Though having your own family is a natural part of life, there are certain factors that can make pregnancy difficult to achieve naturally. This section is dedicated to exploring certain factors that are responsible for causing female fertility (or infertility), as well as the possible causes and treatments for them.
Age is a major factor in female fertility, as well as a woman’s lifestyle choices and genetic conditions. Understanding the particular challenges in conceiving is important to improve chances of a pregnancy, be it natural or medically assisted.
Possible causes of infertility
The most common female infertility factors include:
Polycystic Ovaries (PCO) is a common female hormone imbalance, which can result in ovarian cysts and cause irregular (unpredictable) ovulation. Some women with PCO only have a period every second or third month making it very difficult to predict ovulation and ultimately making it difficult to become pregnant. Symptoms include weight gain, excess body hair and skin problems, such as acne. Although the cause is not known, it does seem to have some genetic links. Some women with PCO have Polycystic Ovarian Syndrome (PCOS), where the features mentioned above are also accompanied by disturbances in sugar balance, rather like diabetes. This is known as insulin resistance and is associated with a number of metabolic disturbances.
PCO is diagnosed primarily by an ultrasound scan of the ovaries, as well as blood tests to measure the hormones associated with ovarian function. It may also be necessary to test sugar and insulin levels if PCOS seems to be present.
Endometriosis is a term used to describe unnatural growth patterns of endometrial tissue. This tissue is meant to grow within the uterus to protect a fertilised egg early in pregnancy but can grow in other areas interrupting the function of the fallopian tubes or causing growths in the ovaries called endometriomas that effect follicle growth.
Symptoms of endometriosis include pelvic pain before and during menstruation, pain with intercourse, discomfort during urination or heavy periods.
Endometriosis can only be diagnosed definitely by laparoscopy, which involves putting a telescope into the abdomen under anaesthesia. Ultrasound scanning may suggest the presence of endometriotic cysts, in which case the diagnosis can be assumed.
The fallopian tube is where fertilisation of the egg occurs. During a natural pregnancy, the sperm and the egg join together to form an embryo, while in one of the fallopian tubes. If there is tubal damage, this is unlikely to happen or, in some cases, the fertilised egg may actually implant into the tube – this is an ectopic pregnancy, which can lead to serious complications.
Causes of blocked fallopian tubes include:
- Pelvic infections
- Previous pelvic surgery
If you have had two or more consecutive miscarriages it is essential that you seek medical advice to determine the cause of them and seek treatment to prevent further miscarriages from occurring. Fetal loss is the most common pregnancy complication occurring in 25-30% of recognized pregnancies. Recurrent miscarriages are especially difficult, because the initial excitement of a confirmed pregnancy is repeatedly followed by great disappointment when the miscarriage occurs.
The most common cause of miscarriage or early pregnancy loss is chromosomal abnormalities in the fetus, which account for at least 50-60% of all first trimester losses. Chromosomal abnormalities are typically the result of errors that occur as the embryo divides and grows. The chance of these errors occurring generally increases with the age of the mother due to poorer egg quality.
Genetic testing of the embryos produced in an IVF treatment can help to reduce the risk of miscarriage as only chromosomally normal embryos would be replaced into the uterus.
Secondary infertility is when a couple who has already naturally conceived a child experiences difficulties in becoming pregnant again. When a childless couple is unable to conceive, they tend to seek advice or treatment. However, couples who already have children ,and may be affected by secondary infertility, are much less likely to do so because of the misconception that they are fertile.
Several lifestyle tendencies, injuries or diseases, which may have occurred since the past pregnancy, could impact fertility the second or third time around. All of the same fertility factors listed in this section should be taken into consideration when assessing secondary infertility.
Having an irregular menstrual cycle is typically because of a hormonal imbalance which effects the predictability of what should be a recurring 28 – 35 day menstrual cycle. Women with irregular menstrual cycles generally do not ovulate or produce eggs regularly which makes planning for a pregnancy very difficult. Fortunately, the majority of factors that cause irregular menstrual cycles are treatable.
These factors include: PCO and PCOS, significant weight loss or weight gain, hormonal imbalance and co-existing medical problems, such as thyroid disease or diabetes.
The ovarian reserve refers to the capacity of your ovaries to produce healthy, viable eggs. The ovarian reserve and the quality of available eggs naturally begins to decrease after the age of 35 though eggs are still produced up until menopause.
Symptoms of an impending menopause include hot flashes, irregular periods, night sweats, irritability, difficulty concentrating or decreased sexual drive. Though a diminishing ovarian reserve is something that occurs naturally as women age, external factors like environmental toxins and lifestyle choices can also play a role.
Fibroids, polyps and adenomyosis are different types of growths that can occur on the reproductive organs of a woman, negatively affecting her fertility. Fibroids are non-cancerous tumors that range in size and grow in or around the uterus. Polyps are small, typically non-cancerous growths uterine lining, cervix and vagina. Adenomyosis occurs when endometrial tissue grows into the muscular layer of the uterus.
Symptoms of fibroids, polyps and adenomyosis can include irregular or heavy menstrual bleeding, pain or spotting during intercourse.
Testing and treatment: Determining the baseline condition and possible solutions
Testing is important to identify any health conditions that may be preventing pregnancy. By identifying underlying health conditions, doctors are able to develop a plan to help improve the chances of conceiving for the couple.
The best time to visit a doctor in Dubai for consultation is during the first few days of your monthly cycle. Timing is important in improving your chances of getting pregnant sooner. During your initial consultation, it is best to bring all your medical records to provide your doctor with an in-depth overview of your health. Doing this will give the doctor the best chance of identifying the best fertility plan for you.
You must also be prepared to perform any tests required your fertility status, including sperm count and analysis, comprehensive blood count and blood screening, and cervical mucus tests. At our UAE clinics, our in-house doctors and specialists will be more than capable of giving you the best chance to fulfil your dreams of having a child.