Infertility is a condition where a couple is unable to conceive a child after trying for more than a year.
Infertility is a common issue which may be caused by hormonal, physiological or in certain cases unknown causes. In India, an estimated 10-15 percent of infertile couples are actively seeking treatment. Of the infertility cases reported, 46-50 percent is attributed to male factors and the rest to female factors, says Dr. Aswati Nair, fertility consultant, NOVA IVI Fertility, Delhi.
According to her, the single best determinant for female fertility is the age of the female. “The female fertility potential starts decreasing from the age of 33, with a decline in the quantity and quality of eggs, eventually leading to a poor ovarian reserve,” she says.
Other factors which impact the fertility health of a woman include a hormonal imbalance caused by conditions such as Poly Cystic Ovarian Syndrome (PCOS), endometriosis, infections and pelvic inflammatory diseases causing tubal blockage and faulty functioning of the Fallopian tubes, weight, and lifestyle-related issues.
Below, Dr. Nair explains a few causes of fertility, symptoms and also shares the diagnosis and treatment.
What causes infertility in women?
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Although the variation of menstrual days is normal, a menstrual cycle of fewer than 21 days or longer 35 days is considered abnormal and may be caused by hormone issues or PCOS. (Photo: Istock/Getty Images)
Ovulation problems increase the risk of infertility in women. Without ovulation, there will be no eggs to fertilise which can be identified through symptoms such as irregular or absence of periods. Ovulation problems are often caused by PCOS and POF (Premature Ovarian Failure).
Other causes for infertility include:
*Blocked Fallopian tube caused by conditions such as endometriosis, pelvic inflammatory diseases, etc.
*Advanced maternal age defined as the age of the female partner beyond 35 years.
Identifying the Symptoms:
Painful and irregular periods:
An average menstrual cycle lasts for 28-30 days. Although the variation of menstrual days is normal, a menstrual cycle of fewer than 21 days or longer 35 days is considered abnormal and may be caused by hormone issues or PCOS.
Similarly, very painful cramps or heavier than normal blood flow during periods could be a sign of endometriosis and hence should not be ignored. Endometriosis is a condition where the tissue lining the uterus begins to grow outside the uterus, towards the ovaries causing ovarian cysts, and the pelvis causing adhesions and pelvic scarring and hampering tubal function.
Growth of facial hair, unexplained weight gain or loss, acne, and skin trouble, and thinning hair on the scalp are all symptoms of hormonal imbalance which impact the fertility health of a woman. Hot flushes, loss of libido, fatigue, joint pains could be a sign of premature ovarian failure.
Diagnosis and treatment for infertility
Today, in most cases, technological advancements allow us to treat infertility with medicine, surgery or Assisted Reproductive Technology (ART). Diagnosis for infertility is usually done by a blood test, ultrasonography and other imaging modalities, hysterosalpingography or laparoscopy.
However, implementing the ideal treatment is subject to the condition that influenced infertility. For instance, while infertility caused by anovulation can be treated with oral medication, injections or both, conditions like fibroids or endometrial polyps can be managed surgically. In cases where it is not amenable to medical or surgical treatment and those with unexplained infertility, IVF (in-vitro fertilization) or ICSI (Intracytoplasmic Sperm Injection) treatment is recommended.