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Infertility (female): Treatment, symptoms, advice and help

About infertility (female)

The term infertility refers to failure of conception even after one full year of unprotected sexual intercourse. It is a complex problem with diagnostic and treatment challenges and which may have psychosocial and economic repercussions.

Infertility (female): Incidence, age and sex

About 1 in every 7 couples in the United Kingdom suffers from infertility disorders. The female partner contributes to about 30% of cases which is the same as that of males (30%). Another 10% causes are combined and the remaining 30% are unexplained. The incidence of infertility in women especially seems to augment with increasing age. The fertility in a woman usually begins to decline after the age of 30 years.

Signs and symptoms of infertility (female): Diagnosis

The symptoms of infertility usually arise from the underlying causes which may include hormonal disorders, localised ovarian or uterine problem, premature or delayed puberty.

The diagnosis of female infertility includes detailed history and comprehensive physical examination (including gynaecological examination) of female individual along with her male partner. Investigations like blood hormone levels, endometrial biopsy or laparoscopic evaluation may be done to detect the cause of infertility in a woman. Her male partner may need to get semen analysis to rule out any disorder in him.

Causes and prevention of infertility (female)

Several causes may lead to female infertility which includes generalised disorders or localised reproductive tract disorders. Generalised causes include diabetes, thyroid disorder, adrenal gland disorder, pituitary insufficiency, obesity, malnourishment or eating disorders like anorexia.

Localised causes of female infertility include polycystic ovarian disease, fibroids, endometriosis, pelvic inflammatory disease, ovarian dysfunction or blockages in the fallopian tube. Other causes include toxins (tobacco, alcohol) and emotional stress which may also contribute to female infertility. In fact, the localised causes like polycystic ovarian disease, fibroids, and endometriosis are the commonest causes which are implicated in female infertility.

Infertility (female): Complications

Infertility is a disorder which may lead to immense psychological stress and increased anxiety.

Infertility (female): Treatment

The first and foremost step in treatment of female infertility includes evaluation and subsequent management of underlying cause; for example, management of polycystic ovarian disease by hormonal medications and pelvic inflammatory diseases by antibiotic medications.

If the couple is not able to get successful results, then other treatment modalities may be tried. The affected female can be given ovarian stimulation drugs (if needed) like clomiphene, which may be either followed by “intrauterine insemination” (IUI) or “assisted reproductive techniques” (ART). Intrauterine insemination (IUI) is a procedure wherein the sperm is introduced in the female’s uterus during ovulation period for effective fertilization to occur inside the human body. The success rate of this procedure is not very high. However with the advent of assisted reproductive techniques” (ART) which includes in vitro fertilization (IVF), infertility management has not a new hope. This procedure follows ovarian stimulation by drugs and involves extraction of eggs from ovary (female) and sperms from male partner. This is followed by external fertilization of eggs and sperms in a laboratory setting. Thereafter the fertilized egg (embryo) is reinstated into the uterus of the female, for normal pregnancy to ensue. The treatment of infertility should be ideally tailored according to each couple depending upon the cause, health status and economic status of the couple.