Infertility is a medical condition characterized by the inability of a person or a couple to achieve a pregnancy despite having regular, unprotected sexual intercourse for a period of twelve months or longer. Infertility can affect both men and women, and there are several different factors that can contribute to these reproductive issues.
Dealing with infertility can be emotionally challenging. Women experiencing infertility often go through feelings of sadness, frustration, anger, and even grief. The desire to become a parent and the frustration of unsuccessful attempts can lead to anxiety and depression.
Today we are going to talk about some of the causes of infertility and the different types of infertility women experience. We will also look at the differences between primary infertility and secondary infertility as well as a treatment option to explore if infertility is caused by uterine fibroids or adenomyosis.
There Are Several Types of Infertility
If a woman has never been pregnant, this is considered primary infertility.
Secondary infertility refers to a situation in which a woman who has previously been able to conceive and have one or more biological children experiences difficulty achieving another pregnancy.
Infertility can also be categorized as absolute or relative.
- Absolute infertility refers to a situation where a person or a couple has a medical condition or circumstance that makes it physically impossible for them to conceive a biological child. For example, if a woman has undergone a hysterectomy or her partner has had a vasectomy.
- Relative infertility is when a woman or a couple faces challenges or difficulties in conceiving a child due to certain factors, but the possibility of conception still exists. Some causes of infertility could be related to hormonal imbalances, disorders pertaining to ovulation, sperm quality issues, or other conditions that reduce the likelihood of natural conception but don’t entirely eliminate the possibility.
Signs of Infertility in Women
Signs of infertility in women can vary widely depending on the underlying cause. Some women might not experience any noticeable signs of infertility, while others might have symptoms that could indicate potential fertility issues. The presence of these signs does not necessarily guarantee infertility, but if you are having issues conceiving, they should be further investigated by a medical professional.
Here are some signs that might indicate fertility issues and warrant further attention:
- Irregular Menstrual Cycles
- Persistent irregular periods (either very short, long, heavy, or light) could indicate hormonal imbalances or ovulation issues that might affect fertility.
- Painful Periods
- Severe menstrual cramps or pelvic pain, especially if accompanied by heavy bleeding, might be associated with conditions like endometriosis or uterine fibroids, which can impact fertility.
- Absent or Infrequent Periods
- If you have irregular or absent periods, it could suggest anovulation (lack of ovulation) or other hormonal issues.
- Excessive Facial or Body Hair
- Excessive hair growth (hirsutism) could be a sign of polycystic ovary syndrome (PCOS), a condition that can affect fertility.
- Pain During Intercourse
- Pain or discomfort during sexual intercourse could be due to various factors, including infections, endometriosis, uterine fibroids, or other issues that might affect fertility.
- Changes in Cervical Mucus
- Changes in cervical mucus consistency or production might indicate hormonal imbalances affecting ovulation.
- Unexplained Weight Changes
- Sudden and unexplained weight gain or loss can impact hormonal balance and potentially lead to fertility problems.
- Recurrent Miscarriages
- Experiencing multiple miscarriages might suggest an underlying issue affecting fertility or the ability to maintain a pregnancy.
- As women age, fertility naturally declines. If you’re over 35 and have been trying to conceive for twelve months without success, it is advised that you seek medical advice.
Common Causes of Infertility
Thyroid disorders: an overactive or underactive thyroid gland can affect menstrual regularity and ovulation.
Pelvic inflammatory disease (PID): a history of pelvic infections, especially if left untreated, can lead to scarring and damage to the reproductive organs.
Prior surgeries: previous surgeries involving the reproductive organs might lead to scar tissue or other complications that affect fertility.
Tubal factor infertility: this condition occurs when the fallopian tubes are blocked, preventing the egg and sperm from meeting. Tubal issues are one of the most common types of infertility and are responsible for approximately 25–30% of infertility cases. The condition can cause one or both fallopian tubes to be fully closed, or there may be scarring constricting the tubes.
Transcervical fallopian tubal recanalization, or TFTR, is a procedure that an interventional radiologist can perform to reopen the fallopian tubes. It is a much more affordable option and less invasive than in vitro fertilization (IVF).
Cervical disorders: there are instances where issues with the cervix can affect fertility.
- Cervical mucus changes its properties throughout a woman’s cycle. On fertile days, it becomes viscous and suitable for sperm migration; however, if the cervical mucus is too thick or lacks the appropriate qualities needed for sperm transport, it could hinder the movement of sperm through the cervix.
- Infections or inflammation of the cervix (cervicitis) can alter the cervical environment and affect the quality of cervical mucus.
- In some rare cases, the woman’s immune system will produce anti-sperm antibodies that attack and immobilize sperm, making it difficult for them to pass through the cervix. This is often referred to as a “hostile cervix”.
- Scarring on the cervix due to procedures or treatments might obstruct the passage of sperm.
- Cervical stenosis is a narrowing of the cervix, which can make it challenging for sperm to pass through.
Genetic factors contribute to infertility in approximately 10–15% of cases, impacting both men and women. Chromosomal alterations are commonly identified as one of the primary genetic causes of infertility in couples who are unable to have children.
Mental and emotional health issues can inhibit a woman’s ability to conceive. Conditions such as psychological trauma and depression can contribute to infertility, and most fertility researchers have concluded that the stress hormone cortisol disrupts the signals between the brain and the ovaries and can have a significant impact on fertility.
Reproductive health conditions such as endometriosis, which is a condition when the endometrial tissue grows outside of the uterus, or uterine fibroids, which are benign tumors (myomas) that grow in the uterus and affect many women of reproductive age. Learn more about uterine fibroids and infertility.
Adenomyosis is another reproductive health condition that can play a role in infertility. Although it is a completely different condition, it causes symptoms similar to uterine fibroids, and as a result, it is often misdiagnosed as fibroids. Adenomyosis occurs when the inner lining of the uterus (endometrium) breaks through the muscle wall of the uterus (myometrium).
Many women who are diagnosed with uterine fibroids or adenomyosis are offered a hysterectomy as their primary or only treatment option, but this is not a viable solution for patients looking to preserve fertility. There is another safe effective option that does not compromise the integrity of your uterus.
A UAE (uterine artery embolization) procedure is an excellent alternative to surgery that successfully treats both uterine fibroids and adenomyosis keeps the uterus intact and in many cases allows these women to become mothers after the procedure. Many women have experienced a successful pregnancy after UFE and gained relief from unpleasant monthly symptoms.