It is not uncommon to have trouble becoming pregnant or to
experience infertility. Infertility is defined as not being able to become
pregnant, despite trying for one year, in women under age 35, or after six
months in women 35 and over. Pregnancy is the result of a chain of events. As
described in the Fertility Awareness section above, a
woman must release an egg from one of her ovaries (ovulation). The egg must
travel through a fallopian tube toward her uterus. A man's sperm must join with
(fertilize) the egg along the way. The fertilized egg must then become attached
to the inside of the uterus. While this may seem simple, in fact many things can
happen to prevent pregnancy.
Reasons for Infertility
Age
There are many different
reasons why a couple might have infertility. One is age-related. Women today are
often delaying having children until later in life, when they are in their 30s
and 40s. A couple of things add to this trend. Birth control is easy to obtain and use,
more women are in the work force, women are marrying at an older age, the
divorce rate remains high, and married couples are delaying pregnancy until they
are more financially secure. But the older you are, the harder it is to become
pregnant. Women generally have some decrease in fertility starting in their
early 30s. And while many women in their 30s and 40s have no problems getting
pregnant, fertility especially declines after age 35.
As a woman ages, there are normal changes that occur in her ovaries and eggs.
All women are born with over a million eggs in their ovaries (all the eggs that
they will ever have), but only have about 300,000 left by puberty. Then of
these, only about 300 eggs will be ovulated during the reproductive years. Even
though menstrual cycles continue to be regular in a woman's 30s and 40s, the
eggs that ovulate each month are of poorer quality than those from her 20s. It
is harder to get pregnant when the eggs are poorer in quality.
Ovarian reserve is the number and quality of eggs in
your ovaries and how well the ovarian follicles respond to hormones in your
body. As you approach menopause, your ovaries don't respond as well to your hormones, and in time they
may not release an egg each month. A reduced ovarian reserve is natural as a
woman ages, but young women might have reduced ovarian reserves due to smoking,
a prior surgery on their ovaries, or a family history of early menopause. Also,
as a woman and her eggs age, if she becomes pregnant, there is a greater chance
of having genetic problems, such
as having a baby with Down Syndrome. Embryos formed from eggs in older women
also are less likely to fully develop, a main reason for miscarriage (early pregnancy loss).
Endometriosis is the growth of cells similar to those that form the inside of the uterus, but in a location outside of the uterus. Endometriosis implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity. They can also be found in the vagina, cervix, and bladder. Treatment of endometriosis can be with medication or surgery.
An ectopic pregnancy is a pregnancy located outside the inner lining of the uterus. The majority of ectopic pregnancies occur in the Fallopian tube. Symptoms include abdominal pain, amenorrhea, and vaginal bleeding. Treatment options include observation, medication, or surgery.
A miscarriage is any pregnancy that ends spontaneously before the fetus can survive. Miscarriage usually occurs before the 13th week of pregnancy. The cause of a miscarriage cannot always be determined. The most common causes of a miscarriage in the first trimester are collagen vascular disease (lupus), hormonal problems, diabetes, chromosomal abnormalities, and congenital abnormalities of the uterus.
Uterine fibroids are benign tumors that originate in the uterus and are usually round or semi-round in shape. The most common symptom of a uterine fibroid is abnormal vaginal bleeding. Other symptoms include pressure, pelvic pain, pressure on the bladder, or pain during a bowel movement. Treatment options vary from surgery to medication.
Polycystic ovarian syndrome (PCOS), also known by the name Stein-Leventhal syndrome, is a hormonal problem that causes women to have a variety of symptoms including irregular or no menstrual periods, acne, obesity, and excess hair growth. Treatment of PCOS depends partially on the woman's stage of life and the symptoms of PCOS.
Pregnancy symptoms vary from woman to woman. There are some symptoms that are more frequent in some women. These symptoms include a missed period, nausea, vomiting, bloating, weight gain, headaches, food cravings, and mood changes.
Infertility is the diminished ability to conceive a child. The primary cause of infertility in men is a sperm disorder. In women, the primary cause of infertility is an ovulation disorder. Most forms of infertility can be treated. Conventional infertility therapies include drugs or surgery.
Amenorrhea is a condition in which there is an absense of menstrual periods in a woman. There are two types of amenorrhea, 1) primary and 2) secondary. Treatment of amenorrhea depends on the type (primary or secondary). In prmiray, surgery may be an option and in secondary amenorrhea medication or lifestyle changes may be treatment options.
The female reproductive system is designed to carry out several functions, including producing the female egg cells, conception, and producing female sex hormones that maintain the reproductive cycle. During menopause the female reproductive system gradually stops making the female hormones necessary for the reproductive cycle to work.
Graves' disease is an autoimmune disease that affects the thyroid. Some of the symptoms of Graves' disease include hand tremors, rapid heartbeat, trouble sleeping, enlarged thyroid, thinning of the skin or fine brittle hair. Causes of Graves' disease are thought to be multifactorial such as genes, gender, stress, and infection. Treatment for Graves' disease is generally medication.
Preeclampsia is related to increased blood pressure and protein in the mother's urine. Preeclampsia typically begins after the 20th week of pregnancy. When preeclampsia causes seizures, it is termed "eclampsia" and is the second leading cause of maternal death of in the US. Preeclampsia is the leading cause of fetal complications. Risk factors for preeclampsia include high blood pressure, obesity, multiple births, and women with preexisting medical conditions such as diabetes, kidney disease, rheumatoid arthritis, lupus, or scleroderma. Pregnancy planning and lifestyle changes may reduce the risk of preeclampsia during pregnancy.
Pregnancy planning is important to help prevent exposure of the mother and fetus to potentially harmful medications and substances during the early days, and throughout the pregnancy. Nutritional planning, prevention of birth defects, conditions such as high blood pressure, heart disease, diabetes, and kidney disease need careful monitoring. Gestational diabetes, preeclampsia, and pregnancy induced hypertension are conditions that may arise during pregnancy. Immunizations, inherited disorders, exercise, air travel, intercourse, and birth control are important factors to consider when planning a pregnancy.
Premature menopause is when a woman goes through menopause before the age of 40 because of genetics, illness, or a medical procedure. Symptoms of premature menopause include irregular or missed periods, mood swings, hot flashes, periods that are heavier or lighter than usual, vaginal dryness, bladder irritability, incontinence, dry skin, eyes or mouth, sleeplessness, and decreased sex drive. Though premature menopause cannot be reversed, the symptoms can be managed with methods similar to those used for natural menopause.
Premature ovarian failure (POS) is the cessation of normal functioning of the ovaries in women under the age of 40. Premature ovarian failure may be caused by follicle depletion or dysfunction. The most common symptom of premature ovarian failure are irregular periods. There is no "treatment" that will restore the ovarian function, but there are treatments that my relieve symptoms.
Women's health is an important topic area to guide a woman through the stages of her life, as well as knowing the conditions and diseases that may occur. Educating yourself so that the transitions into different phases of life is key to a healthy, happy, and productive life.
Sexual health information including birth control, impotence, herpes, sexually transmitted diseases, staying healthy, women's sexual health concerns, and men's sexual health concerns. Learn about the most common sexual conditions affecting men and women.
Taking prescription medications or over-the-counter drugs or supplements should be discussed with your doctor. There are some medications that have been found to cause no problems in pregnancy, however, medications such as Accutane for acne, should never be taken during pregnancy.
Women experience and tolerate pain differently. For some pregnant women, focused breathing is all they need to get through labor and childbirth; but for others, numbing of the pain is desired.
There are a number of different medications a woman can take during labor and childbirth. It is important for you to learn what pain relief options are available. Please discuss the options with your health care provider well before your "birth day" so that when you are in labor you understand the choices.
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