Female Infertility Treatment. Infertility is caused by females causes around one-third of the time, and by both females and malefactors, approximately one-third of the time. In the other instances, the etiology is either unknown or a mix of male and female variables.
The reasons for female infertility might be challenging to identify. Depending based on infertility, there are several therapies available. Many infertile couples will conceive a child even though they are sterile.
Overall, treatment success rates for infertility are about 50% if a woman receives a diagnosis. 1
The success of a therapy depends on:
- The real problem’s origins
- How old is the woman?
- Her prior pregnancy experience
- For how long has she been struggling with infertility?
- Affirmative or negative results for male-factor infertility
- Most likely to benefit from fertility treatments are women whose infertility is caused by issues with ovulation.
Although in vitro fertilization may assist women with infertility caused by disorders like damaged fallopian tubes or severe endometriosis conceive, treatment with drugs is unlikely to be effective.
Treatment of the underlying cause of infertility is often the initial step in treating infertility. Medication for thyroid illness, for instance, may be able to restore fertility in situations where the condition has caused hormone abnormalities.
A prevalent problem, of female infertility, is an inability to become pregnant and have a successful pregnancy.
After a year of trying to conceive (with no contraception), this is the usual diagnosis.
There are several treatment options for infertility, including drugs to fix hormonal disorders, surgery for physical difficulties, and in vitro fertilization (IVF) (IVF).
What Is Female Infertility?
When a woman’s reproductive capabilities, namely her capacity to conceive a child, are compromised due to illness, we call this condition infertility.
This is often discovered after a year of unsuccessful attempting to conceive by heterosexual couples (man and woman) (but may be diagnosed sooner depending on other factors).
One-third of the causes of infertility in heterosexual couples are attributable to male factors, one-third to female factors, and one-third to a mix of these factors or unknown causes.
Female infertility or “female factor infertility” refers to cases when the female spouse is determined to be the root cause of the inability to conceive.
The inability to get pregnant is the most common sign of infertility. A menstrual cycle that is either too long (35 days or more), too short (less than 21 days), irregular, or nonexistent may indicate that you are not ovulating. There may be no additional indications or symptoms.
If you haven’t been able to conceive in an acceptable amount of time, consult your doctor for an examination and treatment of infertility. Both you and your spouse should be assessed. Your doctor will take a thorough medical history and do a physical exam.
Fertility testing may involve the following:
Ovulation detection. An at-home, over-the-counter ovulation prediction tool detects the rise in luteinizing hormone (LH) before ovulation. A progesterone blood test — a hormone released after ovulation — may also confirm if you’re ovulating. Other hormone levels, such as prolactin, may also be measured.
Hysterosalpingography. X-ray contrast is injected into your uterus during hysterosalpingography (his-tur-o-sal-ping-GOG-rush-fee), and an X-ray is taken to look for issues within the uterus.
The test also determines if the fluid exits the uterus and leaks into your fallopian tubes. If any problems are discovered, you will most certainly need more testing.
Ovarian reserve evaluation. This examination aids in determining the amount and quality of eggs accessible for ovulation. Women over the age of 35 who risk having decreased egg production may be subjected to this battery of blood and imaging tests.
Additional hormone testing. Other hormone tests examine levels of ovulatory hormones and thyroid and pituitary hormones, which regulate reproductive processes.
Imaging examinations. A pelvic ultrasound examines the uterus and fallopian tubes for illness. A sonohysterogram, also known as a saline infusion sonogram or a hysteroscopy, often reveals things within the uterus that a standard ultrasound cannot.
What Tests Will My Healthcare Provider Run To Diagnose Female Infertility?
Your doctor may do certain diagnostic tests as part of a routine physical examination. Such examinations may consist of:
- It’s time for your annual checkup.
- In other words, a Pap smear.
- Inspection of the pelvic region.
- Ultrasound imaging of the pelvis.
- Breasts are checked for abnormal milk output.
There may be a need for further laboratory testing. Examples of such checks may be:
- Lab testing Your doctor will order blood tests, but the specific ones will depend on your medical history and the possible diagnosis. Thyroid, prolactin, ovarian reserve, and progesterone testing are all examples of possible laboratory analyses (a hormone produced during the menstrual cycle that signals ovulation).
- For an X-ray hysterosalpingogram (HSG), a caregiver injects a dye into the cervix and then monitors the dye’s progress down the fallopian tube using an X-ray. Any obstructions are revealed by this test.
- Laparoscopy involves inserting a tiny monitoring device called a laparoscope into the abdominal cavity and seeing the organs from there.
- A transvaginal ultrasound is performed by putting an ultrasound wand into the vagina, as opposed to an abdominal ultrasound, in which the probe is positioned over the belly. The ovaries and uterus may be seen more clearly by the doctor.
- The uterine lining may be examined for polyps, fibroids, and other structural abnormalities using a saline sonohysterogram (SIS). When doing a transvaginal ultrasound, the uterus is filled with saline (water) to improve the doctor’s view of the uterine cavity.
- A hysteroscope (a thin, flexible instrument with a camera on it) is inserted vaginally and via the cervix to examine the uterus and ovaries. The gynecologist inserts it into the uterus and examines the lining.
What Causes Female Infertility?
Infertility may arise from a wide variety of factors. Some couples, however, experience “unexplained” infertility or “multifactorial infertility,” meaning that the specific reason is unknown (multiple causes, often both male and female factors). Female factor infertility may have many underlying reasons.
- Problems with the uterus: This includes polyps, fibroids, septum or adhesions within the cavity of the uterus. Other anomalies (such a septum) are apparent from birth, whereas polyps and fibroids may develop at any moment. Adhesions may arise after a surgery such a dilation and curettage (D&C) (D&C).
- Fallopian tube dysfunction: The most prevalent cause of “tubal factor” infertility is pelvic inflammatory illness, mainly caused by chlamydia and gonorrhoea.
- Ovulation issues: there are a variety of reasons why a woman could not ovulate (release an egg) on schedule.
- Several factors, including as hormonal imbalances, an eating problem, alcohol misuse, a thyroid ailment, extreme stress, and pituitary tumours, might interfere with ovulation.
- Problems with egg quantity and quality: Women are born with all the eggs they will ever have, and this supply might “run out” early before menopause. Moreover, some eggs will have an abnormal amount of chromosomes and will not be fertile or develop into a healthy child. All of the eggs may be affected by some chromosomal abnormalities (such as “balanced translocation”). The occurrence of the sporadic but more frequent others increases with a woman’s age.
Who Is At Risk For Female Infertility?
A woman’s chances of being infertile are affected by a wide variety of variables. Female infertility may be caused by a number of factors, including the woman’s general health, her genetic makeup, her lifestyle choices, and her age. Specific factors can include:
- Ovulation problems caused by hormonal imbalance.
- Menstrual irregularity.
- Being too thin.
- Extreme activity has led to a low body fat percentage.
- Flaws in the structure (problems with the fallopian tubes, uterus or ovaries).
- Fibroids of the uterus.
- Lupus, rheumatoid arthritis, Hashimoto’s disease, and other thyroid gland illnesses are examples of autoimmune diseases.
- STIs, or sexually transmitted infections (STIs).
- syndrome of polycystic ovaries (PCOS).
- A lack of ovaries at the primary level (POI).
- An excessive dependency on drugs (heavy drinking).
- DES syndrome (DES is a drug given to women to reduce pregnancy issues including early delivery and miscarriage. However, some offspring of moms who used DES have developed infertility.
- A past ectopic (tubal) pregnancy.
How Does Age Impact Female Infertility?
A woman’s fertility declines with age. With more and more couples waiting until their 30s and 40s to have a family, advanced maternal age is emerging as a major cause of female infertility. For women over the age of 35, reproductive problems are more common. These are some of the reasons why:
- Overall number of eggs is lower.
- More eggs have an abnormal number of chromosomes.
- The occurrence of further health problems is heightened.
Female Infertility Treatment
Infertility treatment is determined by the reason, your age, how long you’ve been infertile, and your personal preferences. Because infertility is a complicated condition, therapy requires substantial financial, physical, psychological, and time demands.
Treatments might either aim to restore fertility by medicine or surgery, or they can assist you in becoming pregnant using advanced procedures.
