Infertility in Women Best Homework Help
What is Infertility?
Infertility can be defined as the inability of a woman to get pregnant even after trying to get pregnant for 6 months to 1 year especially in women above the age of 35 years. The term infertile can also be used to describe women who can get pregnant but are unable to stay pregnant.
Pregnancy or conception involves several steps. Any problem at any of these steps may cause infertility. For a woman to get pregnant:
- her body must release an egg from either of the ovaries, a process known as ovulation
- the egg released must go through the fallopian tube and travel to the uterus also as the womb
- this egg must join with a sperm along the way for fertilization to occur
- finally, the fertilized egg must attach to the side of the uterus, a process known as implantation.
Infertility can also be described as a disease that limits or impairs a woman’s ability to get pregnant or to give birth to a baby. In heterosexual couples, infertility is diagnosed after the couple has tried getting pregnant for a year.
Among heterosexual couples (man and woman), causes of infertility can be divided into unknown reasons, male problems, and female problems. Each of these factors is an equal contributor to infertility.
Infertility that is due to female problems is known as female factor infertility or female infertility. Infertility in women is very common. 10% of women deal with infertility. Chances of becoming infertile increase as a woman grows old.
Causes of Infertility in Women
Infertility in women can be caused by several factors. Pinpointing the specific cause can be a little challenging. In addition, some couples are known to have unexplained infertility or multifactorial infertility
Common causes of female factor infertility include:
- problems with the fallopian tubes – problematic fallopian tubes can cause female infertility. Infertility caused by problems in the fallopian tubes is known as tubal factor infertility. Fallopian tube problems are caused mostly by a pelvic inflammatory disease which is often caused by gonorrhea and chlamydia.
- problems with the uterus – uterus problems can include fibroids, adhesions, or septum in the cavity of the uterus and polyps. Fibroids and polyps can occur at any time and form on their own. on the other hand, uterus problems such as septum are present at birth. After surgical procedures such as dilation and curettage, adhesions are likely to form.
- problems with egg quality and number – during birth, women are born with numerous eggs. Sometimes this supply of eggs can run out even before a woman has reached menopause. Additionally, some eggs may contain the wrong number of chromosomes meaning they can neither fertilize nor grow into a healthy fetus.
- problems with ovulation – irregular ovulation can be caused by several factors. For instance, substance abuse, severe stress, pituitary tumors, hormonal imbalances, and past eating disorders are some of the causes of irregular ovulation.
Who is at Risk for Infertility?
A woman’s risk of infertility can be increased by several factors. Factors that can contribute to infertility in women include general health conditions, lifestyle choices, age, and inherited genetic traits.
Factors that can increase a woman’s risk of becoming infertile include:
- obesity or being overweight
- hormone issues that hinder ovulation
- being underweight
- abnormal menstrual cycle
- sexually transmitted infections
- uterine fibroids
- smoking tobacco
- a past ectopic pregnancy
- having a low body-fat content from extreme exercising
- structural problems of the ovaries, fallopian tubes, and uterus
- primary ovary insufficiency
- polycystic ovary syndrome
- excessive substance use
- autoimmune disorders for example thyroid conditions, Hashimoto’s disease, and lupus
- DES syndrome which is a medication previously given to women to prevent pregnancy complications such as miscarriage and premature birth.
A woman’s chances of becoming pregnant reduce as she ages. In most women, age is the main cause of their infertility. This is probably because in today’s world most women are waiting until they are in their 30s and 4os to have children.
Women who are 35 years or older have a high risk of developing fertility issues. This is because of:
- an increased risk of developing other health conditions that may cause infertility
- the overall number of eggs available for fertilization is reduced
- more eggs have an abnormal number of chromosomes
Diagnosis and Testing of Infertility in Women
When a woman goes to see a doctor, the healthcare provider will need to know and understand the menstrual cycle of the woman, if they have any abnormal discharges or vaginal bleeding, pelvic pain, miscarriages, and past pregnancies.
