Women Infertility Causes

Laparoscopy and dye
 
A laparoscopy and dye test is an operation that has to be carried out under general anesthetic, although you can usually go home a few hours afterwards so it doesn't involve an overnight stay in hospital. During the test, the doctor uses a tiny telescope (laparoscope) to look at the condition of the womb and fallopian tubes.

Women Infertility Causes

Once you are asleep, the doctor makes a small cut just beneath your navel, and your abdomen is inflated with carbon dioxide to give a clear view. Then the laparoscope is put through the incision, and dye is injected through the tubes to make sure they are clear, or 'patent'. If there are no blockages or scarring, the dye passes through the tubes freely and spills out the ends.

The laparoscopy does not usually cause any problems, although you will probably feel some discomfort around the cut, and you may feel bloated or have a stomach ache. There ia also sometimes pain around the shoulder, which is caused by the left-over gas in the abdomen. Some women, particularly those who have never had a general anaesthetic before, find the prospect of an operation rather alarming, but a laparoscopy is a fairly standard fertility investigation. It is often suggested when there is suspected endometriosis or a history of pelvic inflammatory disease, and can give a more detailed assessment of any blockages or adhesions that have shown up on an HSG or HyCoSy.

'I've had quite a few laparoscopies and they aren't too bad. The recovery time can be up to a week and I did have shoulder pain, but it really didn't feel too bad. There's nothing to worry about. I had my appendix out this year, and that was much worse.' Gillian, 34
 
Hysteroscopy 
 
A hysteroscopy is an examination of the womb that involves putting a small telescope (hysteroscope) through the cervix. It may be carried out when you are having a laparoscopy, or can be done separately. You will be given a local anaesthetic or some form of sedation before the hysteroscopy is carried out. The hysteroscopy gives a good view of the inside of the womb, but is usually offered only where there is a reason to suspect there may be problems. Fibroids, adhesions or any irregularities in the shape of the womb can be assessed with a hysteroscopy.

Reproductive immunology 

Still fairly new, reproductive immunology is a rather controversial area of fertility testing and treatment. It is based around the idea that the female immune system may react against sperm and embryos, stopping fertilisation and implantation or causing miscarriage.

It may be suggested that you should have tests to check whether your immune system could be preventing you getting pregnant or maintaining a pregnancy. Usually this will mean having blood tests, but you may be offered other tests, such as an endometrial biopsy where a small piece of the womb lining is taken out for further testing, and you may then be offered treatment. The test results may suggest that you have raised antibodies, or higher than normal levels of the natural killer (NK) cells that we all carry in our bodies.
 

There are only a few clinics offering these tests, as many doctors consider them to be of limited value. They say, for example, that testing levels of NK cells in the blood is of little use as they are totally different to the NK cells that are found in the womb. If you've had recurrent miscarriages, or a number of unsuccessful IVF attempts, you may consider investigating this area, but it is important to remember that these tests and treatments are still in their infancy and are not scientifically proven. To find out more, you can check out Women Infertility Causes.

 

Causes Of Infertility In Women

Hydrosalpinx

Sometimes one of the fallopian tubes becomes completely blocked and it can swell and fill up with watery fluid.
This is known as a hydrosalpinx, and is usually caused by previous infection or surgery. The fluid tends to collect at the end of the tube that is closest to the ovary. Women who have a hydrosalpinx may experience very severe pelvic pain, but it is possible to have no symptoms at all.

Causes Of Infertility In Women

Sometimes only one tube is affected, but it can occur in both at the same time (bilateral hydrosalpinges). If both tubes are completely blocked, the only way to get pregnant is with IVF. There is evidence that a hydrosalpinx can reduce embryo implantation rates and increase the risk of miscarriage. For this reason, women who have hydrosalpinges often have their fallopian tubes removed before starting IVF.
 
'The consultant said our only chance of having a baby was through IVF, but that our chances of IVF working were halved because I had bilateral hydrosalpinges. We were distraught. He said l would have to have my tubes removed, I knew they didn't work, so I thought I might as well do it right away, but there is a stigma to being sterilized at 31.' Mikaela, 32

Physical problems with the womb or ovaries 
 
There can be physical problems with the ovaries or the womb that make it difficult for a woman to conceive. Sometimes the outer surface of the ovaries may be scarred, usually after some kind of surgery, and this makes it difficult for follicles to develop normally. The womb is sometimes oddly shaped, and depending on how serious this is, it can lead to infertility and miscarriage.
 
Asherman's syndrome
 
The name Asherman's syndrome is given to a rare condition where scar tissue is found inside the womb. It sometimes causes the front and back walls of the womb to stick together, although in milder cases the scarring is found in just a small portion of the womb. It can be the result of a D and C (dilatation and curettage) or an ERPC (evacuation of the retained products of conception), which involve clearing the womb after a miscarriage, to remove a retained placenta or to terminate a pregnancy. Scarring can also be caused by a caesarean section or other surgery, or by infection.
 
