Female Infertility: Common Symptoms and What Causes It

Female infertility, which affects around one-third of infertile couples, might be caused by ovulation abnormalities, hormone imbalances, tubal damage, or uterine difficulties. Symptoms often include irregular menstrual periods and trouble conceiving. Weight, smoking, and age are all risk factors. Early detection and treatment are critical, especially for people over 35 or with reproductive health difficulties.

Pregatips
The inability to conceive after at least a year of frequent, unprotected sexual activity is the definition of infertility. About one-third of infertility cases are caused by female causes, while another third are caused by a combination of male and female factors. In the other situations, the reason is either unknown or a mix of variables related to both genders.

Determining the causes of female infertility may be difficult. Different treatments are available based on the underlying cause of infertility. Eventually, a lot of infertile couples will naturally become parents.

What Are The Different Types Of Female Infertility?

Infertility may be primary or secondary. Primary infertility indicates that you have never been pregnant and are unable to conceive after six months (over 35) or one year (under 35) of trying.Secondary infertility happens when you are unable to conceive after a successful pregnancy and delivery.

Symptoms Of Female Infertility

The primary sign of infertility is the inability to get pregnant. A menstrual cycle that is excessively lengthy (35 days or more), too short (less than 21 days), irregular, or nonexistent may indicate that you are not ovulating. There may not be any further signs or symptoms.

Causes of Female Fertility

A variety of conditions in women may interrupt this process at any stage. Female infertility is caused by one or more of the following reasons:

Ovulation disorders

The majority of instances of infertility are caused by infrequent or no ovulation. Ovulation abnormalities may be caused by issues with reproductive hormone control by the brain or pituitary gland, as well as difficulties with the ovary.
  • Polycystic Ovarian Syndrome (PCOS): Ovulation is suppressed by a hormonal imbalance caused by PCOS, or polycystic ovarian syndrome. Insulin resistance, obesity, atypical facial and body hair growth, and acne are associated with PCOS. It is the main reason why women are infertile.
  • Hypothalamic dysfunction: Each month, the pituitary gland secretes two hormones, luteinising hormone (LH) and follicle-stimulating hormone (FSH), which induce ovulation. A very high or extremely low body weight, excessive physical or mental stress, or a recent considerable weight gain or loss may all affect ovulation rates and change the way hormones are produced. Periods that are irregular or nonexistent are the most common indicators.
  • Primary ovarian insufficiency: Also known as premature ovarian failure, this is often caused by an immunological reaction or the early loss of eggs from your ovary, which might be due to genetics or chemotherapy. The ovary no longer makes eggs, and it reduces oestrogen production in women under 40.
  • Too much prolactin: The pituitary gland may produce too much prolactin (hyperprolactinemia), reducing oestrogen synthesis and leading to infertility. This may also be triggered by drugs you are taking to treat another ailment.

Damage to the fallopian tubes (tubal infertility)

Damaged or clogged fallopian tubes prevent sperm from reaching the egg or impede the transit of the fertilised egg into the uterus. Fallopian tube damage or blockage may result from the following causes:
  • Pelvic inflammatory disease refers to an infection of the uterus and fallopian tubes caused by chlamydia, gonorrhoea, or other sexually transmitted infections.
  • Previous surgery in the abdomen or pelvis, such as for ectopic pregnancy, where a fertilised egg implants and develops outside the uterus, typically in a fallopian tube, can also contribute to this condition.

Endometriosis

Endometriosis develops when tissue that normally grows in the uterus implants and grows in other locations. This excess tissue development, and its surgical removal, may produce scarring, which can obstruct fallopian tubes and prevent an egg and sperm from joining.Endometriosis may also prevent fertilised eggs from implanting properly. The illness also seems to have an indirect effect on fertility, such as harm to sperm or eggs.

Uterine or cervical causes

Several uterine or cervical factors may interfere with egg implantation or raise the risk of :
  • Benign polyps and tumours (fibroids or myomas) are frequent in the uterus. Some may obstruct the fallopian tubes or interfere with implantation, reducing fertility. However, many women with fibroids or polyps get pregnant.
  • Problems with the uterus that exist at birth, such as an abnormally shaped uterus, might make it difficult to get or stay pregnant.
  • Cervical stenosis is a narrowing of the cervix that may be caused by a hereditary abnormality or cervix injury.
  • Sometimes the cervix is unable to create the appropriate mucus to enable sperm to pass through it into the uterus.

