In the modern world, many couples postpone pregnancy planning to a later date. If earlier the realization of reproductive function took place in 20-25 years, now this milestone is shifting towards 30 years and older. This is due to some social reasons, and to the desire to first build a career and “get on your feet”, and only then to have children. It often turns out that when a woman finally decides to become a mother, it turns out that something has happened in her body over the past time, and naturally it is no longer possible to get pregnant. What to do in this case, and what can cause infertility in women, will be discussed in detail in this material.
Causes of infertility in women
Polycystic ovary syndrome
Polycystic ovary syndrome is the most common endocrine pathology, which serves as a reason for contacting clinics that treat infertility, and, accordingly, one of the most common reasons why it is impossible to get pregnant. Polycystic fibrosis determines either the complete absence of ovulation, or an obvious decrease in ovulation, which is why pregnancy does not occur.
Infertility treatment in women with polycystic fibrosis is associated with attempts to stimulate ovulation with special drugs. In the absence of success of drug therapy, the patient is prescribed IVF. It should be noted that women with polycystic ovaries have a high risk of developing ovarian hyperstimulation syndrome.
Tubal infertility is the most common cause of non-pregnancy. This pathology is determined by the complete or partial obstruction of at least one fallopian tube. Obstruction of the fallopian tubes can be a consequence of an ectopic pregnancy or an unsuccessful surgical operation, the result of an inflammatory process or endometriosis.
This diagnosis is made as a result of special examinations (hysterosalpingography) or during laparoscopic operations. There are surgical methods for correcting the obstruction of the fallopian tubes, but they are not always effective and quite often carry the risk of ectopic pregnancy. A more effective treatment of female infertility with tubal factor is IVF.
The endometrium is the mucous membrane that lines the uterine cavity. Endometriosis is an inflammatory autoimmune disease in which tissue similar to the endometrium grows outside the uterine cavity. The cause of this phenomenon remains unknown, but there are certain risk factors for this disease. The development of endometriosis can lead to: heredity, damage to the uterine wall, hormonal failures, low immunity, poor environmental conditions, and so on. About 5-10% of women of reproductive age suffer from this pathology. Endometriosis also causes female infertility.
The diagnosis of “endometriosis”, as a rule, is made during laparoscopic operations, and in the case of such a diagnosis, complex treatment is required, which consists in a combination of surgical methods with hormonal drugs. If the treatment did not lead to tangible results, and pregnancy did not occur naturally, then the patient is referred for IVF. Endometrioid disease itself can have different degrees of development. The more advanced the process is, the less chance of pregnancy. If women with the first and second stages of endometriosis respond well enough to the IVF program, then with 3-4 stages of endometriosis, the chances of pregnancy after IVF are low.
As a rule, hormonal reasons are behind the violation of egg maturation. If the ovarian dysfunction is caused by hormonal imbalance, then it makes sense to contact an endocrinologist and correct the work of the endocrine glands (thyroid gland, pituitary gland, adrenal glands).
Numerical and structural abnormalities of chromosomes, as well as fragmented X-chromosome syndrome, may be the genetic causes of female infertility. Chromosomal abnormalities (for example, Shereshevsky-Turner syndrome) are the cause of 25-50% of cases of primary amenorrhea (absence of menstruation over the age of 16). In 10-15% of cases of secondary amenorrhea (a condition when, after a period of normal or intermittent menstrual cycle, menstruation disappears for six months or more), karyotype abnormalities are diagnosed.
The genetic cause of infertility may be the answer to the question “Why can’t I get pregnant?” in cases when, after conducting all standard studies, doctors throw up their hands and cannot name a specific reason. However, the genetic cause can also be diagnosed – karyotyping is carried out for this.
Indications for caritoping are:
- Delay in sexual development
- Primary or secondary amenorrhea
- Two or more cases of miscarriages in the medical history
Other causes of female infertility
Changes in the structure of the uterus and cervix may complicate the onset of pregnancy. In many cases, the solution to the problem is artificial insemination (AI).
One of the reasons for non-onset of pregnancy may be uterine fibroids. Based on the ultrasound data, the doctor will be able to conclude that surgical correction of this problem is necessary.
In quite rare cases, the cause of female infertility is malformations of the ovaries, tubes or uterus, which, as a rule, are congenital in nature.
Whatever the cause of infertility, a doctor should diagnose you. Numerous forums on the Internet devoted to the question “How to get pregnant if it doesn’t work?” they can be a good source of moral support, but nothing more. Do not engage in self-diagnosis or make questionable conclusions based on someone else’s experience. The standard of the World Health Organization quite categorically states: if a couple regularly lives a sexual life and does not use means of protection, but at the same time pregnancy does not occur during the year, then we can talk about the diagnosis of “infertility”. And if this is the case, then you need to consult a reproductive doctor who will carry out the necessary diagnostics and prescribe appropriate treatment.