“The English language lacks the words to mourn an
absence… For those who deeply want children and
are denied them, those missing babies hover like
silent ephemeral shadows over their lives. Who can
describe the feel of a tiny hand that is never
held?”
― Laura Bush, Spoken from the Heart
Infertility is cruel, devastating, and unforgiving! It
denies women one of the few things that completes
them – a child. Infertility can take over your life
and make it seem unbearable.
Unfortunately, female infertility is still
stigmatized and scowled at, even though it is fairly
common. And more surprisingly, when a couple
suffers from infertility, it is women who bear most
of the blame.
Are you suffering from infertility and trying to
make your way out of the hell-hole? Or are you
beginning your baby-making journey and want to
understand what infertility is? If you nodded
along anxiously, Let us lend you a hand. Read our
post below to learn more about infertility in women.
What Is Infertility?
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Male Infertility
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In Vitro Fertilization
Fertility Problems
Infertility means the incapability to get pregnant
even after unprotected and frequent sex. Almost
85 out of 100 couples who are trying to conceive
will do so within a year of trying. It is the
remaining 15 that fall under the infertility
category.
[ Read: Can Ovarian Cysts Prevent Pregnancy ]
Symptoms Of Infertility In Women:
When it comes to infertility, the most prominent
symptom is the inability to get pregnant!
There are a few symptoms of female infertility
that hint at a problem with your reproductive
system before you start trying to make a baby.
Here are a few of them:
Abnormal periods are an indicator that something
is not right with your reproductive health. Watch
out for more or less than average bleeding.
Irregular periods are also a symptom of infertility
in women. Now, what exactly is irregular? Well, if
the days between two cycles vary drastically, your
periods may be termed irregular.
Some women even miss periods. Or some women
experience a sudden halt in their periods. If you
experience any of these two, you need to see a
doctor.
If your monthly periods are painful, or you suffer
from back or pelvic pain, you may have some
underlying condition that may cause infertility.
Hormonal imbalance is a common cause of
infertility in women. Some of the symptoms that
can indicate a hormonal problem in your body
include acne; change in sex drive, excessive body
hair growth, loss of hair, and unwanted weight
gain.
[ Read: Blocked Fallopian Tubes ]
Causes Of Infertility In Women:
There are various reasons a woman may experience
infertility. Here are some of the major causes of
female infertility:
1. Ovulation Related Causes:
Every month, your ovary releases an egg, which is
a prerequisite for falling pregnant. But sometimes,
your ovulation process goes haywire and causes
infertility. In fact, 25 out of 100 infertility cases
in women are due to ovulation disorders!
Here are the major ovulation problems a woman can
encounter:
Polycystic Ovary Syndrome (PCOS):
Do you suffer from irregular periods? You may
have PCOS! Some women with this disorder often
have difficulty getting pregnant. PCOS causes
hormonal imbalance in the body due to changes in
the pituitary gland and ovaries. PCOS also leads to
ovulation problems. Some symptoms of PCOS include
insulin resistance, weight gain, excessive growth of
hair on the body, and acne.
Hypothalamic Dysfunction:
The pituitary gland plays a significant role in
female fertility. It produces certain hormones that
stimulate ovulation every month. But sometimes,
the hormones lose their rhythm and behave
erratically. Some of the reasons for hypothalamic
dysfunction are excessive stress – both mental and
physical, obesity, low body weight, etc.
Premature Ovarian Insufficiency (POI):
What happens when the body considers itself its
enemy? You end up with a problem like premature
ovarian insufficiency. Women suffering from this
problem lose the ability to produce eggs and
estrogen even before they hit the age of 40. POI
is an autoimmune issue where your body attacks
the ovarian tissues. It can be due to genetics. If
you are undergoing chemotherapy, you have a high
chance of developing POI too.
Hyperprolactinemia:
Sometimes, your body produces a little too much of
prolactin. An excess of the hormone can reduce
estrogen in the body and cause infertility. It is a
rare pituitary gland related problem, but it does
happen! Sometimes, some medication too can cause
excess prolactin in the body.
[ Read: Ectopic Pregnancy ]
2. Tubal Infertility:
The second most common cause of infertility in
women is damaged fallopian tubes. What happens
when your fallopian tube is just not working the
way it should? Well, without a properly functioning
tube, there is no way for the sperm to make its
way to the egg. And even if the sperm does make
it to the egg and fertilize it, a blocked tube can
prevent it from reaching the uterus!
Here are some factors that can cause fallopian
tube damage or blockage:
Pelvic Inflammatory Disease (PID):
PID is a very common, but often undiagnosed
sexually transmitted disease among women. It
affects the uterus as well as the fallopian tubes.
