General Information on Infertility in Women

Causes Of Infertility In Women

Infertility is the inability of a couple (where the woman is under 35) having normal, unprotected sex for over a year, (two years for women over 35) to conceive. However, it is important to note that infertility is the total absence of reproductive function in an individual. This condition is very rare. Most ‘infertile’ people have biological parts of their reproductive system impaired, which results in reduced chances of their conceiving. Thus they are not really infertile, they are subfertile. This condition however, is also broadly referred to as infertility.

While both male and/or female factors can contribute towards infertility, here, we will look at the most common causes leading to infertility in women

Ovulatory disorders:

Because the ovulation cycle is so complex, even the minutest deviation can disrupt the process and affect ovulation. Impaired ovulation is the single, most common cause of infertility among women. Deficiencies in one or more of the controlling hormones, absent, damaged or diseased ovaries, stress or even weight loss can lead to ovulatory disorders.

The most common form of ovulatory disorder is Polycystic Ovary Disease (PCOD). Around 30% of the women suffering from ovulation dysfunction have Polycystic Ovary Disease. Their ovaries are enlarged and have a smooth but thicker-than-normal outer cover with a number of small, harmless cysts spread all over. Their menstruation cycle is very irregular and they tend not to ovulate. Women with PCOD also tend to be overweight and develop hirsuitism.

Anatomical disorders:

Women are more prone to anatomical disorders than men. Infection and inflammation can lead to disorders of the female sex organs. The most common anatomical disorders among others are:

• Fallopian tube damage where the tubes get blocked on account of scarring due to infection or due to earlier abdominal surgery. Fallopian tubes can also be affected by Pelvic inflammatory disease (PID) caused by sexually transmitted micro-organisms.
• Uterine disorders such as congenital abnormalities, infections or fibroids that can prevent the fertilized egg from implanting and growing in the womb.

Aging:

Females are born with a fixed though plentiful supply of eggs. These eggs slowly begin to diminish from childhood through adulthood. While the process of ovulation does contribute to this decrease, some portion of the eggs are absorbed by the body over a period of time. A rapid decline in fertility sets in after the age of 35 as the eggs also begin to degrade reducing chances of naturally conceiving. With age, changes in hormonal levels can also cause irregular ovulation resulting in declining fertility.

Unexplained infertility:

Some patients show no obvious cause for their inability to conceive in spite of thorough investigations being conducted. This is normally due to genetic factors among others, that present technology is not equipped to detect.

Other factors:

Although infertility is not a health need, infertile women wishing to conceive have excellent infertility treatment options available today. If you are concerned with your fertility, connect with your health provider who will advise you on what tests to have and the best likely infertility treatment for you.

Risks To Fertility Caused By Environmental Factors

Although the effect of the environment on fertility is not very well understood as yet, studies conducted point towards there being a definite link between the environment and reproductive problems. Indications are that toxins present in environmental chemicals and pollutants do play an important part in causing infertility, in successfully carrying a baby to term and in the health of offspring.

In the course of our daily lives, we are exposed to a number of toxins both at home and at work that can have a negative impact on our ability to successfully reproduce. We aren’t always aware of all the substances that can affect fertility adversely and while exposure to toxins are mostly related to one’s occupation, exposure can also take place due to chemicals used at home or in the garden. For instance, certain chemicals such as those found in herbicides and pesticides have been found to disrupt the workings of the endocrine system, thereby affecting the normal functioning of hormones such as estrogen and testosterone. Repeated exposure to heavy metals like lead, mercury and cadmium can also have an impact on fertility and exposure to radioactivity, x-rays, electromagnetic or microwave emissions are believed to lead to sperm abnormalitie

Studies conducted show that the following are some occupations/industries that have the potential to create fertility problems:

• manufacturing or handling of plastics, synthetics or rubber
• agriculture (on account of pesticides)
• painting
• textiles (on account of chemicals used)
• dentistry
• firefighting
• drycleaning
• metal working and welding
• anesthesiology
• aircraft industry
• medical workers
• pharmacists
• x-ray technicians
• pottery workers (on account of lead)
• garment workers
• Office workers (on account of electromagnetic radiation from visual display terminals).
And the list can go on….and on.
The toxins we are exposed to at home include among others:
• normal tap water (on account of detergents present)
• second-hand smoke (on account of cigarettes, marijuana etc.)
• household cleaners
• pesticides, herbicides and insecticides
• microwave emissions
• eating pads or electric blankets

Here too, the list can go on. One obviously cannot avoid all of these substances, all of the time in the present day scenario. However, being aware that chemicals that surround us in our day to day living could impact efforts to conceive and successfully give birth to a healthy baby, is important.

If you have concerns regarding the effect on your fertility due to being exposed to environmental toxins either in your workplace or home, or elsewhere, talk to your Fertility Doctor and find out what you can do to protect yourself against their negative effects.

Smoking And It's Impact On Fertility

It is common knowledge that tobacco smoke contains several substances, many of which are toxic. Besides all the other reasons why smoking is considered harmful to health, studies show that tobacco smoke definitely has a negative impact on fertility for both women and men.

In women, smoking compromises their menstrual health and their entire reproductive system. Toxins present in the smoke have a negative effect on female sexual organs. Smoking causes up to a 22% reduction in a woman’s fertility. Several studies have been conducted on the subject and the findings in almost all of them agree that women smokers who plan to have babies immediately or even in the future, should quit smoking.

