The desire to become a mother is natural for a woman. Unfortunately, according to statistics the pregnancy does not occur after numerous attempts in 14% of families. Often, but not always, the reason lies in the woman's health. Female infertility is diagnosed after 12 months of active, but unsuccessful attempts to conceive a child. Contrary to popular belief, female infertility is not due to heredity, painful menstrual periods, or irregular sexual acts. Its reasons are quite different.
The main reasons for female infertility are attributed to:
- Abnormalities of the uterus. There are quite many varieties of such pathologies that prevent conception and bearing of a child - intrauterine septum, fibroids, endometriosis, polyposis, and others.
- Absence of the fallopian tubes or their obstruction. The first condition is possible due to a surgical removal of the fallopian tubes because of ectopic pregnancy or inflammatory and purulent processes in it, and the obstruction is a result of adhesions after inflammation.
- Adhesion processes that prevent the passage of the egg to the uterus.Peritoneal factor of infertility.
- Hormonal disorders that lead to changes in the ovulation mechanism.
- Endometriosis - an excessive growth of the endometrium.
- Immunological causes - presence of antibodies to sperm.
- Psychological factors. Fear, unwillingness to have children, or stresses can also lead to female infertility.
Depending on reasons that led to inability to conceive a child, several types of female infertility have been identified:
- Tubo-peritoneal infertility. That diagnosis is made to a woman, if a malfunction or dysmorphology of the fallopian tubes or adhesions in the pelvic area are discovered. In most cases the tubal and peritoneal factors are related to each other, so they are considered as one type of female infertility. The causes of this type of infertility may include: lack of female hormones or excess of male hormones, long term endometriosis, surgery on pelvic organs, inflammation of the ovaries or fallopian tubes and other reasons.
- Uterine infertility. It is characterized by anatomical defects of the uterus, regardless whether the pathology is of a congenital or acquired nature. Congenital disorders include didelphia, uterine hypoplasia, or if the uterus has partitions. And acquired defects can occur due to endometritis, uterine fibroids, or surgical interventions in that reproductive organ. This type of female infertility is characterized by the absence of menstrual periods (secondary amenorrhea). In most cases, uterine adhesions are formed, which prevent pregnancy.
- Endocrine infertility. This form is associated with hormonal factors and it is the most common type in women. There are three forms of endocrine female infertility:
- Anovulatory infertility is connected to a lack of ovulation (release of the egg from the ovary does not occur).
- Lureal-phase defect. This form of endocrine infertility is related to unavailability of the endometrium for embryo implantation. Fertilization can occur, but because of impossibility of embryo implantation, the pregnancy is terminated.
- Luteinized unruptured follicle syndrome. In this form of infertility the egg cell dies, as the yellow body is formed before ovulation occurs. The reason for this condition is abnormality of production of the progesterone hormone.
The causes of endocrine female infertility are disfunction of the ovaries or pituitary, insufficiency of thyroid hormones, as well as adrenal hyperplasia.
Methods of treatment of female infertility
Medicine allows us to combat female infertility quite successfully, although it does not guarantee a cure for every woman. These days, a variety of different therapies are used for this problem, the main methods of treatment include:
- Hormone therapy. This treatment is indicated for endocrine infertility. It consists of reception of drugs aimed at correcting the performance of the endocrine system. Also, the hormone therapy can be used to stimulate ovulation, which can lead to multiple pregnancy. Thanks to taking properly selected hormonal drugs, the treatment progresses very well - ovulation occurs in 85% of cases.
- Artificial insemination is used exclusively during a normal patency of the fallopian tubes, as the fertilization of an egg with this method of treatment takes place in the tube itself, the same way it happens in natural conception. That reproductive technology consists of introduction by the doctor of the obtained previously semen into the uterus of the woman. This method is applied in cases of immunological reasons for not occurance of pregnancy which are a presence of antibodies to the husband's (or any) sperm. Artificial insemination can be performed using the sperm of the husband or a donor.
- In vitro fertilization (IVF). It is the most common reproductive technology and it is applied in the absence of the fallopian tubes or ovaries, in cases of endometriosis, and certain diseases and pathologies of the uterus. In IVF the ovum fertilization takes place in a laboratory and not in the woman's body. In order to obtain several ovicells for fertilization, the doctor prescribes a special hormone therapy to stimulate ovulation. The mature oocytes (according to the results of ultrasound unvestigation) are retrieved from the ovary by puncture, after which they are placed in a special environment, where processed sperm cells are added to them for fertilization. The fertilized cells develop within 3-5 days in a special incubator under supervision of an embryologist. When embryos, in the embryologist's opinion, are ready, they are transplanted into the uterus. 14 days after the transfer the woman undergoes a medical test to determine the concentration of hCG in her blood, which indicates a pregnancy. This method of infertility treatment is widely used because of its high efficiency - about 50% of the women successfully carry a child after IVF procedures. Pregnancy after IVF is not different from a normal pregnancy.
- Laparoscopy. In some cases, it is advisable to obtain a pregnancy by surgical elimination of abnormality of the uterus or fallopian tubes. If a surgery is necessary for treatment of female infertility a minimally invasive laparoscopic method is used, since it is the least traumatic to the body. Laparoscopy has been used successfully to eliminate adhesions, obstruction of the fallopian tubes, removal of cysts, polyps and in other cases.
In many cases, female infertility can be cured, so when difficulties with a natural conception occur you should see a doctor for professional help. After a series of laboratory and diagnostic studies the specialist will select an adequate treatment for the problem.