Infertility Treatments In Women, Infertility Testing & It’s Causes

Medically reviewed by Maria Sarino, MD FACT CHECKED

Infertility is a condition where the ability to get pregnant or bear a child becomes limited or gets impaired in one way or the other.

For couples, it is diagnosed after one year of trying to get pregnant. According to reports, one-third causes of infertility are because of male problems, one-third are because of female problems, and one-third are because of unknown reasons.

When the cause of infertility is female problems, it is known as female infertility. On the other hand, if a female is fertile, then her ovaries release healthy eggs.

Moreover, the reproductive tract also helps the eggs to pass into the fallopian tubes and then fuse with the sperm for fertilization. Not only this, but in the case of fertility, the fertilized egg travels to the uterus and implants in its lining.

However, if any of these processes are destroyed or damaged, then the female is not fully fertile and it may lead to female infertility. Female infertility has become a common condition, and there may be many reasons for the same.

There may be several possible causes of female infertility, and therefore it is challenging to coin out the exact cause. Some of the possible reasons include the following:

  1. Problems With The Uterus

    Normal uterine function and the role of Uterus could be really important in successful fertilization of eggs. For this very reason, if there is any issue with the Uterus linings, there could be issues in fertility.

    For this very reason, one of the leading causes of infertility in females is problems with the uterus. It includes fibroids, polyps, septum, or adhesions inside the cavity of the uterus.

    Fibroids and polyps can develop on their own at any time in an adult female. On the other hand, conditions like septum are present since birth.

    Other important pointers regarding Uterine Fibroids.

  2. Problems With Fallopian Tubes

    Another common cause of infertility in females is problems with fallopian tubes. Pelvic inflammatory disease is caused due to gonorrhea or chlamydia, which decreases the chances for a female to conceive.

    A few important pointers are discussed here.

  3. Ovulation Problems

    There may be many reasons why a female cannot ovulate regularly. These reasons include past eating disorders, hormonal imbalances, substance abuse, severe stress, thyroid conditions, pituitary tumors, and others lifestyle related issues.

    Age could also be one of the important factors.

  4. Problems With Numbers And Quality Of Egg

    Sometimes, the supply of eggs in the female body runs out before she reaches menopause. This factor cuts down the chances of a female getting pregnant.

    Alongside this, some eggs have the wrong number of chromosomes, because of which they cannot fertilize and grow into a healthy fetus. Some chromosomal issues affect all the eggs at large, while others affect only a few eggs and lead to infertility.

    POI could also be categorized in the same way.

Infertility Tests For Women

You can always know about your fertility by visiting your regular gynecologist and having a general physical exam.

  1. Ovulation Testing

    The fertility of a woman primarily depends on the fact whether she’s ovulating or not. Ovulation is the process of the release of healthy eggs from the ovaries.

    In case the ovaries are not ovulating or releasing the eggs, then there could be no chances of conceiving. Hence, ovulation testing is aimed at determining whether the female is ovulating or not.

    Under ovulation testing, you could get a blood test done that determines the different hormones to substantiate whether you are ovulating or not.

    More on it here.

  2. Ovarian Reserve Testing

    Under this method, the major focus could be to determine the number of eggs released during ovulation. However, ovarian reserve testing may generally be done during your early menstrual cycle phase.

    More on it here & here.

  3. Imaging Tests

    Several imaging tests may even help to determine your fertility. Some of these imaging tests include a pelvic ultrasound or a Son hysterogram.

    The pelvic ultrasound could help to detect any uterine or ovarian disease. On the other hand, Son hysterogram could help to identify the different details inside the uterus that may not be seen through the regular ultrasound.

    More on it here.

  4. Hysterosalpingography

    Under Hysterosalpingography, the medical healthcare professionals may check, the details of your fallopian tube and uterus.

    They may look out for blockages or problems in your fallopian tube and uterus and even take an X-ray to determine if the cavity is normal and the fallopian tubes spill out the fluids or not.

    Detailed governmental pointers here.

  5. Other Types Of Hormone Testing

    Several types of hormone testing might even be done to substantiate the level of ovulatory and pituitary hormones. The major reason behind checking the pituitary hormones level is because they could control the reproductive processes.

