Infertility in Women

A healthy woman is born with a certain amount of eggs approximately one to two million but by the time of puberty only three hundred thousand of those eggs remain and as a woman ages, those eggs begin to decline. Once Menopause occurs a woman’s menstruation cycle ends, and ovaries stop producing eggs completely. According to the world health organization, Infertility in Women is a disease of the reproductive system from failure to conceive a pregnancy by unprotected sex within a 12-month period. As well as a woman who is able to get pregnant but couldn’t carry until birth could also be infertile (WHO, 2016). There is two types primary and secondary infertility, primary refers to couples who are trying to conceive for up to a year but cannot and secondary is when a couple has had one child but is unable to conceive again.

A women’s reproductive age is 15-49 years old and infertility in the United States affects about 10 percent of the population which amounts to 6 million people (Women Health, 2018). Research has shown that there is a major difference between infertility in the first world and third world countries. Current studies and data are widely base on developed areas since global infertility rates are hard to determine due to infertility affecting both males and females. The who mentions that globally one in every four couples have trouble with infertility (WHO, 2016). Many people from developing countries still think its taboo to talk about infertility as they see it as evil or some sort of religious curse as well as many other things.

There are many risk factors that can affect a woman’s ability to have a child some of those include: sexually transmitted diseases, chronic diseases, fibroids, age, cancer treatments, problems with the reproductive tract and health problems that may cause hormonal alterations. Certain lifestyle and environmental factors may also affect fertility such as exposure to toxins, smoking, delaying pregnancy until the mid-30s or 40s, being overweight, underweight or obese and drinking too much alcohol or caffeine. Also, it’s more common for a woman to experience infertility than it’s in men. This is due to age and how many eggs she has left. Genetic causes include mutations in the follicle-stimulating hormone (FSH), gonadotropin-releasing hormone (GnRH) receptors, mutations in the androgen receptor causing androgen insensitivity syndrome and luteinizing-hormone (LH). Infertility in women can be caused by many factors including endometriosis, problems with ovulation, ovulatory dysfunction, ectopic pregnancy, physical uterus problems, blocked fallopian tubes, tubal or other anatomical disorders or any unknown causes. Most cases though are due to problems with ovulation, being unable to fertilize the eggs. Ovulation complications happen by polycystic syndrome PCOS. The polycystic syndrome is a hormonal disorder that interferes with the ovulation cycle and it is the most common cause of female infertility (Women’s Health, 2018). The ovaries can develop several small groups of fluid and not regularly release eggs. Another common cause is Primary ovarian insufficiency (POI) which is when the ovaries stop working before 40 years of age. Age is the most prevailing influence after the age of 35 a woman chances of having a baby starts to decline. This is due to a woman’s fertility which begins to slowly decrease in her late 20s, and starts to decline more suddenly around age 35, and drops sharply at age 40. After a certain age, the quality of her eggs decreases and the chance for chromosomal abnormalities increase and approximately 71% of miscarriages are due to chromosomal abnormalities.

One of the ovulation diseases mentioned above was Polycystic Syndrome, this is one of the most common conditions for women who are infertile. This disease affects the hormones of the reproductive system and in response, the body ovaries get bigger than normal and they may have tiny cysts on them. Women who suffer from this disease experience an increase in insulin production from the pancreas that can result in insulin resistance, therefore their cells don’t reply well to insulin. This can lead to hyperinsulinemia or hyperinsulinism and high levels of insulin can incite the ovaries to an overproduction of androgens. High levels of androgens affect the development of eggs and the release of the egg for ovulation. If the egg isn't released it can’t be fertilized therefore no pregnancy.

Along with infertility some of the long-term risks are chronic anovulation and extraovarian factors, such as high blood pressure, diabetes mellitus, coronary disease’s risks, and dyslipidemia. Some of the symptoms of infertility in women are, no period, irregular periods an average women cycle is 28 days if a woman’s cycle is off balance, she may have hormone issues, and if a woman is experiencing painful or heavy periods it may be a symptom for endometriosis. Some of the signs are reduced sex drive, skin blemishes, facial hair growth, weight gain, and thinning hair. The complications of this disease are infertility and its treatment, for example, if the patient was taking medications to stimulate the ovaries, such as gonadotrophins and clomifene that could lead to ovarian hyperstimulation syndrome and going through it can lead to stress and depression (Medical News, 2018).

The Diagnosis for infertility may include some tests such as an ovulation test, hysterosalpingography, ovarian reserve testing, and other hormone tests that check the levels of ovulatory, thyroid and pituitary hormones that control reproductive processes. Treatment for infertility all depends on the woman’s case, age, and how long you’ve been infertile and personal reasons. Treatments can help restore fertility through medication or surgery or help you get pregnant with high-level techniques like, In Vitro Fertilization (IVF). The medications for fertility restoration that help stimulate hormone (FSH) and luteinizing hormone (LH) to start ovulation some medications are Clomiphene citrate, Letrozole, and a few others.   

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