Unexplained infertility

Sometimes, the reason for infertility is never discovered. A combination of minor issues in both couples may result in unexplained reproductive difficulties. Although it is irritating to get no particular solution, this issue will resolve itself over time. However, you should not postpone therapy for infertility.

Risk Factors

Certain factors may increase your chance of infertility, including:
  • Age
  • Smoking
  • Weight
  • Sexual history
  • Alcohol
  • Excessive or strenuous workout
  • Endometriosis
  • Structural abnormalities (physical issues with the fallopian tubes, uterus, or ovaries).
  • Uterine fibroids
  • Ovarian cysts
  • Tumours
  • Autoimmune diseases (lupus, rheumatoid arthritis, and Hashimoto's disease).
  • Pelvic inflammatory illness is caused by sexually transmitted infections (STIs).
  • Polycystic Ovarian Syndrome (PCOS). PCOS is a hormonal disease that may lead to infertility.
  • Primary ovarian insufficiency (POI)
  • A previous ectopic pregnancy

Prevention

For ladies thinking about becoming pregnant soon or in the future, the following recommendations may be helpful:
  • Maintain a healthy body weight
  • Quit smoking
  • Avoid alcohol
  • Reduce stress
It is important to see your doctor frequently to address any additional concerns of infertility. Once you start having sex, you should arrange yearly visits with a gynaecologist so your doctor can better spot issues that may influence your future fertility.

What Tests Will A Doctor Use To Detect Female Infertility?

The majority of testing takes place at your healthcare provider's office. These tests may include:
  • A physical examination.
  • A pelvic examination.
  • Pelvic ultrasonography.
Additional testing may be required in a laboratory setting. These tests may include:
  • Blood tests: The sort of blood test you get will be determined by your health history and the disease for which your physician is testing. Blood testing includes thyroid function tests, hormone levels for ovulation and menstruation, and ovarian reserve tests. Diminished ovarian reserve occurs when you have fewer eggs remaining in your ovaries than others your age.
  • X-ray hysterosalpingogram (HSG): Your physician injects contrast dye into your cervix and uterine cavity, then uses an X-ray to see the dye flow into your fallopian tube. This test tests for bottlenecks.
  • Laparoscopy: During this procedure, your doctor inserts a tiny monitoring equipment called a laparoscope into your belly to examine your organs.
  • Transvaginal ultrasound: Unlike an abdominal ultrasound, which uses a probe on your abdomen, a transvaginal ultrasound requires your physician to put a wand into your vagina.
  • Saline sonohysterogram (SIS): This test examines the lining of your uterus to detect polyps, fibroids, and other structural abnormalities. During a transvaginal ultrasound, your clinician will fill your uterus with saline to get a clearer image of the uterine cavity. SIS may also be used to determine whether the fallopian tubes are open.
  • Hysteroscopy: During this test, your physician inserts a hysteroscope (a tiny instrument with a camera attached) into your vagina and cervix. This permits your doctor to get a better look at your uterus.

When To See A Doctor?

When to seek assistance may depend on your age:
  • Most physicians advocate attempting to conceive for at least a year before testing or treatment, up to the age of 35
  • If you're between 35 and 40, go to your doctor after six months of trying
  • If you're over 40, your doctor may recommend testing or therapy straight soon
  • If you or your partner have a history of irregular or painful periods, pelvic inflammatory disease, multiple miscarriages, cancer treatment, or endometriosis, your doctor may recommend starting testing or treatment right soon.
Infertility may be quite difficult. If you've been trying to conceive for 12 months without success — or six months if you're over 35 — contact your healthcare practitioner. A healthcare practitioner may assist in determining the reason and recommending a treatment strategy. Try to maintain a cheerful attitude. Most individuals can conceive with the correct therapy.

FAQs on Understanding Female Infertility: Symptoms and Causes

  1. What signs indicate that a woman is infertile?Some infertile women may have irregular or no menstrual cycles. In addition, some men may exhibit hormonal symptoms such as changes in hair growth or sexual function.
  2. Can I determine whether I am infertile at home?While no at-home fertility test can give an official diagnosis, the majority utilise authorised laboratories and provide reliable findings, according to the firms. If you have any queries regarding your at-home fertility test findings, see your doctor.
Disclaimer: Medically approved by Dr Seema Jain, Director- Department of IVF and Fertility at Cloudnine Group of Hospitals, Pune