Not all women can easily achieve pregnancy, if at all, and there are many factors which cause infertility in both women and men.
What is female infertility?
Female infertility is clinically defined as the failure to achieve pregnancy after 1 year of regular sexual intercourse without the use of birth control (or 6 months for women over the age of 35), and for women who have had two or more failed pregnancies.
What are the main reasons for female infertility?
Infertility in women can be caused by age, physical or health conditions, hormone issues, lifestyle or environmental factors.
Ovulation disorders: which affect the release of eggs from the ovaries. These include hormonal disorders such as Polycystic Ovary Syndrome.
Hyperprolactinemia: This is a condition in which there exists too much prolactin. This is a hormone produced in the pituitary gland, named for its role in lactation. It also has other wide-ranging functions in the body, from acting on the reproductive system to influencing behaviour and regulating the immune system. Either too much thyroid hormone or too little can affect the menstrual cycle or cause infertility.
- Uterine or cervical abnormalities
- Fallopian tube damage or blockage
- Endometriosis: which occurs when endometrial tissue grows outside of the uterus, may affect the function of the ovaries, uterus, and fallopian tubes.
- Primary ovarian insufficiency (early menopause): when the ovaries stop
- working and menstruation ends before the age of 40.
- Cancer (and its treatment
Treatment methods for female infertility:
In the past, treatment methods for infertility included only:
- Fertility drugs and hormones: to help the women ovulate or restore hormones levels
- Surgery: to remove tissue (such as endometriosis) or to open blocked fallopian tubes.
Thanks to modern advancements in medicine, infertility can now be treated with assisted reproductive technology IVF (In Vitro Fertilization).
What is IVF (In Vitro Fertilization)?
In vitro fertilization (IVF) is a complex series of procedures used to help with fertility or prevent genetic problems and assist with conception. During IVF, mature eggs are collected from the ovaries and fertilized by sperm in a laboratory. The success rate of IVF and the delivery of a healthy baby depends on various factors, including:
- Maternal age
- Embryo quality and status
- Reproductive history
- Cause of infertility
- Lifestyle factors
IVF for women over 40
Age is one of the biggest factors affecting a woman’s odds of conceiving and having a healthy baby. A woman’s fertility begins to decline from the age of 30, and especially over 40. The risk of pregnancy complications also increases with age. As a result, IVF is the primary form of treatment recommended for women over 40.
Preparation for IVF
Before a woman starts IVF, there is an in-depth preparation process which includes:
- Ovarian reserve testing: To determine the quantity and quality of your eggs, your doctor might evaluate the concentration of follicle-stimulating hormone (FSH), estradiol (estrogen), and anti-mullerian hormone in your blood during the first few days of your menstrual cycle. Test results often used together with an ultrasound of your ovaries, can help predict how your ovaries will respond to fertility medication.
- Semen analysis
- Infectious disease screening: You and your partner will both be screened for
- infectious diseases, including HIV.
- Practice (mock) embryo transfer: Your doctor might conduct a mock embryo transfer to determine the depth of your uterine cavity and the technique most likely to successfully place the embryos into your uterus.
- Uterine exam: Your doctor will examine the inside lining of the uterus before you start IVF. This may involve a sonohysterography — in which fluid is injected through the cervix into your uterus — and an ultrasound to create images of your uterine cavity. Or it might include a hysteroscopy — in which a thin, flexible, lighted telescope (hysteroscope) is inserted through your vagina and cervix into your uterus.
- Medications for ovarian stimulation: To stimulate your ovaries, you might receive an injectable medication containing a follicle-stimulating hormone (FSH), a luteinizing hormone (LH), or a combination of both. These medications stimulate more than one egg to develop at a time.
- Medications for oocyte maturation: When the follicles are ready for egg retrieval — generally after eight to 14 days — you will use human chorionic gonadotropin (HCG) or other medications to help the eggs mature.
Side effects and emotional aspects of IVF
Like with any medical treatment, there is the possibility of side effects while undergoing IVF procedures, such as:
- Multiple birth: IVF increases the risk of multiple birth if more than one embryo is transferred
- Premature delivery and low birth weight
- Ovarian hyperstimulation syndrome
- Egg-retrieval procedure complications
- Ectopic pregnancy
It is very important to be prepared emotionally before embarking on a course of IVF treatment. IVF can be a long and tiring process involving many invasive tests, doctors appointments and a series of highs and lows in relation to hopes and disappointments.
The fertilization process
Fertilization can be attempted using two common methods:
• Conventional insemination: During conventional insemination, healthy sperm and mature eggs are mixed and incubated overnight.
• Intracytoplasmic sperm injection (ICSI): ICSI, involves a process whereby a single healthy sperm is injected directly into each mature egg. ICSI is often used when semen quality or number is a problem or if fertilization attempts during prior IVF cycles failed. * The ICSI method is used in all Be parent IVF programs.
The world of IVF can be confusing, overwhelming and feel like a language all of its own. If you are are struggling with female infertility and need guidance as to whether IVF treatment is right for you please reach us at [email protected] for an assessment by one of our trained case facilitators.