If you have ever suffered from an STD, you can
end up with this painful disease and also suffer
from infertility.
Ectopic Pregnancy:
Ectopic pregnancy is a heartbreaking phenomenon
where you are pregnant, yet you are not! An
ectopic pregnancy occurs when a fertilized egg
implants itself in the fallopian tube. The only
solution to this problem is surgery, which can
damage the tubes and cause future infertility.
Pelvic Tuberculosis:
Most of us associate tuberculosis with the lungs.
But the fact is, TB can impact any part of the
body, including the pelvis! Pelvic tuberculosis is a
big cause of infertility in women.
[ Read: Unexplained Infertility ]
3. Endometriosis:
Do you suffer from uncommonly painful periods?
You may have endometriosis (popularly referred to
as Endo). Endo is a common cause of infertility
and occurs when uterus tissues find other places to
call home. These endometrial tissues can obstruct
the sperm from meeting the egg and cause
infertility. Sometimes, Endo can also damage the
uterus lining and prevent the implantation of a
fertilized egg. Some of the causes for
endometriosis include:
Retrograde Menstruation:
The most common cause of endometriosis,
retrograde menstruation causes the menstrual
blood, along with the endometrial cells, to flow
back through the fallopian tubes into the pelvic
cavity instead of out of the body. These
endometrial cells then cling on to the pelvic walls
and the surface of pelvic organs, causing
endometriosis.
Embryonic Cell Growth:
Embryonic cells are the source of cells that line
the abdominal and pelvic cavities. Sometimes, a
portion of the abdominal lining turns into
endometrial tissue, causing endometriosis.
Surgical Scar Implantation:
Endometriosis is often the most common cause of
secondary infertility in women (inability to get
pregnant after having a successful first
pregnancy). If you underwent a C-section during
your last pregnancy, you could contract Endo. A
surgery such as C-section can cause the
endometrial cells to attach to a surgical incision,
causing endometriosis.
Endometrial Cells Transport:
Another cause of endometriosis is Endometrial cells
transport. When the blood vessels or the lymphatic
system transport endometrial cells to other parts
of the body, it too can cause Endo.
Immune System Disorder:
A wayward immune system too can cause
endometriosis. Sometimes, a problem with the
body’s immune system can lead to it attacking the
endometrial tissue growing outside the uterus,
causing endometriosis.
[ Read: Common Reasons For Not Getting
Pregnant ]
4. Uterine Or Cervical Causes:
There are some uterine or cervical disorders that
can lead to infertility. Some of the major causes
include:
Fibroids or Myomas:
It is common for women to develop fibroids or
myomas in the uterus. But sometimes, these
growths can cause infertility by blocking the
fallopian tube and preventing implantation.
Scarring:
Scarring or inflammation of the uterus due to
endometriosis can also cause infertility.
Uterine Abnormalities:
Many a time, a woman is born with uterine
abnormalities that can cause infertility. Some
women are even born without a uterus!
Cervical Stenosis:
Some women have a narrow cervix, which too can
make pregnancy difficult. Cervical narrowing is
often an inherited disorder. But sometimes, it can
also be due to trauma to the cervix.
Low-Quality Cervical Mucus:
Cervical mucus plays an important part in fertility.
So, when the cervical mucus the body produces is
not top-notch, it can also be a cause of infertility.
Low-quality mucus can make it difficult for the
sperms to travel up the cervix and reach the egg.
[ Read : Yoga For Infertility ]
5. Unexplained Infertility:
One of the most heartbreaking aspects of
infertility is unexplained infertility. Sometimes,
doctors are unable to diagnose the cause of
infertility. Some experts believe that unexplained
infertility may be the culmination of many minute
and overlooked factors affecting both the
partners. But that is just a hypothesis. The good
news is that most cases of unexplained infertility
resolve themselves with time.
Some Other Factors That Can Cause Infertility:
Apart from the diseases and disorders mentioned
above, there are other factors that too can cause
infertility. Keep these points in mind if you are
embarking on the ‘trying to conceive’ journey.
1. Age:
It may be unfashionable to say, but it is the truth.
As a woman ages, the quality and quantity of her
eggs take a nosedive. This decline starts from the
mid-30s and can make pregnancy a difficult
dream to achieve.
2. Smoking:
Are you a smoker? Well, that can be a primary
reason for your inability to get pregnant! Women
who smoke can end up damaging their reproductive
system. Not just that, smoking also increases the
risk of miscarriage and ectopic pregnancy. Smoking
is also said to reduce the quality and quantity of
your eggs.
[ Read : Ayurvedic Treatment For Infertility ]
3. Weight:
If you are obese or very underweight, your chances
of conceiving without too many difficulties can go
down drastically. A woman with a healthy BMI is
more likely to have a healthy reproductive system.
