FERTILITY PROBLEMS IN WOMEN

 Basic information

description

Infertility is the inability to achieve pregnancy after 1 year (or 6 months for women over age 35) of sexual activity without use of birth control. Infertility affects 10% to 15% of reproductive-age couples. Causes of infertility are about equal in women and men (35% in each). In 20% of couples, both have problems, and in 10%, the cause is unknown.

FREQUENT SIGNS & SYMPTOMS

Inability to conceive.

causes

Infertility can be caused by a wide variety of factors, and sometimes the cause is unknown. In women, the causes are often due to ovulation problems or blocked or damaged tubes.

risk increases with

• Endometriosis (disorder of the uterine lining).
• Pelvic inflammatory disease.
• Ovulatory problem (unable to ovulate [release eggs]).
• Physical problems of the reproductive system.
• Repeated weight-gain/weight-loss cycles.
• Obesity.
• Hormone problems (such as thyroid).
• Vaginitis (inflammation of the vagina).
• Disorders of the cervix, such as infection, laceration or tearing from previous childbirth, or narrowing of the cervical opening for any reason.
• Amenorrhea (no menstrual periods).
• Chemical changes in the cervical mucus.
• Ovarian cysts.
• Smoking.
• Tumors.
• Certain genetic disorders (e.g., Turner syndrome).
• Emotional stress.
• Use of some drugs.
• Intrauterine device (IUD) may be a possible cause.
• Diabetes.
• Compulsive or excessive exercising.
• Marriage problems and infrequent sexual intercourse.
• Age. Female fertility decreases with age.
• Drugs of abuse, such as heroin or cocaine.
• Alcohol use.

PREVENTIVE MEASURES

• Specific preventive measures depend on the cause.
• To increase chances of conception, have intercourse every other day starting a few days before ovulation. (Sperm live for up to 72 hours.) Don't use lubricants.

expected outcomes

Some fertility problems are minor and reversible. Other problems may be helped with treatment.

possible complications

• Emotional stress, including feelings of guilt, inadequacy, and loss of self-esteem.
• Treatment costs are high and often not covered by insurance.
• Long-term effects of fertility drugs are unknown.

 diagnosis & treatment

general measures

• The first diagnostic tests may include a health history, blood tests, and a pelvic exam. Further testing may then be done. Multiple tests are available to study specific aspects of reproduction. You may be referred to a fertility specialist. The causes of infertility can be complex.
• A fertility treatment plan will be developed that is based on each couple's needs. It may include lifestyle changes, medical therapy (e.g., drugs or surgery), or assisted reproductive techniques (ART). ART can help many couples who are unable to conceive. The different ART options will be explained to you.
• To learn more: Resolve, 1760 Old Meadows Rd., Ste 500, McLean, VA 22102; (703) 556-7172 (not toll-free); website: www.resolve.org or American Fertility Assn., 305 Madison Ave., Suite 449, New York, NY 10165; (888) 917-3777; website: www.theafa.org.

medications

• Drugs may be prescribed to treat a cause of infertility.
• Ovarian stimulating drugs may be prescribed.
• Begin taking folic acid now. This will reduce the risk of birth defects once you become pregnant.

activity

Moderate and regular exercise are needed for good health. Avoid strenuous exercise if it causes menstrual periods to be irregular.

diet

Eat a well-balanced diet. If overweight, try to lose weight. Avoid caffeine and alcohol.

 notify our office if

• You or a family member is unable to get pregnant.
• Pregnancy is not achieved after treatment. There are additional options.

Special Notes: