Female infertility
Infertility is defined as not being able to conceive after 12 months of having regular unprotected sexual intercourse. About one in 6 couples in Australia will have a problem with conceiving.
About 40 per cent of infertility cases involve a female factor; another 40 per cent of cases involve a male factor; and in the remaining cases there is either a combination of male and female factors (10 per cent), or no identifiable cause (10 per cent).
Causes of female infertility
There are numerous causes of infertility in women, however the 3 most common causes are:
- problems with ovulation;
- tubal disease; and
- endometriosis.
Other problems associated with female infertility include abnormalities of the uterus, such as fibroids (benign growths in the muscle layer of the uterus).
Problems with ovulation
Problems with ovulation (release of an egg from one of the ovaries each month) are the most common cause of infertility in women. There can be a number of causes of this, some of which include polycystic ovarian syndrome, ovarian failure, very low body weight, and disorders of the thyroid and pituitary glands.
Tubal disease
Blockage or scarring of the fallopian tube may prevent the egg travelling from the ovary towards the uterus to meet with sperm. Causes of blockage of the fallopian tubes include infection, previous surgery and endometriosis.
Endometriosis
Endometriosis is a condition where the tissue that forms the lining of the uterus is also found outside the uterus. It can cause damage to the fallopian tubes and ovaries.
Investigation of infertility
Couples having difficulty conceiving should see their doctor, ideally together, for an initial assessment. Further investigations will depend on the findings of the assessment and what is likely to be the cause of the problem.
The most common test for ovulation is a measurement of the progesterone level in the blood during the second half of the menstrual cycle. Further blood tests, such as levels of other hormones, may also be required to look for some of the causes of ovulation disorders.
There are several options for assessment of possible tubal disease. These include a special X-ray of the uterus and fallopian tubes (hysterosalpingogram) or an ultrasound of fallopian tube patency (how open and clear the tubes are).
Laparoscopy involves using an instrument to have a look inside the pelvis through a tiny cut in the abdomen, carried out under a general anaesthetic. As well as for assessing the fallopian tubes, laparoscopy can also be used to look for endometriosis elsewhere in the pelvis. It has the advantage that if endometriosis is found it can be treated at the same time.
Treatment
Options for the treatment of infertility will depend on the cause of the problem.
Last Reviewed: 28 April 2006
