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What Affects Fertility
A couple is said to be infertile if they are unable to conceive after one or two years of trying. They should then consult an infertility specialist at an infertility center. • Age is a factor that reduces a woman's chances for fertility. Women above 35 years have decreasing fertility and their chances of getting pregnant are reduced. • The amount of fat in a woman's body may have a bearing on her ability to conceive. • Occupational and lifestyle factors also play no small role in the process of reproductive health. • Ovulation problems caused by hormonal disorders account for nearly a third of all problems of infertility in women. Resultant disorders could range from empty follicles or failure of the ovarian follicle to rupture. The hormonal rhythm is a delicate balance; a slight imbalance of which can cause ovulation disorders. • Pelvic Inflammatory Disease (PID) is a term that covers a gamut of infections affecting the reproductive organs of a woman. Infection in the fallopian tubes (salpingitis) is a common cause of infertility in women. Frequent bouts of infection can lead to tubal damage. • Endometriosis is a situation when fragments of the endometrial lining are implanted in other areas of the pelvis leading to cysts that can result in infertility in women. • Polycystic Ovarian Syndrome is a major cause of infertility in women in America. This is characterized by high levels of male hormones - androgen and testosterone. This results in inability to produce mature eggs and also manifests in symptoms such as acne and increased facial hair. • Some women's bodies develop antibodies to sperm, which cause infertility and miscarriage. Adrenal or thyroid deficiencies can result in premature ovarian failure resulting in infertility. A thorough infertility work-up evaluates five major fertility factors: The Cervical Factor, the Male Factor, the Ovulatory Factor, the Uterine Factor, and the Pelvic Factor. The Cervical Factor The ability of the cervix to nurture and transport sperm into the upper female reproductive tract is known as the cervical factor. In the "normal" female, the cervix produces large amounts of clear watery mucus just prior to ovulation. After ovulation, the mucus thickens and inhibits sperm from reaching the fallopian tubes, and hence, the egg. A simple procedure to assess the cervical factor is the postcoital test. Just before ovulation occurs, the couple has intercourse. Six to ten hours later, the female partner is examined in the office. A small portion of the cervical mucus is taken for examination. The clarity and texture of the mucus is examined under the microscope to determine if there is a reasonable number of sperm swimming freely. Although this test has been performed for years, it is still somewhat controversial. If the postcoital test is inadequate, mucus cultures, test for sperm antibodies, and a semen analysis may reveal the nature of the problem. Treatment is based on these collective findings. The Male Factor With half of all diagnosed cases of infertility attributed to the male partner. Male fertility can be a touchy and confusing subject for both you and your partner. A successful conception must often be pursued with an active participation from both. Start with useful information for any hopeful father such as a discussion of life factors that can influence fertility, for better, or for worse. The Ovulatory Factor Simply put, the ovulatory factor refers to the ability of a woman to release a healthy egg each cycle (ovulate). Problems with ovulation or inconsistent ovulation are very common causes of female infertility (it accounts for about one fifth of all causes of infertility). Each month, a normally ovulating female develops one egg as a result of the carefully synchronized secretion of pituitary hormones. During ovulation, the egg is released from the ovary into the fallopian tube. Many factors may interfere with this process, and cause either abnormal ovulation or ovulatory failure. Abnormal ovulation is typically caused by hormonal irregularities, and can usually be treated with medications. Ovulatory failure can be due to abnormal pituitary function, polycystic ovarian syndrome, premature ovarian failure (menopause), or overactive secretion of the hormone prolactin. The Uterine Factor The uterine factor refers to any abnormalities of the uterus or the uterine lining that may interfere with implantation of the embryo and/or maintenance of the pregnancy. A conventional test to assess uterine functionality is an x-ray test called a hysterosalpingogram. This test can be helpful in identifying uterine abnormalities such as fibroids, abnormally shaped organs, and defects. Another test to assess uterine functionality is a hysteroscopy. In this procedure, a small telescope is inserted in the uterus to allow direct visualization of the cavity. Many abnormalities can be treated through the hysteroscopy. An ultrasound examination is also an important tool in evaluating the uterine factor, specifically the uterine lining and the structure of the reproductive organs. The test can detect various abnormalities within the pelvic area, including fibroids, ovarian cysts, or problems with the fallopian tubes. The Pelvic Factor The pelvic factor primarily refers to problems affecting the fallopian tubes and other organs within the pelvic cavity. Patent (open) fallopian tubes and a normal relationship between the organs in the pelvic cavity are essential to allow sperm to reach the egg and travel to the uterus after fertilization. Factors interfering with this process can impede pregnancy. The pelvic factor is assessed once the other factors are examined. This is typically done with a minor surgical procedure called laparoscopy. Previous pelvic infections and endometriosis can destroy the normal relationship between the uterus, ovaries, and fallopian tubes. The tubes can be blocked or surrounded by scar tissue known as adhesions. In most cases, pelvic adhesions, endometriosis, and tubule blockage can be successfully treated through the laparoscope.
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