INFERTILITY AND WOMEN

What is infertility?

     Infertility is the inability of a sexually active couple who are not using contraception get pregnant after trying for one year.

For pregnancy to occur, several things must happen:

It should develop an egg in one of the ovaries of women.

The ovary to release an egg each month (ovulation). The egg must then be picked up by one of the fallopian tubes.

A man's sperm must travel through the uterus to the fallopian tubes to join the egg and fertilize it.

The fertilized egg must travel through the fallopian tubes and adhering (implanted) to  the uterus lining.

Approximately 35 to 40 percent of infertility cases are due to female infertility, but a similar number of cases are due to male infertility. Therefore, before taking many tests and treatments, your partner should have a semen analysis to ensure that his semen is normal. Even if abnormal, there are many treatments available.

What causes female infertility?

     Approximately 25 percent of women with infertility ovulate rarely or never. These women often have irregular periods or not have them at all. Ovulation can be altered due to changes in the way the pituitary gland (a gland at the base of the brain) releases certain hormones. These hormones, luteinizing hormone (LH) and follicle-stimulating hormone (HFS), send a signal to the egg develops and the ovary releases it.

Among the problems that interfere with the normal release of LH and HFS are

lesions in the hypothalamus (part of the brain that works with the pituitary gland)

pituitary tumors

having too low or high weight

too much exercise

extreme stress

Other hormonal disorders that interfere with ovulation or affect fertility are

Polycystic ovary syndrome (PCOS)

hyperthyroidism or hypothyroidism

diabetes

early menopause

sometimes, Cushing syndrome (a disorder that causes a very high level of cortisol, sometimes called "the stress hormone")

The ability to get pregnant also can be affected by age, since the number and quality of eggs gradually decreases from approximately 35 years. Other factors include

reproductive tract problems.

How is infertility diagnosed?

     Your doctor will begin with a medical history about your menstrual cycle, past illnesses, sexually, transmission surgeries and any medications you are taking.

Step two is pelvic examination to confirm your reproductive tract (vagina, uterus and ovaries) is normal and blood tests to measure your hormone levels. In addition, it will take a medical history of your partner and will do a semen analysis. According to the results of these tests, your doctor may make them more tests, including one to ensure that the fallopian tubes of women are not blocked.

What is the treatment for infertility?

     Treatment for infertility depends on the cause and age. There are two main categories: one contributes to fertility drugs or surgery, and the other techniques used in assisted reproduction.

Fertility drugs (clomiphene pills, and injections of the hormone HFS and HL) are the main treatment for women with ovulation disorders. It is possible that women without a clear cause of infertility also use these drugs. Doctors sometimes combine drug treatment with intrauterine insemination (IUI), in which sperm are released into the uterus with a catheter (a thinflexible tube) is inserted into the vagina. IUI is made attime of ovulation.

Assisted reproductive technology uses techniques such as mixing sperm with an egg outside the body (in vitro fertilization or IVF) or injecting a single sperm into an egg and transferring the resulting embryo into the uterus. Some women who are left with very few eggs in the ovaries opt for IVF using a donor egg.