Smoking has been found to negatively impact a woman’s ability to become pregnant. Women who smoke can take up to two months longer than non-smokers to conceive. They also have a lower chance (40%) of getting pregnant. Smoking can reduce a woman’s ovarian reserve and damage the quality of the eggs she produces. It affects the maturing of the eggs and the ovulation process as also, the ability of the egg to be fertilized. Smoking can also bring forward the onset of menopause, in some cases by as much as two years.

The success of in vitro fertilization procedures is also greatly impacted among women who smoke - fewer eggs are retrievable, successful fertilization rates are lowered and there is an increased rate of miscarriages. It has been found that smoking causes a reduction in blood flow which in turn affects tubal motility and successful implantation of the embryo during in-vitro fertilization. Smoking is believed to increase the chances of tubal pregnancies as well.

It is believed that smoking can have many harmful effects on the fetus too, during pregnancy. These range from reduced birth weight, fetal malformation such as cleft palate or lip, increased spontaneous miscarriages and increased chances of further complications in the pregnancy. There is a lot of evidence regarding the risks of smoking during pregnancy leading to higher mortality and the baby developing serious respiratory infections. It is also believed that children of smokers have a greater chance of developing cancer than children of non-smokers.

Smoking is equally bad news for men. It adversely affects sperm production and can be a precipitating factor in preventing successful fertilization. Smoking affects blood circulation in men which can cause erectile dysfunctions as also, negatively impacting his reproductive organs. Smoking can alter hormone production and increase the risk of chromosomal damage in the sperm which in turn could lead to genetic abnormalities in the offspring or increase miscarriage rates.

If you are planning on having a baby, it is important to establish and maintain a healthy lifestyle. Besides cutting out alcohol, taking the right vitamins and other supplements, eating healthy and exercising, included is giving up smoking if you are in the habit of doing so. In fact, it is recommended that you quit as soon as you decide on getting pregnant, and not just wait until your pregnancy is confirmed.

Quitting smoking can have a beneficial effect very quickly. Quitting increases a woman’s chances of getting pregnant and women who have quit smoking for a year, regain the ability to become pregnant in the same time frame as non-smokers. Giving up smoking is not easy and once you’ve decided to quit, it is important to take all the help you can get to be successfully free of the habit. Create a plan and take the support of your family, your fertility doctor, nurse, counselor and everyone else who can help you stay tobacco free – it’s your fertility at stake and the future of your unborn child.

Will Science Continue To Develop New Treatments For Infertility

In 1978 Louise Brown was born in Manchester, England. Her birth to parents deemed to be infertile was a world first. She had been conceived by assisted reproductive IVF treatment and was considered a miracle of modern medicine. Today the ‘fertility industry’ is an international and multi-billion dollar one, that has helped a countless number of parents to have children that a relatively small number of years ago would literally have been inconceivable.

For couples that are either unable to or are having difficulty conceiving, IVF and it’s associated treatments offer a real scientific hope to them in their quest. However, the scientific advances of recent years also raises ethical questions.

From the early years of fertility treatments the procedures centered on work involving the gametes (sperm and ova). The absence of a womb in the woman would leave only two options surrogacy or adoption. In recent years the prospect of a womb transplant has become a reality. Successful transplants have been carried out on mammals such as sheep, rabbits and pigs.

To date, they have not resulted in a successful pregnancy. In 2002 doctors in Saudi Arabia successfully transplanted the womb from a healthy 46 year old woman into one aged 26. Unfortunately the transplant only survived two menstrual cycles before having to be removed - a blood clot having formed. The procedure carried out here was more akin to a ‘graft’ operation. Fertility experts currently believe that in order to succeed the transplant needs to include the major blood vessels, meaning that the womb to be transplanted would need to come from an organ donor. Such a procedure would be a major operation and as such would carry all the risks of major surgery. But, as is well known, the desire of women to have children is so strong that it will probably not be long before the procedure is attempted in the operating theatre.

Current legislation on fertility, specifically human embryo treatment, does limit the extent to which scientists can develop some concepts. Experiments have been undertaken to grow an artificial womb by growing uterine lining cells in the laboratory. Due to legislation this type of experimentation has to stop after one week. However, a human embryo placed in an artificial womb has survived for seven days. Similar experiments with mice have resulted in fetuses of mice surviving the equivalence of a 30 week human gestation.

In another piece of research scientists are able to maintain fetuses from sheep and goats in tanks of synthetic amniotic fluid. Their main aim is to develop a synthetic human uterine environment that is conducive to the natural development of a human fetus, this could then be used for women who have problems maintaining a fetus towards the end of their pregnancy. This extreme example of a hi-tech incubator carries some serious ethical questions, as it is known that even the use of modern hospital incubators to keep babies alive can result in the baby having poor cognitive and/or physiological development.

More akin to traditional IVF treatments is the specter of artificial gametes. Current stem cell research has led to the successful production of mice sperm from stem cells, which in turn fertilized a mouse’s eggs and went on to produce a litter of live mice. However, they all had developmental problems and all died. This work is in its infancy but it will develop. Will it develop to the extent that a ‘man’ is not needed at all in the human reproductive process? Probably not, yet! The scientists involved in this research are doing it with a view to stimulating the natural growth/development of sperm in infertile men, rather than synthetically manufacturing human sperm.

Regarding the female gamete, scientists are developing techniques to encourage more than one egg per month from a woman’s ovaries to mature. They’re working on extracting immature eggs and ripening them under laboratory conditions. This would mean that women undergoing IVF treatments would not have to take sometimes risky ovary stimulating drugs to produce more than one viable egg.

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