Common causes of fertility problems in women

05.01.2015

About 10 percent of reproductive-age couples in the United States will have difficulty getting pregnant. About 30 percent of cases are due to fertility problems in the woman, 30 percent to fertility problems in the man, and the rest to unexplained causes or multiple factors involving both partners.

If you've had regular, unprotected sex for more than a year (or six months if you're over 35) without conceiving, see your doctor. The National Infertility Association says at least half of those who have an infertility evaluation and treatment will be able to have a successful pregnancy.

You also may want to see a genetic counselor. Sometimes there's a genetic reason for female infertility that could be passed down to children. A genetic counselor can help couples understand their options for conceiving.

Read on to learn about the common causes of infertility and available treatments. Keep in mind that success rates may vary because one couple can have multiple fertility problems.

- endometriosis;

Endometriosis is a condition that occurs when tissue found in the uterine lining (called endometrial tissue) grows outside your uterus, usually in the abdominal-pelvic cavity.

Possible symptoms: Some women have no symptoms, while others have painful menstrual periods or intercourse, heavy bleeding or unusual spotting, and general pelvic pain.

Possible solutions: Surgery to remove endometrial tissue, fertility drugs with artificial insemination, surgery to remove abnormal tissue or unblock tubes, assisted reproductive technologies (ART), or adoption.

Success rates: Up to 40 percent of women conceive (either naturally or with treatment) after having surgery. When fertility drugs to increase egg production are combined with artificial insemination, the success rate is between 9 and 15 percent per cycle. The success rate per cycle with a form of ART called in vitro fertilization (IVF) averages around 35 percent.

- ovulation problems;

An ovulation problem is any condition (usually hormonal) that prevents a mature egg from developing in your ovaries.

Possible symptoms: Absent or infrequent periods and abnormally light or heavy bleeding.

Possible solutions: Fertility drugs and IVF, or adoption.

Success rates: About 40 percent of women receiving clomiphene citrate to induce ovulation become pregnant over the course of treatment (usually three to six cycles). When fertility drugs to increase egg production are combined with artificial insemination, the success rate is between 9 and 15 percent per cycle. The success rate per cycle with IVF averages around 35 percent.

- poor egg quality;

The quality and number of eggs your ovaries produce – naturally or with fertility treatment – often declines significantly with age.

Possible symptoms: None.

Possible solutions: IVF using donor eggs or embryos, or adoption.

Success rates: Women who have IVF using donor eggs have an approximate 50 percent chance of having a baby per IVF cycle.

- polycystic ovarian syndrome;

Polycystic ovarian syndrome (PCOS) is a condition in which small follicles in your ovaries don't develop into the larger, mature follicles that release eggs. It's also characterized by hormone imbalances and unpredictable ovulation patterns.

Possible symptoms: irregular periods, excessive hair growth, acne, and obesity.

Possible solutions: Lifestyle modifications (like diet and exercise), fertility drugs and IVF, or adoption. A diabetes drug called metformin (Glucophage) can help restore regular ovulation in some women.

Success rates: Many overweight patients who lose 5 to 10 percent of their body weight will start ovulating regularly. About 40 percent of women receiving clomiphene citrate to induce ovulation become pregnant over a course of treatment (usually three to six cycles).

- tubal factors;

Blocked or damaged fallopian tubes prevent your partner's sperm from getting to your egg and also prevent the fertilized egg from getting to your uterus. Leading causes include pelvic inflammatory disease, sexually transmitted infections (such as chlamydia), and previous sterilization surgery.

Possible symptoms: None.

Possible solutions: Surgery to open the tubes, IVF if surgery fails or the tubes are too badly damaged to repair, or adoption.

Success rates: Conception rates vary widely – from 5 to 60 percent – depending on the location and severity of the blockage and the amount of scar tissue that develops after surgery. Couples who try IVF have about a 10 to 40 percent chance of having a baby per IVF cycle, depending on their age.

- unexplained fertility problems.

Your doctor may diagnose an unexplained fertility problem if there's no clear explanation for your infertility (meaning the results of all tests are normal). Some experts think weight problems (being significantly under- or overweight), excessive exercise, and even environmental toxins may be contributing factors.

Possible symptoms: None.

Possible solutions: Fertility drugs combined with artificial insemination or other ART procedures (such as IVF), or adoption.

Success rates: When fertility drugs to increase egg production are combined with artificial insemination, the success rate is between 8 and 17 percent per cycle. About 10 to 40 percent of couples conceive with each cycle of IVF, depending on age.

Source: babycenter.com