Nothing is more exciting than planning a new addition to the family, which is part of what makes struggling to conceive so difficult and painful. At South Lake OBGYN in Clermont, FL, we are here to help you understand what could be causing your issues with fertility, so you can better understand the different options available for you.
What Can Cause Infertility in a Woman?
There are several hormonal conditions that can have a negative impact on a woman’s fertility. Symptoms of some of these conditions can overlap, so if you have any concerns it’s important to let your OB/GYN know so you can work towards the right diagnosis.
Overactive or Underactive Thyroid
Hyperthyroidism causes too much of the thyroid hormone to be present in the body. This can interfere with ovulation in women by causing an irregular menstrual cycle, whereas in men it can reduce sperm count.
Hypothyroidism means the body has lower levels of the thyroid hormone. Lower thyroid levels can cause heavy, persistent menstrual cycles, as well as interfere with ovulation. In either case, having your thyroid levels checked and addressed can be a great first step to take if you are struggling to conceive.
Polycystic Ovary Syndrome
Also known as PCOS, this condition can either factor into or cause reproduction issues. PCOS is very common, and many women with PCOS conceive without a problem. However, PCOS can interfere with the menstrual cycle and ovulation. In those cases, it’s a good idea to work together with your OB/GYN on ways you can manage the symptoms of PCOS to improve your chances at conception.
Menopause that sets in before 40 years of age is considered premature. This will interfere with the production of estrogen, which in turn negatively impacts a woman’s ability to conceive. A specialist can help you figure out if you have premature menopause, and what options you may have available to help you.
Diabetes can make conception more difficult. If you have diabetes and are trying to conceive, it’s important to make a game plan with your doctor. This will include managing your blood sugar levels and insulin appropriately to help keep you and your potential pregnancy as healthy as possible.
Cushing’s Syndrome can interfere with a woman’s ability to conceive, especially if it’s undiagnosed or untreated. Cushing’s Syndrom causes high levels of cortisol in the body, which can disrupt the ovaries and cause irregular cycles.
Fallopian Tube Obstruction
Any obstruction of the fallopian tubes can make it difficult for sperm to reach an egg, or for an embryo to reach the uterus. Fallopian Tube Obstruction can be caused by injury or scarring within the fallopian tubes.
Some conditions affecting the uterus itself can interfere with conception. Some of these conditions include:
- Uterine fibroids
- An abnormality of the uterus or fallopian tubes
- Scarring within the uterus
An exam can help bring issues with the uterus to light, so you and your specialist can work on a treatment plan.
An imbalance in estrogen levels or the presence of anti-sperm antibodies within the cervix can make it impossible for sperm to swim through the cervix to reach the uterus. The cervix is meant to protect the uterus from infection, so if the body is falsely identifying the sperm as something harmful, it can cause the development of these anti-sperm antibodies.
Combined or Undiscovered Reasons
Sometimes multiple factors or conditions can combine to cause issues relating to conception. In other cases, the cause may be more difficult to uncover. This can be frustrating and discouraging for many patients. Reaching out to a specialist who is dedicated to helping you sort through your symptoms and options can make a huge difference in cases where the cause of your problems is a mystery.
Fertility Issues FAQs
1. How Does It Correlate With Age?
Women are born with all the eggs they will ever have already stored in their ovaries. That means that as you age, egg production will naturally slow. Once you pass 30 years old, conception probability tends to decrease by three to five percent each year.
1. How Can I Know for Sure?
If you want answers, there are tests that may be able to help you better understand why you are having difficulties conceiving.
A Blood Test
A blood test can check your hormone levels, to see if hormonal imbalances could be an underlying factor when it comes to difficulty conceiving. Some of the hormone levels commonly checked in a blood test include estrogen, progesterone, and prolactin. It’s also common to have your thyroid and testosterone levels checked as well.
An Endometrial Biopsy
An endometrial biopsy, or ERA, can help determine if the lining of your uterus is ready to carry an embryo. A pipelle will be inserted through the vagina into the uterus, where it can lightly scrape the lining of the uterus to gather a sample for testing. This sample can also be tested for any sort of abnormality that may be causing issues when it comes to conception.
A Laparoscopy or Hysterosalpingography
With the help of a laparoscopy or hysterosalpingography, your doctor may be able to uncover previously hidden issues with the fallopian tubes. Both can be excellent diagnostic tools, but they do differ from each other. Your specialist will be able to walk you through what to expect from either a laparoscopy or a hysterosalpingography, and which one they believe will be most helpful for you.
