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UNDERSTANDING FERTILITY & TREATMENT

Female Age and Fertility

Successful pregnancy outcome is very much related to female’s age. The decline in fertility potential in women usually begins in the early 30s and accelerates in the mid to late 30's. As women wait longer to have children, more couples have fertility problems due to declining egg quality in her ovaries. This means reduced ability to become pregnant and higher miscarriage rates.

Infertility rates are now higher in the general population than for the population in this study from the 1950s.

Infertility Rates for Couples Chart

This study found in Tietze C: “ Reproductive span and rate of conception among Hutterite women”. Fertility and Sterility 1957;8:89-97

Ovulation Problems

Ovulation is the release of mature eggs from a woman’s ovary and is a very important part of the reproductive process. Anovulation is the term used for woman does not ovulate. Anovulation can be due to hormonal imbalances, age and early menopause. It is a condition that can occur without any symptoms. The most common symptoms are an extended menstrual cycle, the absence of menstruation, as well as inconsistent basal body temperature.

Polycystic Ovaries (PCOS)

Polycystic ovarian syndrome (PCOS) is a condition in which the ovaries secrete abnormally high amounts of androgens (male hormones) that often cause problems with ovulation. Women with PCOS have enlarged ovaries which contain multiple, small cysts. Ovulation induction drugs can help the ovaries to release eggs. Insulin-regulating drugs such as metformin may correct ovulatory problems.

Endometriosis

The uterus /womb has a cavity, the endometrium is the lining covering the cavity inside the womb. Part of this lining is shed every month and the results in a menstrual period. When this lining grows outside the uterus, we call it endometriosis. Endometriosis is possibily caused by menstrual bleeding flows backwards through the fallopian tubes and grows outside the uterus. Endometriosis can block the fallopian tubes and prevent the sperm from reaching and fertilizing the egg. Painful intercourse and painful heavy menstrual periods may be symptoms of endometriosis. A surgical procedure called a laparoscopy can confirm the diagnosis of endometriosis.

Tubal Infertility

The fallopian tubes connect the ovaries to the uterus. One egg cell each month is released from the ovaries, floats down the fallopian tubes, and into the uterus. Tubal infertility refers to cases where fertility problems are due to issues related to the fallopian tubes. Tubal infertility accounts for about 20-25% of all cases of infertility. It includes cases of completely blocked fallopian tubes, either one blocked tube , no blockage but tubal scarring or other damage. Tubal infertility is usually caused by pelvic infection, such as pelvic inflammatory disease (PID), or endometriosis, or scar tissue that forms after pelvic surgery.

Uterine Problems

Uterine Polyps, Uterine Fibroids, Intrauterine Adhesions (scar tissue within the uterine cavity), Congenital Uterine Malformations, these are problems of the uterus and uterine lining can cause or contribute to reproductive problems such as infertility or recurrent miscarriage.