Timing intercourse, however, may not be enough to help a couple conceive on its own. The treatment options for infertility are condition-specific.
Medications used to treat impotence are one example in guys. Scrotal varicose veins may be removed surgically, and clogged epididymis can be unblocked.
Fertility pills are medications prescribed to women to control or start the ovulation process. Hormonal therapies may include clomiphene (Clomid, Serophene) and letrozole (Femara), as well as dopamine agonist treatments.
Female infertility treatment: everything you need to know.
In cases when egg transport is hindered by scarring or blockage of the fallopian tubes, surgical repair may be an option. The use of in vitro fertilization (IVF) is another option that may be suggested.
In certain cases, doctors will use laparoscopic surgery to treat endometriosis. A laparoscope is a thin, flexible microscope with a light at the end that is inserted via a tiny incision in the belly. Pain and infertility issues may be alleviated or improved when the surgeon removes implants and scar tissue.
Medications To Restore Fertility
Fertility medicines are medications that control or induce ovulation. Fertility medications are the primary therapy for infertile women owing to ovulation problems.
Fertility medicines, in general, stimulate ovulation in the same way as natural hormones — follicle-stimulating hormone (FSH) and luteinizing hormone (LH) — do. They’re also utilized to attempt to induce a better egg or an additional egg or eggs in women who ovulate.
Clomiphene Or Clomiphene Citrate
Patients may take clomiphene in the form of an oral tablet (orally). It stimulates the production of hormones responsible for ovarian follicle maturation. 2 If a woman takes clomiphene and still does not become pregnant after six cycles of menstruation, her doctor may recommend trying another fertility drug.
- Clomiphene is often used at the onset of menstruation.
- 80 percent of women taking clomiphene will ovulate while taking it. Fertility experts estimate that only around 50% of women who ovulate really end up with a live delivery.
- When clomiphene is used, the likelihood of having a multiple birth rises. The odds of having twins are 1 in 10, while having triplets or more is very unlikely (less than 1 in 10,000).
Letrozole is a medication that, when taken orally, reduces a woman’s natural oestrogen levels, causing her ovaries to produce eggs.
- Typically, patients take letrozole for around 5 days towards the conclusion of their menstrual cycle.
- About 19 percent of couples with unexplained infertility who used letrozole for four months had a live birth, according to a study published in 2015 by experts at the NICHD Reproductive Medicine Network.
- Comparatively, the live birth rate for couples taking clomiphene was 23%, therefore this percentage was somewhat lower.
- Letrozole may be more effective than clomiphene in treating polycystic ovarian syndrome, according to other research.
Gonadotropins And Human Chorionic Gonadotropin (hCG)
Ovulation may be induced in a woman by injecting gonadotropins such follicle-stimulating hormone (FSH) to encourage the development of an egg follicle. When a woman does not react to clomiphene, or if they need to increase follicle development for assisted reproductive technology, doctors may often give gonadotropins (ART).
- For the first seven to twelve days of the menstrual cycle, gonadotropins are injected.
- While a woman is receiving gonadotropin therapy, a medical professional may utilize transvaginal ultrasonography to check on the progress of the developing eggs inside the follicles. Also, the doctors take blood samples often to monitor estrogen production in the ovaries.
- Gonadotropins increase the risk of multiple births compared to clomiphene, and around 30% of women who conceive with this prescription have multiple births.
2 If there are going to be more than one baby, odds are that they’ll be twins. The remaining one-third is comprised of births of triplets or more.
- Similar to luteinizing hormone, hCG may be utilized to stimulate egg release from mature follicles.
Bromocriptine Or Cabergoline
Oral medications like bromocriptine and cabergoline are used to reduce excessive levels of the hormone prolactin, which may prevent ovulation if left untreated. High levels of prolactin may be caused by tumors in the pituitary gland, certain drugs (including antidepressants), renal illness, and thyroid problems.
- Most women’s prolactin levels are abnormal, but 90% of them may have normal levels with the use of bromocriptine or cabergoline.
- Approximately 85% of women who take bromocriptine or cabergoline ovulate after their prolactin levels return to normal.