A woman is likely to be asked the following questions:
- if they have any pelvic pain
- if they have had abdominal surgeries in the past
- if they had previous miscarriages or pregnancies
- if their menstrual cycle is regular or if it is irregular and painful
- if they have abnormal discharges or heavy bleeding
Tests done to Diagnose Infertility in Women
Several tests can be done. Some of these tests are done as physical exams. They include:
- a pap test
- a pelvic ultrasound
- an overall physical exam
- an examination of the breasts for unusual production of milk
Lab tests that can be done include:
- laparoscopy – this test involves inserting a laparoscope into the abdomen to enable the doctor to look at the organs. A laparoscope is a small monitoring instrument.
- blood tests – depending on the health history of a person and the diagnoses being considered by the doctor, a blood test is done. Lab tests include tests of ovarian reserve, thyroid testing, prolactin levels, and tests of progesterone and ovarian reserve.
- transvaginal ultrasound – a transvaginal ultrasound is done by inserting an ultrasound wand into the vagina. to allow the doctor to have a better view of the ovaries and the uterus.
- hysteroscopy – this test involves inserting a hysteroscope into the vagina and through the cervix. The hysteroscope is moved into the uterus to help the doctor view the inside of it.
- saline sonohysterogram – this test is done to observe the lining of the uterus to look for fibroids, polyps, and other abnormalities in structure. The uterus is filled with saline water to have a better look at the uterine cavity during a transvaginal ultrasound.
- x-ray hysterosalpingogram – this test involves injecting a dye into the cervix so that the doctor can watch its movement through the fallopian tubes using an x-ray. This test helps to identify if the fallopian tubes are blocked.
How Is Infertility in Women Treated?
Infertility in women can be treated in several ways including:
- medication – women whose infertility is caused by irregular ovulation may be prescribed several drugs including gonadotropins, clomiphene citrate, and letrozole. Gonadotrophins usually trigger ovulation. in addition, these medications can help a woman get pregnant by causing the ovaries to release numerous eggs at the same time instead of the single egg released every month.
- Hysteroscopy – this procedure involves placing a hysteroscope into the uterus. This procedure is done to remove fibroid tumors, polyps, to open up blocked tissue, and to divide scar tissue.
- Laparoscopy – women with pelvic disease or those with tubal disease undergo laparoscopy to repair their reproductive organs. During this surgical procedure, a laparoscope is placed through a cut near the belly button. This procedure is done to treat endometriosis, remove ovarian cysts, get rid of scar tissue, and open blocked tubes.
- Intrauterine insemination – during this procedure, a sperm gets rinsed with a special solution. it is then placed into the uterus during the woman’s ovulation. This procedure is also done when a woman is on medication to trigger the release of an
- In vitro fertilization (IVF) – This technique involves the placement of embryos into the uterus. These embryos are first fertilized in a dish. Thereafter, a woman takes gonadotrophins to help trigger the development of multiple eggs. Once the eggs are mature, the doctor collects them using a needle. Sperms are collected, cleaned, and added to the eggs in a dish. Days later the fertilized eggs are put back into the uterus using an intrauterine insemination catheter.
- Gamete intrafallopian tube transfer (GIFT) and zygote intrafallopian transfer (ZIFT) – GIFT procedure is similar to IVF in that they involve retrieval of an egg, combining it with sperm, and inserting it immediately into the fallopian tubes.
In ZIFT, fertilized eggs are placed into the fallopian tubes within 24 hours.
- ICSI – this is known as intracytoplasmic sperm injection. During this procedure, sperm is directly injected into the egg in a dish and then placed in the uterus.
- Egg donation – this helps women who have problems with the ovaries or quantity of eggs although they have a normal uterus. An egg is removed from a donor’s ovary. The donor should have been on fertility drugs. Once Vitro fertilization is done, the fertilized egg is transferred into the uterus.
Infertility in women is caused by several factors such as irregular ovulation, blocked fallopian tubes, problem with the uterus, and quantity and quality of eggs. However, infertility can be treated in different ways.