Infertility

Infertility

Female infertility is, in basic terms, the inability of a pre-menopausal woman to become pregnant. While the entire process from egg to healthy newborn baby is immensely complex, there are relatively few steps leading up to the start of a pregnancy: producing a viable egg, a sperm fertilising the egg, and the fertilised egg implanting in the uterine wall.

In some cases, a woman's ovaries may simply not be producing eggs. This can be caused by malnutrition or extremely low body fat (amenorrhea, or cessation of the monthly cycle, is often seen in advanced anorexia and competitive athletes), or a physical disorder of the ovaries (cysts, tumors, etc.), among other things. Proper use of hormonal birth control (the pill, Norplant, Depo-Provera, etc.) works by preventing egg production.

An egg may be produced, but be blocked from completing its journey down the fallopian tube by pelvic inflammatory disease (PID), or other physical obstructions. Tubal ligation, the most common method of elective surgical sterilisation, works by blocking the fallopian tubes.

And finally, if a viable egg is produced and fertilised, it may not succeed in implanting in the uterus. Failed implantation can be caused by physical obstruction (commonly PID), or hormonal imbalance preventing the uterus from properly 'preparing' itself for implantation. Intrauterine Devices (IUDs) prevent pregnancy as a physical barrier to implantation, while the "morning after pill" prevents implantation via hormonal means.

In all cases, a normal, healthy, fertile woman can expect to naturally experience more than one of these things repeatedly during her lifetime. However, she's unlikely to ever realize her ovaries skipped a month, or produced a bad egg, or perhaps a fertilized egg or two never implanted. However, when such occurrences are a constant part of a woman's monthly cycle, a diagnosis of infertility often follows.

Some cases of infertility, especially hormone imbalances, are relatively easily treated. A woman suffering amenorrhea will often see a resumption of her menstrual cycle following changes in her diet and/or exercise regimen. Other hormone-related fertility problems may be treatable with synthetic hormones administered via pill or injection.

Some cases of physical infertility can be treated surgically, if a relatively simple blockage is involved. In other cases, a fertility doctor may be able to harvest a number of viable eggs, and perform in vitro fertilisation (fertilising the egg in a laboratory), followed by implanting the fertilized egg in the uterus.

However, in some cases, there is no way to treat infertility so a woman can bear her own biological child. While donor eggs for in vitro procedures are available, and in some cases a surrogate mother can carry the child through pregnancy, in cases where a woman is unable to bear her own children, depression and relationship stress can take a heavy toll. As part of any fertility treatment, and especially in cases where fertility specialists are unable to help, professional counseling can make all the difference.

Infertility Links

Department of Health

HFEA - Guide to Infertility