April 24, 2020

Planning to start a family can be one of the most exciting times of your life. You ask your friends who have children for stories. You read books and watch YouTube videos on the subject. You pick out names, imagine holding your little ones, and think about all the wonderful memories you’ll make together during graduations, family trips, and regular everyday activities. But, if month after month you and your partner realize that — once again — you are not pregnant, you may be wondering about whether you’re experiencing fertility issues. How can you know for sure? How is it diagnosed? And, what can you do to treat it?

What is infertility?

Infertility is an umbrella term used to describe any condition that prevents conception. For a woman to be considered to be dealing with infertility, she must have been unsuccessfully attempting to get pregnant for at least one year. It often results in discouragement, frustration, and has an emotional impact on couples who are struggling with it.

Types of Infertility

There are two types of infertility in women. These include:

  1. Primary infertility: This type of infertility includes women who have never been pregnant, and have been unsuccessful at conceiving after attempting it for one full year of having unprotected sex with a male partner.
  2. Secondary infertility: This type of infertility refers to women who have been able to conceive and give birth in the past, but who are now unable to conceive or to carry a baby to term.

Causes of Infertility in Women

About one-third of infertility cases are related to women. There are several factors that could cause fertility problems in females. These include:

  • Pelvic inflammatory disease (PID)
  • Endometriosis
  • Ovulation disorders
  • Uterine fibroids
  • Hormone imbalance
  • Tumors or cysts
  • Abnormal cervical mucus
  • Obesity
  • Alcohol or drug use
  • Congenital anomalies
  • Eating disorders
  • Being over the age of 35

Diagnosing Infertility in Women

Diagnosing infertility requires several examinations — including a pelvic exam and taking a sample of your cervical mucus. It also includes urine and/or blood tests to determine whether you have any infections or hormonal imbalances.

If none of the more conservative approaches are conclusive, your OB-GYN may recommend a hysterosalpingography (HSG) — an X-ray that checks the outline of the uterus and fallopian tubes to determine whether there are any blockages. The procedure involves inserting a thin tube into the vagina and through the cervix, then introducing a substance called a contrast agent, designed to note distinctions within internal fluids for medical imaging purposes.

Your doctor may also opt to perform an ultrasound to inspect your uterus and ovaries or do a laparoscopy. This is a surgical procedure that involves making a small incision on the abdomen to insert a thin fiber-optic tube fitted with a camera and small light to inspect your reproductive organs.

Infertility Treatment for Women

There are several ways to treat infertility in women, including antibiotics to treat infections that may be affecting your reproductive organs, fertility drugs, or surgery to remove blockages in your reproductive system. However, some of the most common forms of treatment involve assisted reproductive technology (ART). These include:

Intrauterine Insemination (IUI)

This procedure is commonly known as artificial insemination. This type of treatment is provided in instances where you have a male partner with a low sperm count or decreased sperm mobility, you have abnormal cervical mucus, or if cervical scar tissue is present from a previous surgery. Prior to the procedure, you’ll have to take medications that promote ovulation, as well as monitoring ovulation to determine when eggs are mature. Once you’re ready for the procedure, a semen sample will be sent to a laboratory to separate good sperm from seminal fluid. Sperm will then be introduced in a catheter, then inserted directly into your uterus. The success rate for IUI is about 20% — with an increased chance of becoming pregnant with multiple babies. It’s also minimally invasive and significantly less expensive than in vitro fertilization.

Intrauterine insemination is not recommended for women who have a history of pelvic infections. This is due to a heightened risk of infection after the procedure has been completed. 

In Vitro Fertilization (IVF)

For this procedure, eggs are surgically removed from the ovaries to mix them in a petri dish with sperm. Prior to surgery, you will take medications for a week or two prior to your period to encourage your ovaries to produce more eggs. These medications are injected once or twice per day. It can be done by a nurse or by your significant other. On the day of surgery, you’ll undergo general anesthesia. Egg retrieval will last about 30 minutes.

If you have a male partner, he will provide a sperm sample the morning of the procedure. If you are using a sperm donor, the sample will be ready at your doctor’s laboratory. All sperm samples will be mixed with a substance that helps indicate the ones most likely to succeed in fertilizing an egg. The retrieved eggs and the selected sperm are placed in a petri dish. If a sperm fertilizes an egg, a fertility specialist will place the embryo in an incubator for up to six days.

Once cells start reproducing, the embryo will be implanted into your uterus. This transfer is a simple process that takes about five minutes and requires no anesthesia. About two weeks after the transfer, your fertility specialist will take a sample of your blood to determine levels of human chorionic gonadotropin (hCG) — the hormone that indicates you’re pregnant. It’s important to keep in mind that not all eggs will be successfully fertilized through IVF. It’s also possible for the sperm not to be strong enough.

OB-GYN Women’s Center Can Provide Treatment

At OB-GYN Women’s Center, we understand that when faced with infertility, things can get heartbreaking and overwhelming.

Contact us to schedule an appointment. Let’s discuss your options and find out the best course of action for you.