Generally speaking, infertility refers to a condition in which a woman cannot get pregnant (or is limited/impaired in some particular way) and give birth to a child. In the case of heterosexual couples, infertility is usually diagnosed after one year of planning and trying to get pregnant. In other cases, infertility may be diagnosed even sooner.
In one-third of these cases, infertility is due to male infertility problems, and another third is due to female infertility. The last third is due to either a combination of the two or other unknown reasons.
When the causes of infertility come from the female partner, experts consider it female infertility, often referring to it as “female factor” infertility.
In this article, our experts on obstetrics and gynecology in South Florida, Miami, will talk about the leading causes of female infertility and discuss possible female infertility treatment options.
Female Infertility: How Common Is It?
Unfortunately, infertility is a relatively common problem affecting at least 10% of women in some form. Furthermore, the chances of becoming infertile tend to increase with age.
Symptoms and Causes of Female Infertility
Several things may cause a woman to become infertile, but pinpointing the exact cause may prove to be challenging in some cases. There are also instances of unexplained or multifactorial infertility in couples, where one or both partners have issues that prevent them from conceiving a child.
Still, in the case of female infertility, the most prominent causes may include the following:
- Uterine problems: these medical issues may include fibroids, polyps, adhesions, or septum inside the uterine cavity. Fibroids and polyps can develop at any point in a woman’s life, while a septum will be present at birth. Adhesions may form after certain procedures like D&C (dilation and cutterage).
- Problems with ovulation: there are several reasons why women may not ovulate as they typically should. Past eating disorders, thyroid problems, stress, hormonal imbalances, substance abuse, pituitary tumors, or other conditions like ovarian insufficiency may all contribute to or cause infertility.
- Egg number and quality issues: All women are born with all the eggs they can release during their lifetime, and the supply may literally “run out” before they reach menopause. Furthermore, some eggs may not fertilize or grow into healthy fetuses because they have the wrong chromosome numbers. Chromosomal issues may affect every egg (like in the case of balanced translocation).
- Issues with the fallopian tubes: Tubal infertility happens when the sperm and the egg cannot meet because of some sort of blockage in the fallopian tubes. Aside from tubal infertility, a pelvic inflammatory disease, most often caused by gonorrhea or chlamydia, can also minimize the chances of conception.
Female Infertility Risk Factors
There are several risk factors that may decrease fertility in women. From inherited genetic traits through general health conditions to age and lifestyle choices, a lot of things can contribute to infertility, such as:
- Obesity or being underweight
- Age
- Irregular menstrual cycles
- Hormonal problems that prevent ovulation
- Having a low body fat percentage from overexercising/dieting
- Endometriosis
- Structural problems in the ovaries, uterus, or fallopian tubes
- Tumors
- Cysts
- Uterine fibroids
- Thyroid gland conditions, lupus, Hashimoto’s disease, rheumatoid arthritis, and other autoimmune disorders
- STIs (sexually transmitted infections)
- Ovarian insufficiency or primary ovary insufficiency (POI)
- Smoking
- Heavy drinking
- Polycystic ovary syndrome
- DES syndrome
- Past tubal (ectopic) pregnancies
Age and Female Infertility
As women age, their chances of getting pregnant decrease, unfortunately. Nowadays, age is becoming a more and more prevalent factor in female infertility as a more significant number of couples choose not to have children until their 30s or even 40s. Statistically speaking, women who are older than 35 have a higher risk of experiencing fertility issues because:
- They have fewer eggs
- The remainder of the eggs may have an abnormal chromosome number
- They are more at risk of developing other health conditions that may interfere with fertility
Diagnosis
In order to establish a proper diagnosis and recommend adequate female infertility treatment options, your healthcare provider will most probably ask you about your menstrual cycles first and discuss whether you’ve had any past pregnancies or miscarriages. Furthermore, they will probably ask you about any unusual vaginal discharge, bleeding, or pelvic pain. You will most likely discuss any past sexually transmitted infections and pelvic infections as well. The doctor will also closely examine your medical history and look for any surgeries in the abdominal area which may interfere with your fertility.
Additionally, your healthcare provider may perform several tests, such as:
- Pap test
- Physical exam
- Pelvix exam
- Pelvic ultrasound
- Breast examination (for unusual milk production)
Moreover, the doctor may order further tests that may include the following:
- Blood tests like prolactin level screening, ovarian reserve and progesterone level tests, and thyroid testing.
- HSG or X-ray hysterosalpingogram to check for blockages in the fallopian tube.
- Transvaginal ultrasound which allows the healthcare expert to get a better view of the reproductive organs like the uterus and the ovaries.
- Laparoscopy, in which the laparoscope (the small monitoring instrument) is inserted into the abdomen to view the reproductive organs.
- Hysteroscopy, where the hysteroscope is inserted into the vagina through the cervix to see the reproductive organs.
- SIS or saline sonohysterogram, which looks at the uterine lining to check for fibroids, adhesions, polyps, and other structural issues.
Female Infertility Treatment and Management
After establishing a diagnosis, your healthcare provider may recommend various treatment methods, depending on the cause of infertility.
For instance, structural issues may be resolved with the help of surgery, while thyroid conditions and ovulation issues may be treated with hormonal medications.
Also, some patients may require artificial insemination or in vitro fertilization to get pregnant. Lastly, other options, like gestational surrogacy and adoption, may also be considered for those women (and couples) who want to start a family.
Can You Prevent Female Infertility?
Unfortunately, most female fertility issues can’t be prevented or predicted. Still, the risk factors that may lead to infertility can be controlled to the point that it might even be possible to prevent the condition.
For instance, limiting alcohol consumption and quitting smoking, along with other lifestyle modifications, can improve one’s fertility. Also, healthy dieting, following an active lifestyle, and maintaining a healthy weight can make a massive difference.
Lastly, visiting your healthcare provider regularly to consult about any risks of female infertility is also essential.
There’s Always Help and Compassionate Care Available
Dealing with infertility is highly stressful. That said, if you and your partner are trying to get pregnant for longer than a year without success (or six months if you are older than 35), don’t hesitate to reach out to our experts.
Our skilled healthcare professionals can establish a proper diagnosis and develop an effective treatment plan to guide you through this period in your life.