4. Sexual History:
Women who experience sexually transmitted diseases
can also face fallopian tube damage. A sexual
history of unprotected sex with multiple partners
can cause STDs and infertility in the long run.
5. Alcohol:
A glass or two of alcohol a day is not something to
worry about. But heavy drinking can cause
ovulation problems as well as endometriosis.
When Should You See A Doctor?
Many women are baffled by their apparent inability
to get pregnant. But the question is when is the
right time to see a doctor? Should you try for a
few more months or head to a physician now? Well,
that depends on your age.
Women in their early thirties or even younger can
go a year without worrying too much. If a year or
more of unprotected sex has yet not led to a
pregnancy, you should consider going to a doctor.
Six months of unprotected sex without getting
pregnant and you are between 35-40? That should
raise a red flag or two! Get an appointment with
your doctor and discuss your concerns.
If you are above 40 years of age, you should talk
to a doctor even before you start trying for a
baby.
See a doctor immediately if you have any of the
symptoms of infertility mentioned in this article
like irregular or painful periods, PID, miscarriages,
or endometriosis.
[ Read : Fertility Drugs For Women ]
Diagnosing Infertility In Women:
The first thing you need to do when you are
suffering from infertility is to learn to trust your
doctor. He is the expert, with years of experience
helping women become pregnant!
Once you are at your doctor’s, he will run you
through a gamut of questions to gauge if you have
a fertility problem. In many cases (especially if
you are in your twenties or early thirties) he may
ask you to go back and try without assistance for a
few more months.
But if you are over 35 and have been trying for
more than six months, your doctor will get down to
business immediately.
Firstly, you doctor will need to know the exact
cause of your inability to conceive. So, be ready
for a plethora of tests!
Some of the female infertility tests you can
expect to undergo include:
1. Ovulation Testing:
These days, you can buy an ovulation prediction kit
to figure out if you are ovulating! If all these
tests come back negative, your doctor may
prescribe a blood test for progesterone to
determine if you ovulate. The doctor can also use
ultrasonography to check the quality and quantity
of your eggs if you do ovulate.
2. Hysterosalpingography (HSG):
As mentioned before, tubal abnormalities are a
leading cause of women infertility. If your
ovulation tests come back all clear, your doctor will
ask you to take an HSG. During an
hysterosalpingography, an X-ray contrast dye is
injected into your uterus via the vagina to check if
your fallopian tubes are healthy and undamaged. If
the Xray shows abnormalities, you may require
more tests. But for some women, HSG itself works
as a treatment by flushing out obstructions and
clearing up the fallopian tube. Some women who
undergo HSG end up getting pregnant within three
months of the test. But HSG can be painful, really
painful. Do talk to your doctor about management
before you go for this particular test.
[ Read : Does Fertility Treatment Cause Cancer ]
3. Laparoscopy:
If your HSG shows some fallopian tube issues, your
doctor will ask you to go for a laparoscopy. A
laparoscopy is used to check out the state of your
fallopian tubes, ovaries, and uterus. Apart from
fallopian tube defects, laparoscopy can also help
diagnose endometriosis and scarring as well as
other reproductive issues.
4. Ovarian Reserve Testing:
If you are over 35, your doctor may prescribe the
ovarian reserve test to determine the quality and
quantity of your eggs. The test includes some blood
and imaging tests. Though older women are more
likely to suffer from this particular problem, many
younger women report premature ovarian reserve
depletion too.
5. Hormone Testing:
Hormones can make or break your health, including
your fertility. It is no wonder then that hormonal
tests form a big chunk of fertility tests! Your
doctor may order blood work to check out your
ovulatory, thyroid, and pituitary hormones.
6. Imaging Tests:
Some of the image tests involved in diagnosing
infertility include pelvic ultrasound,
hysterosonography, and hysteroscopy.
7.Genetic Testing:
Genetic testing is the last line of defense,
generally reserved for couples who have gone years
without conceiving.
Treating Infertility In Women:
Infertility is heartbreaking but is definitely not
the end of the road! With medical science coming
of age, millions of women with infertility go on to
become mothers, great ones at that!
Infertility is a complex issue so it is obvious that
treating it too will involve complexities. How your
particular case is treated depends on your age, the
length of your infertility journey, and your
budget!
Some of the female infertility treatment options
your doctor may explore include:
1. Fertility Drugs:
As mentioned before, ovulation-related issues are
the biggest cause of infertility in women. That is
why almost all women seeking treatment for
infertility go through a course or two of fertility
drugs.
Fertility drugs can induce or regulate ovulation by
working like natural hormones.
