The Definition of Female Infertility

Female infertility relates to infertility in a couple that relates to factors associated with the woman rather than the man.

A Brief Description of Female Infertility

Nearly all women who are trying to conceive for the first time, start to panic if their menstrual cycle continues for three or even four months. However, the standard definition of infertility is unsuccessful conception after an entire year of unprotected intercourse. It is only at this point that a couple should decide on choosing to go the route of a comprehensive fertility examination that includes, but is not limited to, a menstrual and pregnancy history, a semen analysis, an ovulation tests, and often a laparoscopy to detect whether endometriosis or pelvic adhesions are present. These tests tend to determine the causes of infertility in 70% to 85% of all couples.

Causes and Risk Factors of Female Infertility

However, it is important to note that female reproductive problems account for 40% of all infertility cases; the male reproductive problems account for an additional 40%; and 20% of the time the experts and physicians cannot determine the precise cause of infertility.

Female Infertility Treatment

Infertility treatments have made enormous progress within the last ten years due to the increased result of technological advances which directly affect the advances in assisted reproductive technology, also known as ART. This dynamic technology often combines the use of various fertility drugs, also known as hormonal therapy, with artificial insemination using any of the following group of techniques:

• intrauterine insemination (IUI),
• in vitro fertilization (IVF),
• gamete intrafallopian transfer (GIFT),
• zygote intrafallopian transfer (ZIFT), or
• oocyte (egg) donation.

Fertility Drugs

Any fertility drugs or various forms of hormone therapy, are specifically designed to manipulate the ovaries into producing eggs, often many eggs are produced in a single by stimulating the woman's hormones to do their carry out the function of their assigned jobs more efficiently or by replacing them with "outside" hormones.

Clomiphene, are more commonly marketed under the brand names of Clomid and Serophene. These are used for the treatment of infertility issues for more than 25 years. They are agents that dramatically increases the production of hormones. These treatments are taken in tablet form. Clomiphene works by making the pituitary gland produce large quantities of FSH, follicle-stimulating hormone.

The follicle-stimulating hormone (FSH) then, in turn, starts to stimulate ovulation. The treatment works so well that it often results in the release of two or more eggs. This therefore has proved that Clomiphene results in a ten percent increase of a women carrying twins.

Powdered forms of FHS, known as Pergonal and Metrodin are mixed with sterile water and taken by intramuscular injections.

Intrauterine insemination (IUI)

This procedure involves a tiny amount of concentrated sperm which has gone through a "washing" process. This is done to remove the majority of the seminal plasma that surrounds the sperm. This is then placed within the uterus via a plastic catheter through the vagina and cervix. The procedure is often painless and only takes a few minutes to complete.

Almost always, IUI is combined with the above mentioned fertility drugs, Clomiphene or Pergonal. This allows for the stimulation of ovulation which is then followed by an HCG injection to trigger the release of an egg. A vaginal ultrasound determines the timing of the IUI, in conjunction with previous menstrual cycle lengths, BBT temperature graphs and/or urinary LH correlation kits.

In Vitro Fertilization

This process is specifically designed to make the task easier for the sperm and the egg to successfully meet by taking the vital reproductive processes out of the body and performing them in glass (vitro). The process involves the removal of mature eggs from the ovaries, fertilizing the sperm in a glass dish after which the embryo is implanted into the uterus.
IVF was primarily used to treat damaged or absent fallopian tubes in women, however, it is used for any kind of infertility today. There are various IVF processed used through-out South Africa and the world, however, they all use the same four basic steps;

1. ovarian stimulation;
2. egg retrieval;
3. fertilization; and
4. embryo transfer.

Using either Pergonal or Metrodin or both for Ovarian Stimulation

Follicle development is very closely followed by the observation of their growth using the transvaginal ultrasound as well as measuring the ability to produce estrogen within the body. The removal of eggs are only possible once the eggs are mature.

Retrieving the eggs

Eggs are removed just before ovulation during IVF. To do this, a very thin needle is passed through the back wall of the vagina and up to the ovaries, this all takes place with the guidance of the transvaginal ultrasound. As the doctor watches the procedure on the screen of the ultrasound machine, the needle punctures the follicle and, with gentle suction, carefully removes the egg along with the follicular fluid. The eggs are placed in a sterile container and are examined by a cell biologist or embryologist. If they are judged to be normal in shape and development, they are ready for fertilization.

Fertilization

Now the eggs and fresh "washed" sperm are mixed together for fertilization. When fertilization has indeed occurred and the eggs, now called embryos, are beginning to undergo cell division, they are graded and prepared for transfer to the uterus.

Embryo Transfer

One to three days after the eggs are retrieved, up to four healthy embryos are inserted into the uterus with a thin plastic tube that is passed through the cervix.

Gamete Intrafallopian Transfer

GIFT is a more sophisticated variation of the basic IVF procedure and usually produces a slightly higher pregnancy rate.

Zygote Intrafallopian Transfer

ZIFT is the latest variation on the IVF-GIFT technique. The freshly fertilized eggs (zygotes) are placed into the fallopian tubes during a laparoscopy after they have reached the embryo stage.

Questions To Ask Your Doctor About Female Infertility

1. Is it a hormonal problem?
2. Is the ovulation process abnormal?
3. Is there another problem present such as endometriosis?
4. What are treatment options?
5. What are the benefits and risks of fertility drugs?
6. Do you recommend IVF?
7. What type of IVF would be most beneficial?
8. What is your success rate for procedures to restore fertility?