Diagnosing and Treating Female Infertility

by : American Pregnancy Association

Infertility is a condition that affects approximately one out of every six couples. An infertility diagnosis is given to a couple who is unsuccessful with their attempts to get pregnant over the course of one year. When the problem exists within the female partner, it is referred to as female infertility. Female infertility factors contribute to approximately 50% of all infertility cases, and female infertility alone accounts for approximately one-third of all infertility cases.

What causes female infertility?

Female infertility usually occurs when there is a problem with ovulation, a damaged fallopian tube or uterus, or there is a problem with the cervix. Age may also contribute to fertility struggles because as a women ages, her fertility decreases.

Ovulation problems may be caused by one or more of the following:

• A hormone imbalance
• A tumor or cyst
• Eating disorders such as anorexia or bulimia
• Alcohol or drug use
• Thyroid gland problems
• Overweight
• Stress
• Intense exercise causing a loss of body fat
• Extremely short menstrual cycle

Damage to the fallopian tubes or uterus may be caused by one or more of the following:

• Pelvic inflammatory disease
• A previous infection
• Polyps in the uterus
• Endometriosis or fibroids
• Scar tissue or adhesions
• Chronic medical illness
• Surgery to remove a tubal pregnancy
• A birth defect

DES syndrome which occurs if your mother took the medication DES to prevent miscarriage during her pregnancy with you.

Abnormal cervical mucus may be the cause of your infertility. Abnormal cervical mucus may prevent the sperm from reaching the egg or make it more challenging for the sperm to penetrate the egg.

How is female infertility diagnosed?

Potential female infertility will be assessed as part of a thorough physical exam. The exam will include a medical history regarding potential factors that could contribute to infertility.

Your healthcare provider may use one or more of the following tests to assess your fertility condition:

• A urine or blood test to check for infections or a hormone problem
• A sample of cervical mucus and tissue to determine if ovulation is occurring

Tracking your ovulation through fertility awareness will help your healthcare provider in assessing your fertility status.

Your healthcare provider may also use a laparoscope inserted through your abdomen to view your organs to assess for blockage, adhesions or scar tissue. An x-ray of your fallopian tubes may also be done to check for blockage. This is accomplished by an injection of blue-colored liquid through the cervix and into the fallopian tubes, which makes it easier for the technician to view the fallopian tubes through the x-ray.

How is female infertility treated?

Female infertility is most often treated by conventional methods that include one or more of the following:

• Taking hormones to address a hormone imbalance, endometriosis, or a short menstrual cycle
• Taking medications to stimulate ovulation
• Taking antibiotics to remove an infection
• Having minor surgery to remove blockage or scar tissues from the fallopian tubes, uterus, or pelvis area

In vitro fertilization is an ART procedure which may also be used to address the problem of blocked or damaged fallopian tubes. The sperm and egg are fertilized in a laboratory and then the fertilized egg is placed in the female's uterus to help facilitate implantation.

Can female infertility be prevented?

There is usually nothing you can do to prevent female infertility that is caused by genetic problems or an illness. There are things that women can do to decrease the likelihood that they experience an infertility issue:

• Avoid sexually transmitted diseases
• Avoid illicit drugs
• Avoid heavy or frequent alcohol use
• Keep good personal hygiene and health practices

When should I contact my healthcare provider?

It is important to contact your healthcare provider if you experience any of the following symptoms:

• Abnormal bleeding
• Abdominal pain
• Fever
• Unusual discharge
• Pain or discomfort during intercourse
• Sore or itching in the vaginal area