What is female infertility?
Infertility, otherwise known as the inability to successfully reproduce, is a problem that affects people of all genders, including women. Some studies claim that for the 10-18% of couples who struggle with fertility, an estimated 30-60% of the causes are related in some part to female infertility. The list of possible factors and causes is long and multiple tests and consultations may be necessary before a diagnosis can be determined. In some cases, female infertility may be unable to be explained by doctors.
The human reproductive process has many stages. For females, the ovaries must release an egg, which is then picked up by the fallopian tube. The male’s sperm cells must swim up the cervix, through the uterus and into the fallopian tube to reach the egg for fertilization. After fertilization, the egg must travel down the fallopian tube to the uterus and then implant into the uterine wall to start developing into a fetus. Any stage of this process can be disrupted or complicated by a number of factors.
Possible female infertility can be assessed through a variety of tests. These include:
- Hormone testing. Doctors may recommend hormone tests in order to check levels of hormones that control ovulatory and reproductive processes.
- Pelvic ultrasound. This imaging test assesses the thickness of the lining of the uterus (the endometrium) and can look for uterine or fallopian tube disease. In addition, a hysterosonography may be used for a closer look into the uterus.
- Physical pelvic exam. A comprehensive physical exam may be done, which includes assessment of the thyroid, breasts, and pelvis. The doctor may also conduct a pap smear, which is a common gynecological test.
- Ovarian reserve testing. This series of blood and imaging examinations can measure the quality and quantity of eggs.
- Ovulation testing. This test can measure the hormones present before and after ovulation to determine if and when the female is ovulating.
Additional testing may include:
- Endometrial biopsy. In this procedure, doctors will scrape a small amount of tissue from the uterine lining just before menstruation. This test is done in order to determine if the lining is thick enough to sustain implantation and growth of a fertilized egg.
- Genetic testing. Doctors may recommend this procedure in order to rule out genetic defects as being responsible for fertility problems.
- Hysterosalpingography. This x-ray is taken by injecting a contrast dye into the uterus and then examining the images to detect abnormalities in the uterine cavity. This test also determines if fluid passes out of the uterus and spills out of the fallopian tubes. Sometimes this test can actually improve fertility by flushing out the fallopian tubes.
- Laparoscopy. This testing is less common and requires a small incision to be made in order to examine the fallopian tubes, ovaries, and uterus. This surgery may identify conditions like endometriosis, scarring, blockages of the fallopian tubes, and other abnormalities or problems with the ovaries and uterus.
There are many different treatments and therapies available to women and couples struggling with fertility. Some may restore fertility, such as fertility drugs that regulate or stimulate ovulation. Surgery is another option and may be used to correct or improve abnormalities or blockages with the uterus, fallopian tubes, and/or ovaries. In cases where fertility drugs and surgery are not appropriate or sufficient, reproductive assistance methods like intrauterine insemination (IUI) or in vitro fertilization (IVF) may be available options.
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