Infertility in women
Some women get pregnant quickly. For others, it can take much longer. Everyone is different.
There are many causes of infertility in women, including:
- damaged or blocked fallopian tubes
- conditions affecting the womb - these include large fibroids or large polyps in the womb (benign growths)
- ovulation disorders
- polycystic ovarian syndrome
- early menopause
- sexually transmitted infections (STIs)
Damaged or blocked fallopian tubes
Fallopian tubes are the tubes that carry the egg from the ovary to the womb.
Damaged or blocked fallopian tubes happen when your tube or tubes are blocked or scarred.
It can also happen after surgery on your pelvis, particularly if scar tissue forms.
An ectopic pregnancy also damage your fallopian tube or create a need to remove a tube.
Surgery on your fallopian tubes may help you to become pregnant if you have damaged or blocked tubes. Most of the time, this can be done by keyhole surgery.
Fibroids are benign (not harmful) tumours that grow in the muscle wall of your womb. They are very common and do not always cause problems.
However, they may cause difficulty when you are trying to get pregnant. This depends on how many you have and where they are in your body.
Fibroids can sometimes prevent a fertilised egg attaching itself to the lining of the womb. They can also prevent sperm reaching the egg, but this is rare.
A submucosal fibroid is a fibroid that grows from the muscle wall into the cavity of your womb. It may block a fallopian tube. This makes it harder for you to become pregnant.
Occasionally surgery may be performed to remove the fibroid. However this surgery is not suitable for all women or for all fibroids.
The endometrium is tissue that is normally found inside your womb. Another name for this tissue is endometrial tissue. Endometriosis is a condition where endometrial tissue is found growing outside the womb.
Endometriosis can cause cysts on your ovaries. In severe cases it can cause scar tissue to form. This is also known as adhesions.
Options include surgery for endometriosis to remove the scar tissue or any cysts. This may improve your chances of becoming pregnant.
There are other hormonal treatments that can be used to treat endometriosis. These can be used when you are not trying to get pregnant.
Certain hormonal imbalances may cause disorders of ovulation. This means that you may not produce an egg each month.
This can be caused by:
- polycystic ovarian syndrome (PCOS)
- early menopause
- having an unhealthy body mass index (BMI) - being overweight or underweight can affect your hormone balance. This may mean you do not ovulate
- excessive exercise like long-distance running
- hormonal problems like problems with your thyroid gland - these can usually be treated with medication
- hormonal problems like producing too much of the hormone prolactin - high levels of prolactin can be treated with medication or by surgery depending on the cause
Polycystic ovarian syndrome (PCOS)
Polycystic ovary syndrome (PCOS) is a common condition that affects how a woman’s ovaries work.
There are some treatments that could increase your chances of becoming pregnant.
If you have PCOS and your body mass index (BMI) is over 25, losing weight will greatly increase your chances of becoming pregnant.
Even a small reduction in your weight can improve your chances. Eating healthily and exercising regularly can help.
There are some medications that you may be offered if you have PCOS. These include clomiphene and metformin. These medications may help you to ovulate.
Some women with PCOS may be suitable for a type of keyhole surgery known as 'ovarian drilling'. This is when the ovaries are treated with heat.
This heat treatment may help to correct the hormonal imbalances that most women with PCOS have.
Menopause is the term used to describe the time of a woman’s life when her periods stop and she stops producing an egg each month. It usually happens around the age of 50.
Early menopause is also known as premature ovarian failure. This is when menopause occurs before the age of 40.
Early menopause is thought to affect 1 in 100 women before the age of 40.
Ask your GP to refer you to a specialist in fertility medicine to discuss your options.
If you are not producing any eggs, an option that may be available to you is egg donation.
Your fertility specialist will advise you if this is the right choice for you. Egg donation is only available from private health services.
This is where a female donor is treated with fertility medications to stimulate ovulation. Her eggs are collected and fertilised with sperm from your partner or other male sperm. The embryos are placed into your womb similar to IVF.
Treating STIs is important for your own health but may also improve your chances of becoming pregnant. It is also important for your baby's health during pregnancy that any STIs are treated.
Using donor sperm
This is where a man donates sperm so a woman can inseminate herself. Insemination usually means using a syringe to place sperm in the woman’s vagina to help her get pregnant.
Conceiving with donor sperm may be recommended if:
- you are a woman in a same-sex couple
- if you are a single woman who wishes to become pregnant
- your male partner has problems with the amount of sperm in his semen or the quality of his sperm