Infertility is defined as trying to get pregnant (with frequent intercourse) for at least a year with no success. Female infertility causes can be difficult to diagnose. There are many available treatments, which will depend on the cause of infertility.
The main symptom of infertility is the inability to get pregnant. A menstrual cycle that's too long (35 days or more), too short (less than 21 days), irregular or absent can mean that you're not ovulating. There may be no other outward signs or symptoms.
When to seek help sometimes depends on your age:
Each of these factors is essential to become pregnant:
For pregnancy to occur, every step of the human reproduction process has to happen correctly. The steps in this process are:
In women, a number of factors can disrupt this process at any step. Female infertility is caused by one or more of the factors below.
Ovulation disorders, meaning you ovulate infrequently or not at all, account for infertility in about 1 in 4 infertile couples. Problems with the regulation of reproductive hormones by the hypothalamus or the pituitary gland, or problems in the ovary, can cause ovulation disorders.
Damage to fallopian tubes (tubal infertility)
Damaged or blocked fallopian tubes keep sperm from getting to the egg or block the passage of the fertilized egg into the uterus. Causes of fallopian tube damage or blockage can include:
Endometriosis occurs when tissue that normally grows in the uterus implants and grows in other locations. This extra tissue growth — and the surgical removal of it — can cause scarring, which may block fallopian tubes and keep an egg and sperm from uniting.
Endometriosis can also affect the lining of the uterus, disrupting implantation of the fertilized egg. The condition also seems to affect fertility in less-direct ways, such as damage to the sperm or egg.
Uterine or cervical causes
Several uterine or cervical causes can impact fertility by interfering with implantation or increasing the likelihood of a miscarriage:
Sometimes, the cause of infertility is never found. A combination of several minor factors in both partners could cause unexplained fertility problems. Although it's frustrating to get no specific answer, this problem may correct itself with time. But, you shouldn't delay treatment for infertility.
Certain factors may put you at higher risk of infertility, including:
Age. The quality and quantity of a woman's eggs begin to decline with increasing age. In the mid-30s, the rate of follicle loss speeds, resulting in fewer and poorer quality eggs. This makes conception more difficult, and increases the risk of miscarriage.
If you're a woman thinking about getting pregnant soon or in the future, you may improve your chances of having normal fertility if you:
If you've been unable to conceive within a reasonable period of time, seek help from your doctor for evaluation and treatment of infertility.
Fertility tests may include:
Depending on your situation, rarely your testing may include:
Infertility treatment depends on the cause, your age, how long you've been infertile and personal preferences. Because infertility is a complex disorder, treatment involves significant financial, physical, psychological and time commitments.
Although some women need just one or two therapies to restore fertility, it's possible that several different types of treatment may be needed.
Treatments can either attempt to restore fertility through medication or surgery, or help you get pregnant with sophisticated techniques.
Fertility restoration: Stimulating ovulation with fertility drugs
Fertility drugs regulate or stimulate ovulation. Fertility drugs are the main treatment for women who are infertile due to ovulation disorders.
Fertility drugs generally work like the natural hormones — follicle-stimulating hormone (FSH) and luteinizing hormone (LH) — to trigger ovulation. They're also used in women who ovulate to try to stimulate a better egg or an extra egg or eggs. Fertility drugs may include:
Risks of fertility drugs
Using fertility drugs carries some risks, such as:
Fertility restoration: Surgery
Several surgical procedures can correct problems or otherwise improve female fertility. However, surgical treatments for fertility are rare these days due to the success of other treatments. They include:
The most commonly used methods of reproductive assistance include:
Coping and support
Dealing with female infertility can be physically and emotionally exhausting. To cope with the ups and downs of infertility testing and treatment, consider these strategies:
ART includes all fertility treatments in which both eggs & sperms are handled. In general, an ART procedure involves eggs retrieval from the ovaries, combining them with sperm in the laboratory and returning them to uterus.
Intra-Uterine Insemination (IUI), Donor IUI
Intrauterine insemination (IUI) is the process by which sperm is deposited in a woman's uterus through artificial means. For many couples, this is a less invasive and more affordable alternative to IVF.
In-Vitro Fertilisation (IVF)
IVF is a multi-step process in which eggs (oocytes) are extracted from the woman's ovary (where the eggs are produced), fertilized by sperm in a laboratory, cultured into early embryos and then transferred into the woman's uterus.
Embryo transfer (ET) is a simple procedure that follows in vitro fertilization (IVF) and is often considered the final step of the in-vitro fertilization process.
Intracytoplasmic Sperm Injection (ICSI)
Intracytoplasmic sperm injection is a procedure where a single sperm is injected into an egg with the help of micromanipulator instrument, and once fertilized embryos are placed into uterus.
Gamete Intrafallopian transfer (GIFT)
Gamete Intrafallopian transfer is a procedure where retrieved eggs and sperms are placed together in fallopian tube & fertilization happens inside your body and the embryo implants naturally. Although, this procedure was once commonly practiced, it's rarely used today because the success with IVF is greater.
Embryo Freezing Oocyte, Embryo Donation TESA(Testicular Sperm Extraction)
A fine needle is inserted into the testis and sample of tissue are obtained by gentle suction and examined under the microscope. If sperm are not found, a small tissue sample (testicular biopsy) is taken through a small incision in the scrotum and testis; sperm can then be extracted from the tissue. The cut is stitched back together with a couple of stitches.
TESE (Testicular Sperm Extraction)
involves retrieving sperm directly from the testis.
MESA (Micro Epididymal Sperm Aspiration)
A procedure to aspirate sperm from the epididymis.
PESA (Percutaneous Sperm Aspiration)
This is the first choice to collect sperm. A fine needle is inserted through the scrotum into the epididymis and sperm are obtained by gentle suction. After each sample is collected, it is examined under the microscope to confirm the presence of sperm.