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Infertility (Female)
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Infertility is defined as the failure to become
pregnant after one year of unprotected intercourse. There are two types of
infertility; Primary infertility, which is infertility without any
previous pregnancy; and secondary infertility, when there has been a
previous pregnancy.
What are the causes of
infertility?
A basic infertility evaluation is carried out to
find out the cause of infertility.
Common causes of
infertility are:
- Ovulation problems
- Tubal causes
- Sperm causes
- Unexplained infertility
- Age-related factors
Some less common causes
are:
- Uterine problems
- Endometriosis
- Previous tubal ligation
- Previous vasectomy
- Various drugs
- Cervical factors
When to see your
doctor?
Though there is no specific time frame as to when to
consult your doctor but you can see your doctor if the pregnancy does not
take place even after one year of unprotected intercourse.
You
might want to wait a little longer if you are in your twenties but if both
of the partners are in mid or late thirties then the advice will be to
seek professional help.
Age of the female is an important factor for if she has
crossed 35 or is near to it then it is advisable to seek help at the
earliest.
Is it correct that the female partner is
responsible for infertility?
No, male factors account for up
to 40 percent of infertility problems.
How would the doctor
go about it?
The first diagnostic step is the evaluation of
the infertile couple and to determine which partner is
infertile.
Normally the steps of a basic infertility evaluation
would include:
- History:
Taking a thorough medical history including any other
medical conditions you might be having, any history of drug intake, and
any other obstetric or gynaecological problems that you may have.
- Physical examination
A thorough physical examination
- Blood tests
Depending on the individual couple’s situation,
various blood tests on either the female or the male may be needed. They
can include testing for the levels of various sex hormones.
- Taking a sample of semen and doing a semen analysis
- Finding out if the woman is ovulating or not (i.e. producing egg in
every menstrual cycle)
- Hysterosalpingogram
This test is done in order to assess the
anatomy of the cavity of the uterus and the fallopian tubes.
- Laparoscopy
May be required after basic tests have been done. The
surgeon looks inside the abdomen through an endoscope to look for any
deformities of the tubes or for endometriosis. What if
they still can’t find the problem?
There are known cases of
‘unexplained infertility’ i.e. cases in which standard testing has not
found a cause for infertility
Treatment for unexplained
Infertility
This can include a combination of the following
modalities
- Ovarian stimulation
-by drugs such as ‘clomiphene
citrate’
-using hormonal injections plus intercourse
- Assisted reproductive technologies as treatment for unexplained
infertility
In vitro fertilization (IVF)
- Gamete intra-fallopian transfer (GIFT)
In GIFT a mixture of sperm
and eggs are introduced into the end of the fallopian tube at
laproscopy. What is the success rate of these advanced
procedures?
Although pregnancy rates vary from center to
center on the specific technique used but generally a 30% success rate can
be expected.
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