3. What Treatments Are Available?
Treatments vary widely depending on the cause or causes behind it. Sometimes the different options can be overwhelming, but with the right diagnosis and help, you should be able to narrow your treatment options down to find the right one for you.
If there’s an issue with your reproductive organs, such as the uterus or fallopian tubes, it may be able to be corrected surgically. One of the most common surgical reconstructions when it comes to reproductive organs is fallopian tube reconstruction. Fallopian tube reconstruction is often used for women who previously had their tubes tied and then later decided to have it reversed.
However, fallopian tube reconstruction can also be used to help women who have other conditions affecting their fallopian tubes. Injuries, infections, and prior tubal pregnancies or pelvic surgeries can all lead to scar tissue within the fallopian tubes, which may be able to be surgically corrected.
If egg production is the root of the problem, there are several medical therapies that can help encourage or increase egg production. Clomiphene citrate can help make the menstrual cycle more predictable. If the patient is considering artificial insemination, this will help pinpoint the perfect time for it to take place. It can also improve ovulation for women trying to conceive naturally.
Gonadotropins are another medical option. This hormonal injection stimulates the production and maturation of eggs within the ovaries. This may be a good option to consider if clomiphene hasn’t been successful.
IUI can help in some cases of men struggling with fertility or cervical imbalances. It bypasses the need for the sperm to travel through the cervix by having the sperm placed directly into the uterus. The sperm will now have a better shot at reaching the fallopian tubes. If there is a viable egg within the tube, IUI can make pregnancy much easier to achieve.
Hysteroscopy can be used as a diagnostic tool and a treatment all in one. A physician who specializes in fertility will use hysteroscopy as a way to see if there are any problems with the uterus, such as fibroids, scarring, polyps, or the uterine structure itself.
During the process, the physician will insert a tiny camera into the uterus so they can properly diagnose and treat. If a diagnosis is made during a hysteroscopy, the issue may be able to be surgically corrected right away. Instruments can be inserted through the hysteroscope to surgically treat some common issues affecting the uterus.
Donor Eggs and Embryos
If your egg quality is determined to be a factor, egg or embryo donation may be something you want to consider. Some women choose to receive an egg donation due to struggling with premature menopause or a genetically inheritable disease. Rather than finding a donor on your own, a specialized clinic will often have access to donors who have already been professionally screened and tested for diseases.
After in-vitro fertilization, some women choose to donate their remaining embryos. A patient struggling to conceive may choose to receive a donated embryo if their uterus is healthy and able to sustain a pregnancy.
Intracytoplasmic Sperm Injection
If sperm are unable to swim to the egg, or if the egg’s outer layer is too tough to be penetrated, ICSI may be able to help. An egg will have a single sperm injected into it with a micropipette, a very small needle. The embryo will then be grown for a couple of days in the laboratory. After that, it can be implanted into the uterus.
The process of In-vitro fertilization begins with a woman taking some hormonal drugs to increase her egg production. With the help of hormonal monitoring and keeping an eye on the ovaries through ultrasound, your specialist will be able to make the call of when to extract the eggs. The eggs will then be fertilized with sperm in a lab.
Once a viable embryo has developed, you will be able to have a single or possibly multiple embryos inserted into your uterus. This will later be followed by a pregnancy test to confirm if an embryo has implanted in the lining of your uterus.
Use of a Surrogate Mother
Women who are unable to carry a pregnancy may opt to have a surrogate mother carry a pregnancy for them. If a woman does not have viable eggs, a traditional surrogate is often used. Traditional surrogate mothers are artificially inseminated with either a partner’s sperm or donated sperm. The surrogate mother in this case will be the biological mother of the baby.
A gestational surrogate mother will not be the biological mother. If a woman has viable eggs of her own but is unable to carry them, she can have her already existing embryo transferred into the womb of a gestational surrogate mother. In this case, the gestational surrogate mother would be considered a birth mother, but the woman whose egg was used would be considered the biological mother.
Our Compassionate Team Is Ready to Help
If you are ready for a consultation to discuss all of your options, contact South Lake OBGYN in Clermont FL today. We are passionate about our work. We believe in doing our best every day to support the health of our patients, and we treat everyone who walks through our doors with compassion and understanding.