Some of the popular fertility drugs in use today
are:
Clomiphene Citrate:
Clomiphene citrate (Clomid, Serophene) is taken
orally. It can help your body ovulate by stimulating
the pituitary gland.
Gonadotropins:
If your doctor thinks that your case requires
something more powerful than clomiphene citrate,
he may prescribe gonadotropins. These injectable
hormones work directly on the ovaries to produce
more eggs.
Metformin:
Metformin is used to treat many PCOS cases
because it helps improve insulin resistance, and help
you ovulate.
Letrozole:
Letrozole (Femara) is often used to induce
ovulation, but its primary use is for the treatment
of breast cancer. That is why it is not commonly
used for treating ovulation-related infertility.
Fertility drugs are used widely these days, but
they do not come without a price. There are some
issues that can complicate the situation when you
are using fertility drugs. Fertility drugs can
increase your chances of conceiving multiples (twins
or more).
One of the more serious issues with fertility drugs
is ovarian hyperstimulation syndrome (OHSS), which
can lead to swollen and painful ovaries. Mild
abdominal pain, bloating, nausea, vomiting, and
diarrhea are all symptoms of OHSS. Remember
that the extended use of fertility drugs can cause
the growth of ovarian tumors in some women.
2. Surgery:
If your doctor thinks that you require something
more invasive than pills for treating infertility, he
may recommend surgery. There are numerous
surgical procedures that can help restore your
fertility. But surgery as a treatment for female
infertility option is losing its popularity with the
advent of several other, less invasive, options.
Laparoscopic or Hysteroscopic Surgery:
If you have problems such as an abnormal
uterinephysiology,polyps, fibroids, or adhesions, a
laparoscopic surgery may be in the offing.
Tubal Surgeries:
If your fallopian tube issue is what’s keeping you
from getting pregnant, surgery can come to your
rescue.
[ Read: IVF Treatment – Step By Step Procedure ]
3. Assisted Reproductive Procedures:
The most popular assisted reproductive procedures
include:
Intrauterine Insemination (IUI):
During IUI, millions of sperm are inserted directly
into the uterus during ovulation.
In Vitro Fertilization (IVF):
IVF is becoming increasingly popular these days,
thanks to its high success rate. An IVF procedure
involves removing healthy eggs from a woman,
fertilizing them with her partner’s sperm in a lab.
The fertilized embryo is then transferred into the
uterus.
4. Others:
There are some offbeat measures that can help
you achieve your ultimate dream – having your
baby!
Some of the other options you can try are:
Donor Eggs:
If your body is not making eggs at all or if the
quality of your eggs is not viable in making a baby,
you can opt for donor eggs.
Surrogacy:
If you are incapable of carrying a child to term,
you can opt for surrogacy. In surrogacy, you and
your partner create a baby in a lab (with your egg
and your partner’s sperms). The fertilized egg is
then placed in the surrogate’s uterus who carries
the baby to term. If this is the path you want to
walk, do consider getting a good lawyer.
Adoption:
Adoption is not a treatment for fertility. But it
does give you’re the ultimate reward – a baby!
Tips For Dealing With Infertility:
Infertility can sap you of energy, leaving you
broken and empty. But if you want to win the
battle, you need to prepare for it. Here are some
tips to help you deal with infertility better:
1. Do Your Research:
Be your advocate when it comes to infertility
treatment. But for that, you need to be aware of
all that infertility entails. So read up as much as
you can about infertility even before you see your
doctor.
2. Seek Support:
It can be a lonely battle when one is dealing with
something as painful yet invisible as infertility. You
can feel alone and depressed. That is why it is
important to seek help to navigate this difficult
phase in your life. Talk to your friends and family.
If that does not appeal to you, seek out online
support groups that can help you vent while
remaining anonymous.
3. Watch Your Weight:
If you want to conceive you need to be a healthy
weight. A healthy BMI will not just help you beat
infertility but will also ensure a healthy pregnancy.
So, watch what you are eating and do exercise
regularly.
[ Read : Ways To Reduce Stress For Getting
Pregnant ]
4. Quit Smoking:
Now is the best time to quit smoking because
smoking is not just bad for your fertility but also
for your overall health.
5. Decrease Alcohol Consumption:
Cut down on your alcohol consumption to give your
fertility a boost.
6. Manage Your Stress Levels:
The last thing a woman suffering from infertility
wants to hear is ‘stop worrying, and you’ll get
pregnant’. But the fact remains that stress can
impact your fertility. So, try and manage your
stress levels as much as you can.
Infertility is a lonely battle. But it is a battle that
can be won! So, don’t lose hope. Hold onto the
vision of your baby – the ultimate prize!
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