus).
A very common reason for the absence of ovulation is an increase in the blood prolactin – a hormone produced by the pituitary gland.
This is a common syndrome that leads to hormonal disorders. Externally polycystic manifests itself in irregular menstrual cycles or their absence for several months, and in some cases – in increased hair growth and overweight. In polycystic ovary, many small follicles form in the ovary, but none of them mature to the end, and the egg is not released.
I want to emphasize that ovulation is a complex process that depends on the correct hormonal signals. With polycystic ovaries, the hormonal background is disrupted. Therefore, one of the important tests for the causes of infertility is to determine in the blood levels of the hormone estrogen (produced by the ovary), pituitary hormones FSH / LH, as well as male sex hormones.
Another common hormonal disorder leading to female infertility is abnormalities in the function of the thyroid gland, when, as a result of hormonal imbalance, again, a fertile egg does not develop.
Damage to the fallopian tubes
The fallopian tubes carry the egg from the place of its birth – the ovary, to the place where it meets the sperm – to the uterus. If the tubes are damaged, then the egg does not reach the right place or gets stuck in the tube (this is how ectopic pregnancy occurs). Tubes can be damaged as a result of an infectious or inflammatory process, decreased mobility of the fallopian cilia, or a congenital anomaly.
After an infection (it can be a venereal or a postpartum / post-abortion infection), adhesions appear in the tubes, which interfere with the normal functioning of the fallopian tubes or even lead to their complete obstruction.
Normally, the endometrium is the cell membrane that lines the inner surface of the uterus. This layer is renewed every month during your period. Endometriosis – a disease in which endometrial cells grow outside the uterus, for example, on the surface of the ovaries, in the abdominal cavity, etc. Clinically, endometriosis is manifested by pain during menstruation, during intercourse, and infertility. Endometriosis causes infertility due to adhesions between the tubes, the formation of cysts on the ovaries, and suppression of ovulation.
Violation of the structure of the uterus
Some women are born with various abnormalities in the structure of the uterus. Moreover, menstruation proceeds normally, and anomalies manifest themselves only in the childbearing period. Congenital anomalies are very diverse: there can be two uterus, there is a two-horned uterus, a uterus with a septum, etc. in the cervical canal.
It should be noted that psychological causes of infertility are quite rare, and it is difficult to deal with them. In addition, knowing our stressful daily life, it is difficult to advise the patient to be less nervous and avoid stressful situations.
Often couples who are faced with the problem of infertility do not know where to go and where to find the information they are interested in. But remember that the best source of information is a gynecologist, because each pair is unique, and your problem requires an attentive and individual approach of a specialist.
It is very important that during this period you have a competent doctor who will tell you about the methods of diagnosing and treating infertility. We are sure that there are very few really hopeless situations; it is important to correctly determine the cause and prescribe individual treatment.
90,000 Endocrine (hormonal) infertility in women – treatment in St. Petersburg. Price in CPC Medica | Infertility treatment in St. Petersburg. Price in DSP Medica
Endocrine, or hormonal infertility is a fairly common reason that a woman cannot conceive a child.It is this factor that becomes decisive in 40% of all cases of inability to get pregnant.
If such a diagnosis is made, do not rush to despair: the treatment of hormonal infertility in women can be long-term, but the percentage of its effectiveness is very high.
It is recommended not to delay the solution of the issue, since changes occur in the body with age, and after 30, problems with conception can only worsen. And if hormonal infertility is detected, treatment after the age of 30 will be more difficult.When contacting the clinic, doctors not only use every chance for a healthy pregnancy, but also create a favorable situation with medication.
Treatment of hormonal infertility in women is preceded by a thorough diagnosis. For this, the process of ovulation is examined, that is, the regular (or not) maturation of the egg, which matures in the ovaries and then, in case of pregnancy, is fertilized. If the egg does not mature, this condition is called anovulation. In this case, there is hormonal infertility, the treatment of which is prescribed by a specialist after a detailed examination of the patient.
Causes of the disease
Anovulation can be caused by various problems: polycystic ovary , hyperprolactenimia, hypogonadism and other diseases. The real reason will be determined by the specialists of the clinic after a medical examination.
The fact that the patient has hormonal infertility, which should be treated immediately, may indicate menstrual irregularities, namely, the absence of menstruation for a long period of time against the background of a low basal temperature.But this is not a 100% indicator, since the egg cell may not mature even with a regular cycle.
Indirect symptoms are: increased intensity of the hairline, painful premenstrual syndrome, a noticeable decrease in libido, profuse bleeding during menstruation. To diagnose hormonal infertility in women, the doctor begins the examination by monitoring the basal temperature and conducting ultrasound studies at different periods of the cycle. An ultrasound scan is performed not only on the small pelvis, but also on the thyroid and adrenal glands.In addition, it is necessary to pass a detailed analysis for hormones: there are many of them, and each has its own optimal period for blood sampling.
What hormones form the ability to conceive and bear a child
When all these indicators are normal, there is no question of hormonal infertility in women and its treatment. In case of a deficiency or excess of one of the components of the general background, its correction is required.
Diagnostics is carried out by both a gynecologist and an endocrinologist, in the case of hormonal infertility, they also prescribe a general treatment, based on the recommendations of both specialists.The minimum period for achieving a result is usually six months, but it can take much longer.
At the same time, statistics show that the inability to get pregnant caused by hormonal infertility, in the treatment of women in most cases can be eliminated. It is important to contact a competent specialist who will select the correct medication regimen.
- FSH (follicle stimulating hormone)
- LH (luteinizing). The ratio of FSH and LH in the patient’s body, which is examined for hormonal infertility, matters: treatment will largely depend on this indicator
- DEA sulfate
- Thyroid hormones: Free triiodothyronine, General thyroxine, and others
- Antibodies to TSH are also tested
Disease control strategy
Treatment of hormonal infertility in women is carried out with the help of hormones.