The symptoms of Asherman's are usually changes to the menstrual cycle, which may become shorter or lighter than before, and sometimes stops altogether. Some women feel period pain but don't bleed. This can be a sign that although menstruation is taking place, the blood can't get out of the womb because the cervix is blocked by scar tissue.

'I had a retained placenta when I had my daughter, and I was told I had to have emergency surgery, but after the ERPC, I had more and more problems. The pain I was having was quite incredible and I didn't have a bleed. They finally referred me to a consultant and we had tests that showed my cervix was completely closed up, and I had 90-95 per cent obliteration of the uterine cavity.' Abbi, 31  

Problems with cervical mucus

Usually cervical mucus reaches a special consistency around the time of ovulation, which makes it easier for sperm to swim through it into the womb. If this doesn't happen and the mucus is thick or very scanty, it may be impossible for the sperm to swim through it and get into the womb. This is now considered to be a very rare cause of infertility.
 
Immune problems 

There is growing interest in reproductive immunology, which is concerned with looking at whether a woman's system may reject sperm or embryos, and prevent the implantation of a fertilized egg. Usually, your body rejects any kind of unrecognized material that starts growing inside it, but when you get pregnant, special blocking antibodies stop your immune system attacking the foetus. 

Some doctors believe that sometimes this blocking system fails, that the body may reject sperm or embryos, or start producing too many natural killer cells that attack growing cells in the body. Reproductive immunology is still a controversial area, and although some clinics now offer tests, others believe they are of limited use and question the validity of both the tests and the treatments offered, as most are not scientifically proven and are often expensive. To find out more, you can check out Causes Of Infertility In Women.

Secondary Infertility Causes

Egg Freezing - an insurance policy?

'I looked at freezing eggs, but it just wasn't an option because of the money it would cost. I was told that the success rates were low, but if you're in the position that I was in and it is your last option, then you just accept that it is a last resort. You think, I'll give it a shot - but basically I couldn't afford it: Suson, 34

Frozen eggs have been touted in the media as the solution to all women's age-related fertility problems. It has been suggested that any woman who knows that having children is really important to her should consider freezing some of her eggs while she is young to allow her to delay motherhood until she is ready.

Secondary Infertility Causes

It sounds fantastic. You freeze a batch of eggs in your twenties when they are still young and fresh, you build your career, buy your home, meet the right man and maybe wait to have your babies until your forties. The problem is that egg freezing is still a new science. Until very recently most eggs didn't survive the freezing and thawing process, as they are much more fragile than embryos. New techniques are being developed, and some clinics are reporting much better outcomes with frozen eggs, and are also freezing ovarian tissue as an alternative.

However, egg and ovarian-tissue freezing are expensive procedures, involve invasive medical techniques and are not particularly likely to succeed. They may offer hope to women who know their fertility is likely to be compromised by cancer treatment, or who are expecting to go through a hereditary premature menopause, but they can't be used as a guarantee of a child in the future.

Boosting Your Fertility Naturally

Whether you have decided you're ready to get pregnant and want to improve your chances of conceiving, or whether you're more interested in preserving your reproductive system for as long as you possibly can, there are some things you can do that may help. Although we may not be able to halt the pace of our biological clock, which was set at birth, we certainly can make sure our lifestyle choices aren't speeding it up.
 
Where your choices matter 

We may be able to influence our fertility by making some quite simple changes to our lives. How much attention we pay to our health, what we eat and drink, and what we do at work and in our spare time can all make a difference.

Smoking
 
If you are a smoker, giving up is one of' the most important things you can do to help increase your chances of getting pregnant and improve your fertility. Women who smoke often take longer to conceive, and smoking can affect your ovarian reserve, reducing egg quality and quantity.
 
Women smokers are twice as likely to have fertility problems as non-smokers. On average, women who smoke reach the menopause two years earlier than non-smokers, and they are more likely to have an early menopause.
One study has suggested smoking can shorten a woman's reproductive life by ten years. What's more, it's not just your own smoking that can affect your fertility - if your partner smokes, that can cause problems too. Women who live with a smoker have been shown to take longer to get pregnant.
 
The dangers of smoking once you get pregnant are very clear-cut. Women who smoke expose their babies to tar, nicotine and carbon monoxide. Smoking reduces the amount of oxygen and the level of nutrients that reach the baby, and pregnant women who smoke increase their risk of having a miscarriage. Their babies are more likely to be underweight, premature or to die in infancy. There is a link between smoking and breathing problems in young babies, and with cot death.
 

Many women who smoke intend to give up once they get pregnant, and it makes sense to cut out cigarettes as soon as you start thinking seriously about trying to have a baby. The good news is that if you do stop smoking, after just a year of abstinence your chances of conceiving are thought to be as good as those of women who have never smoked. To find out more, you can check out Secondary Infertility Causes.