HEALTH - Infertility in Women

The infertility is the inability to get pregnant after at least one year of unprotected sex. Women who are able to get pregnant but then have repeated miscarriages are also said to be infertile.

Infertility affects about 10% of couples. Even under ideal circumstances, the probability that a woman will get pregnant during a single menstrual cycle is only about 30%. About one third of infertility problems are due to female infertility, and another one third are due to male infertility. In the remaining cases, infertility affects both partners or the cause is unclear.

Fertility is the result of the following complex chain of process:
• A woman must release an egg from one of her ovaries (ovulation).
• The egg must go through a fallopian tube toward the uterus (womb).
• A man's sperm must join with the egg along the way(fertilize).
• The fertilized egg must attach to the inside of the uterus (implantation).


General causes for female infertility are:
• Age - Fertility begins to decline when a woman reaches her mid-30s, and then declines after her late 30s. The ovary's ability to develop, healthy eggs declines with age, and increasing the risk of chromosomal abnormalities and unsuccessful implantation.
• Weight - Extreme weight levels, either high or low, can be a reason for infertility.
• Smoking - Cigarette smoking can impair a woman’s fertility.
• Women who exercise too much or diet excessively — sometimes due to eating disorders — may not produce enough estrogen for ovulation to occur.

Certain kinds of birth control continue to reduce ovulation even after they are no longer used.

Medical conditions for female infertility are:
• Infertility may be caused by the damages the fallopian tubes or the peritoneum sometimes cause infertility, or causes hormonal complications. These medical conditions include:
• Pelvic inflammatory disease
• Endometriosis (is associated with chronic pelvic pain and irregular monthly cycles)
• Polycystic ovary syndrome (is a hormone imbalance that can cause irregular periods)
• Asher man’s Syndrome (is scarring inside the uterus that creates intrauterine adhesions)
• Premature ovarian failure
• Uterine fibroids
• Cervical and Uterine Factors
• Production of antibodies against sperm

(Both men and women can have immune reactions to sperm, and produce antibodies to it. Little is known about how prevalent a problem this is and it is under active research) Fertility testing should especially be performed if a woman is over 35 years old or if either partner has known risk factors for infertility. Most healthy women under the age of 30 shouldn't worry about infertility unless they've been trying to get pregnant for at least a year. An analysis of the man's semen should be performed before the female partner undergoes any invasive testing.

Common diagnostic tests for female infertility are:
• Blood and urine tests to evaluate hormonal levels
• Imaging and ultrasound tests, (such as ultrasound, hysteroscopy, or laparoscopy), to examine the uterus and fallopian tubes.

Infertility can be treated with medicine, surgery, artificial insemination or assisted reproductive technology. Many times these treatments are combined. About two-thirds of couples who are treated for infertility are able to have a baby. In most cases infertility is treated with drugs or surgery and you should understand the risks, benefits, and side effects.

The general treatments for female infertility are:
• Lifestyle measures (healthy lifestyle, planning sexual activity with ovulation cycle, managing stress and emotions)
• Drugs to induce ovulation, such as clomiphene and gonadotrophins
• Assisted reproductive technologies (ART) such as in vitro fertilization (IVF)

Infertility in men is most often caused by:
• Problems making sperm ; producing too few sperm or none at all
• Problems with the sperm's ability to reach the egg and fertilize it
• Abnormal sperm shape or structure prevent it from moving correctly
• Injury or illness like cystic fibrosis

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