Female Fertility

Female fertility is a woman’s ability to conceive a biological child

Factors that affect Female Fertility:

1. Age : Women are born with all the eggs they’ll ever have, and as we age, the quantity and the quality of those eggs both decline. Menopause may not happen until your early 50s, but for most women, fertility begins to decline sharply around age 35. By age 40, a woman’s chance of getting pregnant is less than 5% per menstrual cycle, meaning fewer than 5 out of 100 women are expected to be successful each month they try
2. Genetics:
   As with so much of our health, genes strongly influence fertility, including the age of menopause. In fact, you’re six times more likely to experience early menopause (before age 40) if your mother, sister, or grandmother experienced it. Additionally, researchers at Stanford University recently discovered a link between certain genetic markers and hormone levels that suggests our reproductive lifespan may be very nearly fixed by our genetics.
3. Hormones: We’ve talked before about the absolutely crucial role that hormones play in the process of getting and staying pregnant. Hormones are the chemical messengers of the body, flowing back and forth between glands and organs to tell them when and how to kick into gear; any change in your hormones can change the way your body functions. There are many hormones at work in the process of ovulation and conception—like gonadotropin-releasing hormone (GnRH), luteinizing hormone (LH), follicle-stimulating hormone (FSH), estrogen, and progesterone—and each of these must be present at the right time, and in the right quantity, to ensure that the process goes smoothly. For example, the right level of progesterone is crucial for ovulation, embryo implantation, and during early pregnancy; not enough, and you could experience infertility or miscarriage.
4. Anatomical or gynecological issues:Infertility can result from damage to reproductive organs that occurs with injury or disease. One example is pelvic inflammatory disease, an infection in the upper reproductive system; scar tissue from PID could block a woman’s Fallopian tube(s) and prevent ovulation or pregnancy. Another example is endometriosis, a disorder in which tissue from inside the uterus begins to grow on other organs, causing swelling, cysts, or blockages that might prevent pregnancy in a similar way.
5. Medical history:Unfortunately, certain medical treatments can jeopardize a woman’s fertility. As mentioned above, surgery to the ovaries—to remove a cyst or treat endometriosis—could damage the ovaries or reduce ovarian reserve. And chemotherapy and radiation, while obviously life-saving treatments for cancer and other illnesses, can destroy or damage a woman’s eggs or cause premature menopause. In fact, egg freezing was initially developed as an way for women who were about to undergo these types of fertility-damaging treatments to preserve their chance at pregnancy later on.
6. Lifestyle:Let’s face it: your age, genetics, and biology have the greatest impact on your fertility—but that’s not to say that your lifestyle has no impact at all. According to the ASRM, up to 13% of infertility may be attributable to cigarette smoking. Smoking depletes the ovarian reserve and causes chromosomal damage to a woman’s eggs, and it’s estimated that women who smoke reach menopause one to four years earlier than nonsmokers. Other lifestyle factors, like being significantly overweight or underweight or having an irregular sleep cycle, could also affect fertility by creating a hormone imbalance.

Causes of Female fertility:

There are a number of things that may be keeping you from getting pregnant:

Damage to your fallopian tubes. These structures carry eggs from your ovaries, which produce eggs, to the uterus, where the baby develops. They can get damaged when scars form after pelvic infections, endometriosis, and pelvic surgery. That can prevent sperm from reaching an egg.

Hormonal problems. You may not be getting pregnant because your body isn’t going through the usual hormone changes that lead to the release of an egg from the ovary and the thickening of the lining of the uterus.

Cervical issues. Some women have a condition that prevents sperm from passing through the cervical canal.

Uterine trouble. You may have polyps and fibroids that interfere with getting pregnant. Uterine polyps and fibroids happen when too many cells grow in the endometrium, the lining of the uterus.

“Unexplained” infertility. For about 20% of couples who have infertility problems, the exact causes are never pinpointed.

Investigations for Fertility:

Hysterosalpingography (HSG): This procedure involves ultrasound or X-rays of your reproductive organs. A doctor injects either dye or saline and air into your cervix, which travel up through your fallopian tubes. With this method, your doctor can check to see if the tubes are blocked.

Laparoscopy. Your doctor puts a laparoscope  a slender tube fitted with a tiny camera through a small cut near your belly button. This lets him view the outside of your uterus, ovaries, and fallopian tubes to check for abnormal growths. The doctor can also see if your fallopian tubes are blocked.

Treatment for Female Infertility:

Laparoscopy. If you’ve been diagnosed with tubal or pelvic disease, one option is to get surgery to reconstruct your reproductive organs. Your doctor puts a laparoscope through a cut near your belly button to get rid of scar tissue, treat endometriosis, open blocked tubes, or remove ovarian cysts,  which are fluid-filled sacs that can form in the ovaries.

Hysteroscopy . In this procedure, your doctor places a hysteroscope into your uterus through your cervix. It’s used to remove polyps and fibroid tumors, divide scar tissue, and open up blocked tubes.

Medication. If you have ovulation problems, you may be prescribed drugs such as clomiphene citrate (Clomid, Serophene), gonadotropins (such as Gonal-F, Follistim, Humegon and Pregnyl), or letrozole.

Gonadotropins can trigger ovulation when Clomid or Serophene don’t work. These drugs also can also help you get pregnant by causing your ovaries to release multiple eggs. Normally, only one egg is released each month.

Your doctor may suggest that you take gonadotropin if you have unexplained infertility or when other kinds of treatment haven’t helped you get pregnant.

Metformin (Glucophage) is another type of medication that may help you ovulate normally if you have insulin resistance or PCOS (polycystic ovarian syndrome).

Intrauterine insemination. For this procedure, after semen gets rinsed with a special solution, a doctor places it into your uterus when you’re ovulating. It’s sometimes done while you’re taking meds that help trigger the release of an egg.

In vitro fertilization (IVF). In this technique, your doctor places eggs into your uterus that were fertilized in a dish.

You take gonadotropins that trigger the development of more than one egg. When the eggs are mature, your doctor collects them with a device called a vaginal ultrasound probe.

Sperm are then collected, washed, and added to the eggs in the dish. Several days later, embryos — or fertilized eggs — get put back into your uterus with a device called an intrauterine insemination catheter.

If you and your partner agree, extra embryos can be frozen and saved to use later.

ICSI (intracytoplasmic sperm injection). A doctor injects sperm directly into the egg in a dish and then places it into your uterus.

GIFT (gamete intrafallopian tube transfer) and ZIFT (zygote intrafallopian transfer).  Like IVF, these procedures involve retrieving an egg, combining it with sperm in a lab, and then transferring it back to your body.

In ZIFT, your doctor places the fertilized eggs — at this stage called zygotes — into your fallopian tubes within 24 hours. In GIFT, the sperm and eggs are mixed together before a doctor inserts them.

Egg donation. This can help you if you have ovaries that don’t work right but you have a normal uterus. It involves removing eggs from the ovary of a donor who has taken fertility drugs. After in vitro fertilization, your doctor transfers the fertilized eggs into your uterus.

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