Female Infertility Treatment

Factors Affecting Female Infertility

While there are a multitude of diagnoses, we will outline the most commonly seen causes of female infertility:

1. Tubal Factor:

Open (patent) and functioning fallopian tubes are necessary for pregnancy to occur. Tubal disease is a disorder in which the fallopian tubes are blocked or damaged. This is usually caused by a history of previous pelvic infections, prior pelvic-abdominal surgery, or endometriosis. 

While there are a multitude of diagnoses, we will outline the most commonly seen causes of female infertility:

The test typically performed to assess tubal patency is a hysterosalpingogram (HSG), which is an X-ray image of the pelvis. A thin tube-like instrument is passed into the cervix, and X-ray dye is injected into the uterus. As the dye enters the uterus and fallopian tubes, an assessment is made of their structure and function. 

2. Cervico-Uterine Issues 

The cervix is located in the lower part of the uterus. Conditions affecting the cervix can impact fertility, although they are rarely the sole cause of infertility. 

The following conditions can contribute to cervical factors:

• Abnormal Pap smear(s) 
• Prior cervical biopsies 
• Cervical surgery (cone biopsy) 
• Freezing or laser treatment of the cervix 

Cervical problems are generally treated with antibiotics, fertility medications, or intrauterine insemination (IUI). 

3. Uterine Conditions

The uterus (womb) is where the fertilized egg implants and develops. Uterine abnormalities can account for 20% of female infertility and include: 

• Uterine scar tissue from previous surgery or miscarriage (Asherman’s Syndrome) 
• Polyps (benign growth of the endometrial lining) 
• Uterine fibroids 
• Abnormally shaped uterine cavity 

Problems within the uterus may interfere with embryo implantation or increase the risk of miscarriage. 

Tests typically performed to assess the uterine cavity include: 

• Hysterosalpingogram (HSG) 
• Saline infusion sonogram (SIS or SHG) 

In SIS, a thin tube is passed into the cervix and saline is injected into the uterus under ultrasound guidance. This is often the preferred test for evaluating uterine abnormalities. 

Surgery may be required to further evaluate and correct uterine cavity issues. Our specialists are highly experienced in treating uterine factors contributing to infertility. 

4. Irregular or No Ovulation 

Problems with ovulation are a common cause of infertility in women, accounting for approximately 30 percent of cases.

To conceive, a woman must ovulate—release an egg from the ovary into the fallopian tube. Ovulation is linked to the menstrual cycle, which typically occurs every 28–35 days.

Women who experience periods more than every 35 days may be ovulating infrequently or not at all.

Common causes of ovulatory disorders include:

• Polycystic Ovary Syndrome (PCOS) 
• Thyroid hormone imbalance 
• High prolactin levels 
• Higher body weight 

Ovulation can be tracked through menstrual charting, ovulation predictor kits (OPKs), and blood hormone (progesterone) testing.

5. Hormonal Imbalances

Hormonal disorders play a major role in female infertility. PCOS is the most common ovulatory disorder, accounting for 85% of diagnosed ovulatory issues. 

Female athletes, such as marathon runners and gymnasts, may experience hypothalamic amenorrhea, which can disrupt ovulation.

Women with elevated prolactin levels may also experience irregular ovulation, making conception more difficult.

With proper diagnosis and infertility treatment in women, many hormonal conditions can be effectively managed. 

6. Age and Female Fertility 

Age is a significant factor in fertility. As a woman approaches her mid-30s, fertility begins to decline, with a more rapid decline after age 40.

This decline occurs because: 

• The number of eggs decreases 
• Egg quality diminishes 
• Risk of chromosomal abnormalities increases 

Women in their late 30s and 40s are considered to be of advanced maternal age. While conception is still possible, it may require medical assistance through advanced female infertility treatment options. 

7. Endometriosis 

Endometriosis is a common condition affecting women of reproductive age. It occurs when tissue similar to the uterine lining grows outside the uterus and sheds into the abdominal cavity. 

This can lead to inflammation, scar tissue formation, and disruption of: 

• Ovulation 
• Tubal function 
• Embryo quality 

With proper care and treatment, many women with endometriosis can successfully conceive.

8. Recurrent Miscarriages 

Miscarriage is one of the most emotionally challenging experiences for women. Approximately 2 out of 10 pregnancies may result in miscarriage. 

Women are considered to have recurrent pregnancy loss if they experience two or more consecutive miscarriages. About 1% of women experience three or more losses. 

In about 50% of cases, the underlying cause can be identified.

Common causes include:

• Genetic or chromosomal abnormalities 
• Age-related factors 
• Uterine abnormalities 
• Incompetent cervix 
• Hormonal disorders 
• Autoimmune conditions 
• Blood clotting disorders 

Treatment options vary and may include medications, surgery, IVF, or genetic testing.

Although some couples can conceive, maintaining pregnancy may be the challenge. Consulting a fertility specialist is essential to identify and treat the underlying cause.