    In certain rare situations, the healthcare provider may even conduct the following tests to substantiate your fertility-

    Hysteroscopy

    Under this type of testing, the doctor might insert a lightweight, thin device into your uterus through the cervix.

    The device could help the doctor to view any abnormalities in your uterus and thus check for uterine diseases.

    More Information.

    Laparoscopy

    Under this testing method, the small device is inserted beneath your navel by making a small incision. The device could help to identify any potential abnormalities in your uterus, fallopian tubes, and ovaries.

    Thus, laparoscopy could help to detect any blockages or issues with the uterus and the ovaries.

    Medline Plus on laparoscopy.

Infertility Treatments

Doctors use different approaches and treatment options to treat infertility in women:

  1. Fertility Drugs

    Some drugs are taken into use to stimulate fertility in women. The use of these drugs is prevalent throughout the world. Upon the diagnosis, your doctor may recommend you the following:

    Clomid

    This drug works on the pituitary gland and forces it to release more follicle-stimulating hormone and luteinizing hormone than normal. The release of these hormones prompts your ovaries to produce follicles and further for the follicle with this egg to grow and develop for ovulation. Clomid may increase your chances of having twins to 8 percent.

    Follicle Stimulating Hormone

    Follicle Stimulating Hormone or FSH acts directly on your ovaries. Follicles are the fluid-filled sacs where the eggs become mature. This drug leads to multiple follicle development that may increase your chances of getting pregnant.

  2. Assisted Reproduction Therapy

    Another approach to treat infertility in women is Assisted Reproduction Therapy. Also known as ART, this treatment of getting pregnant involves using methods other than having intercourse with your partner. There are two methods namely, intrauterine insemination as well as in-vitro fertilization with or without intracytoplasmic sperm injection directly in your egg.

    Intra-uterine Insemination (IUI)

    Intra-uterine insemination replicates the process of having intercourse with your partner.  This procedure involves placing a small amount of sperm inside your cervix while you are ovulating. The entire procedure is carried out in a clinical setting where the sperm is washed and concentrated to increase your chances of getting pregnant using it.

    That being said, the success of intrauterine insemination also varies depending upon why you are opting for it. Some women do it as a part of their normal cycle without using medication and others mix it with their medication of FSH to develop more than one ovulated egg.

    You may have to opt for IUI in the following cases:

    • When the semen of your partner is normal, but your cervical mucus is hostile. This situation makes the treatment successful.
    • When semen of your partner is normal, and your mucus is receptive to sperm. The chances of success of this treatment in this situation are lesser.
    • When your partner has low motility or low sperm count.

    In-vitro Fertilization (IVF)

    If you are unable to become pregnant with the first 3-4 attempts of intrauterine insemination, your doctor may suggest in-vitro fertilization as the treatment option for infertility. This method includes fertilizing the egg outside of your uterus. Here’s how IVF is performed:

    • The injections of FSH stimulate the ovaries to produce follicles. It aims to develop 6-12 mature egg-containing follicles.
    • The doctor uses a vaginal ultrasound to monitor follicle growth.
    • If the scan exhibits enough healthy follicles, a trigger injection is administered to stimulate ovulation.
    • Your eggs are collected with a procedure called guided egg collection.
    • Both the sperm and eggs are placed together with culture fluid.
    • The combined sperm and egg are checked to see the signs showing early fertilization.
    • 1-2 embryos are transferred into the uterus within 2-5 days of fertilization.
    • The doctor administers a supplementary course of progesterone through your vagina for two weeks.
    • Other normally-developed embryos are frozen in liquid nitrogen for transfer later.

    IVF may require multiple attempts before achieving pregnancy. The success rate of this treatment option depends upon two factors – your age and the genetic quality of your eggs. It means that you must retrieve enough eggs, out of which high-quality eggs should be developed to produce good-quality embryos.

    More on IUI here.
    More on IVF here.
  3. Alternative Therapies

    If you choose IVF to treat infertility, you must follow up with your doctor about everything you are taking and doing to multiply your odds of pregnancy. These may include different options such as growth hormones, acupuncture, DHEAS, steroids, and testosterone. Many scientific studies and research have laid down that these therapies do not serve any significant benefit. Moreover, alternative therapies to treat fertility are not safe, and it is always suggested to have a word with your doctor before taking the same.

Some Important References

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