INFERTILITY IN WOMEN

Infertility is defined by the World Health Organization as “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse”.

Causes of infertility in women
An estimated 34 million women, predominantly from developing countries are affected by infertility as a result of maternal sepsis and unsafe abortion (long term maternal morbidity resulting in a disability). Infertility in women was ranked the 5th highest serious global disability (among populations under the age of 60). There are two types of infertility that may occur in women:

• Primary infertility
This happens when a woman is unable to ever bear a child, either due to the inability to become pregnant or the inability to carry a pregnancy to a live birth. Primary infertility may also include when women spontaneously miscarry their pregnancy or give birth to still born.

• Secondary infertility
This happens when a woman is unable to bear a child, either due to the inability to become pregnant or the inability to carry a pregnancy to a live birth following a previous pregnancy or a previous ability to carry a pregnancy to a live birth. Secondary infertility may also refer to those who can no longer carry a pregnancy to a live birth (those who repeatedly spontaneously miscarry or whose pregnancy results in a stillbirth) following a previous ability to do so.

There are many possible causes of infertility in women and they include:
• Ovulation disorders: Ovulation is the monthly release of an egg from the ovary into the fallopian tube for possible fertilization. Ovulation disorders occur as a result of premature ovarian failure, polycystic ovary syndrome (PCOS), hyperprolactinemia, poor egg quality, over active or under active thyroid gland and some chronic conditions such as AIDS or Cancer.

• Genetic factors: Scientists from the University of Edinburg reported in the Journal of Cell Science that they identified a gene that controls a vital process in the formation of healthy fertile eggs. They say their breakthrough will help researchers better understand how cells divide during reproduction, which in turn will help explain the reason for low fertility and sterility.

• Problems in the uterus or fallopian tubes: Normally, the egg is released from the ovary to the fallopian tube where fertilization occurs, after which the fertilized egg travels down the fallopian tube into the uterus for implantation. So if there’s a problem with the uterus or fallopian tubes the woman may not be able to conceive naturally and this may be due to: scarring after a pelvic or cervical surgery, Endometriosis, Submucosal fibroids (presence of benign or cancerous tumors found in the muscular walls of the uterus) or Previous sterilization treatment (when a woman chooses to have her fallopian tubes blocked).

• Medications: Certain medications can affect the fertility of a woman when used over long term periods. Such medications include NSAIDs (Non-steroidal anti-inflammatory drugs) and some chemotherapy medications which result in ovarian failure and may have their side effects permanent.

• Radiotherapy: There’s usually a high risk of fertility problems if radiation therapy was aimed near the woman’s reproductive organs.

• Hard drugs: Illegal drugs such as cocaine or marijuana may cause infertility in women when they are consistently consumed by such women.
Ensure to see your Gynecologist to know more and to identify the debilitating factor for the infertility experienced.

RISK FACTORS OF INFERTILITY IN WOMEN
The following are some risk factors of infertility experienced in women:

• Age: The fertility rate of a woman starts to drop after she is about 32 years old and more.

• Obesity or being overweight: Obesity or being overweight is often found to be the principal causes of female infertility due to the high levels of cholesterol and fatty tissues.

• Eating disorders – Women who become seriously underweight as a result of an eating disorder may have fertility problems.

• Smoking: Smoking significantly increases the risk of infertility in both men and women and may also undermine the effects of fertility treatment. If a woman smokes while she’s pregnant, there is a greater likelihood of her losing the pregnancy (miscarriage).

• Consumption of Alcohol: A woman’s pregnancy can be seriously affected by any amount of alcohol consumption.

• Being vegan: If a woman is a strict vegan she must ensure to take the adequate amounts of iron, folic acid, zinc and vitamin B-12, otherwise her fertility may become affected.

• Sexually transmitted infections (STIs): Some STIs may cause infertility in women. Chlamydia can damage the fallopian tubes.

• Exposure to chemicals: Exposure to chemicals such as pesticides, herbicides, metals (lead) and solvents have been linked to fertility problems in both women and men.

• Over-exercising or not exercising at all: It has been said that a woman who exercises for more than seven hours in a week may have ovulation problems. Also not exercising at all or living a sedentary lifestyle is sometimes linked to lower fertility in both women and men.

• Mental stress: Studies have shown that female ovulation and sperm production may be affected by mental stress. If at least one partner is stressed it is possible that the frequency of sexual intercourse is less, which may result in a lower chance of conception.

~ Pharm. Mary Agaruwa.