When pregnancy has not been achieved after twelve months of trying through sexual intercourse (six if the woman is over 35 years old), we may be facing a case of infertility.
Statistics tell us that about 55% of cases are due to the female factor. The causes of female infertility can be multiple. In addition, there can be several simultaneous factors. The main ones have to do with ovulation, the quality of embryos, the uterus together with the fallopian tubes and the maternal environment.
Ovulation and fertility according to the woman’s age
Women are born with a limited number of antral follicles, and this number decreases over time, becoming especially noticeable after the age of 35. This decline is more pronounced around the age of 40.
To do this, it is important to assess the woman’s menstrual cycle, knowing her ovarian reserve (performing an antral follicle count by ultrasound and the anti-Müllerian hormone) and to see if there may be a problem with anovulatory cycles (such as, for example, polycystic ovary syndrome).
Tubal factor
Tubal factor is determined as an alteration of the fallopian tubes, the area where fertilization (union of egg and sperm) takes place.
Alterations in tubal permeability may be due to infections,endometriosis, malformación tubárica, hidrosalpinx, intervenciones quirúrgicas o enfermedad inflamatoria pélvica, entre otras.
Uterine factor
Changes in the uterine cavity are divided into:
– Cervical factor: Changes in cervical mucus, infections…
– Uterine factor: Congenital uterine malformations, fibroids, polyps…
Immunological sterility
This occurs when the immune system attacks normal body tissues that it would otherwise ignore. Autoimmune disorders, such as antiphospholipid syndrome or lupus, can affect fertility. They often cause inflammation in the uterus and placenta.
Genetic factor
Genetic and chromosomal alterations that can make conception difficult or impossible and also affect the normal development of pregnancy, causing spontaneous abortions.
Implantation failure
Embryo implantation in the endometrium is a decisive event in gestation, so if it does not occur correctly, pregnancy will not occur. The presence of pathologies such as endometrial polyps, thrombi, fibroids, hydrosalpinx (the accumulation of fluid in the fallopian tubes) or endometritis (infection that causes inflammation of the endometrium) can prevent the embryo from implanting and surviving in the uterus.
As we can see, there are various factors that cause infertility in women, so if you think that this may be your case, the first step is to find the problem, define it and find a solution. Usually, cases that require it are solved with surgery and/or medication, and the treatments that are used, from least to most complex, are:
1- Scheduled intercourse.
2- Artificial insemination.
3- In Vitro Fertilization/ICSI.
4- Oocyte donation.
Our recommendation is that you put yourself in expert hands as soon as possible, making an appointment at a specialized center to carry out an appropriate study to determine the possible causes. At IGIN our consultations are free and we can do them by videoconference. You can request one here.