- If the cause of anovulation is hypothyroidism, then thyroid hormone therapy is prescribed.
- When ovulation does not occur due to prolactinoma, the treatment of hormonal infertility in women is based on taking cabergoline. If hormone therapy does not give the expected result, surgery may be needed.
- Andrenogenital symptom as the reason for the absence of ovulation is eliminated with the help of glucocorticosteroids.
- Progesterone will help to compensate for the insufficiency of the corpus luteum in the ovaries, which causes the inability to become pregnant.
- Some factors that led to anovulation require a change in lifestyle: dietary systems (quantity and set of foods), giving up bad habits, intensifying physical activity. There are times when it is enough to change your daily life to forget about hormonal infertility.
The hormonal background is a very sensitive and delicate system, therefore, their ratio in the clinic will be adjusted with care, carefully checking each step of the appointment. In any case, all these measures are aimed at achieving restoration of ovulation.But even if its function is restored, the intake of drugs is often prolonged until pregnancy and even during it. And only with a successful birth can we say that the treatment of hormonal infertility in a woman is complete.
Such stimulation, aimed at restoring ovulation with the help of hormone-containing drugs, can be direct or indirect. Direct implies the use of oral contraceptives. After their abolition, a favorable background of hormones is formed, which stimulates the onset of ovulation and subsequent pregnancy.
Indirect is the appointment of a drug (clomiphene), which blocks the receptors of one of the hormones, which corrects the background and allows the egg to mature. Not all people are sensitive to this kind of substances, and if this method does not work, and at the same time does not give results and direct stimulation, then in this conservative area, the treatment of hormonal infertility in women exhausts its possibilities.
But the patient still has a high chance of getting pregnant through extracorporeal fertilization (IVF).Many people believe that hormonal infertility is the best treatment. However, this process can take so long that many patients, having lost faith in therapy, prefer to go to IVF.
Prevention and related circumstances
You are much less likely to face hormonal infertility if you:
- Do not follow strict diets;
- You are not overweight;
- The nervous system is not exposed to constant stress;
- You have no bad habits: smoking, alcohol abuse, use of narcotic and psychotropic substances;
- No history of abortion;
- Do not take oral contraceptives or hormones without a doctor’s prescription.
- Do not use uncontrolled methods of alternative medicine or folk remedies instead of prescribed treatment for hormonal infertility in women or in addition to it.
When you go to the clinic, be sure that they will help you. Know that the likelihood of a cure is very high. Believe that soon you will become a mother. A positive attitude is a prerequisite for recovery.
EXAMINATION AND TREATMENT ARE CARRIED OUT ON THE LATEST
- our specialists are candidates of medical sciences, permanent participants of congresses and conferences;
- we use only WHO (World Health Organization) recommendations,
modern scientifically proven approaches and methods;
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- examination and treatment is carried out using the latest high-tech equipment;
- our patients are fully informed about the course of treatment and diagnostic
- We guarantee an individual approach to each patient and provide him with comfort.
What to do if you can’t get pregnant for six months
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When to see a doctor regarding conception?
Any couple after a year of unsuccessful attempts to conceive should be consulted to determine the causes of infertility. For a woman over 35 years old, 6 months is enough to start the examination.
Any parasite after a year of unsuccessful attempts to conceive should be consulted to determine the causes of infertility. For a woman over 35 years old, 6 months is enough to start the examination.
When pregnancy does not occur, doubts arise as to when to start the examination.We ask ourselves the question, is it better earlier or maybe wait and not rush.
The answer is clear enough in this case. It is recommended to start an infertility examination, that is, go to the doctor after a year of regular sexual activity without using any method of contraception (combined oral contraceptives, patches and rings, intrauterine devices, condoms, or simply interrupted sexual intercourse).
We know that there is no 100% chance of getting pregnant during one menstrual cycle, even in high fertility couples.Therefore, it is highly desirable to give the opportunity to nature before having a reasonable suspicion of infertility and starting the examination. It is estimated that couples have a 25% chance of getting pregnant without any problems in one cycle and under normal conditions, and 85% of getting pregnant within a year of stopping contraception.
Many couples who fail to get pregnant during the first year may become pregnant during the second. However, the probability is very small if you do not resort to the help of specialists, so it is advisable to perform a number of diagnostic methods in order to assess the general situation and develop a strategy.“Developing a strategy” does not mean applying treatment with assisted reproduction methods, but having a clear idea of the steps that need to be taken to eliminate the causes of infertility.
However, we need to be more flexible. It should not be assumed that infertility testing should be started before one year has passed, and this should not be the rule for all cases. In those couples where women are older, this period can be reduced, the more the age, the shorter the period.In general, we tend to believe that women over 35 should start testing after six months of sexual activity without using contraception. And in couples where the woman is younger and has no suspicious circumstances in her anamnesis, it may be prudent to postpone the examination only if the couple’s emotional state allows it.
In many other cases, a previous medical history leads us to suspect or even be confident that pregnancy will not occur naturally.This applies to men with testicular disease in childhood, women with premature ovarian failure and, of course, when it comes to a single woman or a couple in which one of the partners underwent voluntary sterilization (tubal ligation or vasectomy).
Sometimes, despite the fact that it has only been a few months of first trying to conceive, a couple decides to start testing and this may be a smart decision. In some cases, uncertainty creates an exciting situation for the couple, which can lead to the deterioration of many aspects of
of their relationship and in the implementation of certain diagnostic methods, and a measured conversation with a gynecologist, can mitigate this situation.