Female infertility Diagnosis

It is very important for a couple to learn as much as they can about infertility and all of its terminology. This way they can understand better what it’s happening with them and deal easily with the diagnosis and the infertility treatment. Further on we present the most important diagnoses for female infertility with a couple of information about their causes, symptoms and treatment. (LEARN MORE)

1) Anovulation means that the woman can’t ovulate (doesn’t release a mature egg from her ovary). The causes of anovulation are: age, hormonal imbalance, early menopause.

As symptoms we can note: extended menstrual cycle or absence of menstruation, abnormal BBT (basal body temperature). Sometimes anovulation can occur without symptoms. The treatment for anovulation is various: it can begin with simple methods like drug therapy and finish with surgical procedures. Examples of treatments: IVF (in vitro fertilization), donor eggs, ovulation induced with drugs.

2) Fibroid tumor is a non-cancerous masse that can be found in the uterus or cervix. Uterine fibroids can cause blockages of the fallopian tubes preventing the embryo from implanting into the uterus and causing a miscarriage. Fibroid tumors are caused by an increased estrogen level. Symptoms: pelvic pain, painful periods, sensation of mass. Fibroid tumors can be diagnosed using pelvic ultrasound, laparoscopy or hysteroscopy.

The size of the fibroids can be reduced with drug therapies like GnRH agonists, oral contraceptives can also control the fibroid’s growth.

3) Amenorrhea means the absence of menstruation. Causes: cervix blockage, increased secretion of prolactin (hyperprolactinemia), decreased production of hormones by the pituitary glands and hypothalamus. Symptoms: excessive hair growth, missed periods, producing breast-milk without being pregnant, balance problems, trouble with vision or coordination. As treatment is recommended the induction of ovulation using clomiphene or if amenorrhea is caused by hyperprolatinemia treatment with bromocriptine can be effective because it suppresses the production of prolactin.

4) Endometriosis occurs when menstrual cycle streams backwards through the fallopian tubes and comes outside the uterus. The menstrual bleeding is in fact the endometrial tissue that passes through the uterus, outside the body. A cause of endometriosis can be the retrograde menstruation (backward flowing of the menstrual bleeding) that passes through the tubes into the pelvis. This might cause an implantation of the endometrial cells on the uterus, ovaries and other organs. Symptoms: heavy, painful menstruation, painful intercourse. Endometriosis can be diagnosed with the help of laparoscopy.

There are more options for treating endometriosis: drug treatment suppresses the pituitary gland and the production of hormones that cause endometriosis. Another option is surgical treatments such as laparotomy or laparoscopy, procedures that remove endometrial implants. Finally, In vitro fertilization is used when the fallopian tubes have been damaged.

5) Immunological infertility occurs when cervical mucous kills sperm or when the uterus rejects the embryo. The cause of this condition hasn’t been found yet. The treatment for immunological infertility consists in steroids, antibiotics if the condition results from an infection, ART (assisted reproductive technologies) like in vitro fertilization (IVF), intrauterine insemination (IUI), intra-tube insemination (ITI).

6) Cervical mucous problems. Mucous is placed in a woman’s cervix to protect the uterus against bacteria. It also helps transporting the sperm to the egg during ovulation. If the cervical mucous is not elastic enough or if it doesn’t exist at all the sperm can’t reach the egg. The main cause of cervical mucous problems is the hormonal imbalances. An increased secretion of estrogen changes the texture and the volume of the mucous. Normally the cervical mucous is thin and watery around the period of ovulation. The quality of the cervical mucous can be tested with a post-coital test in order to see if this a potential cause for woman’s infertility.

Intrauterine insemination is used as treatment for this disorder. During this procedure washed sperm are injected into the uterus.

7) Hyperprolactinemia is the increased secretion of prolactin (is the hormone that causes the production of milk). This disorder causes the suppression of ovulation and can be interpreted as symptom for luteal phase defects or hypothyroidism. Causes: disorder of the thyroid gland, oral contraceptives and drugs like marijuana, high blood pressure medications, some tranquilizers, surgical scars, tumors of the pituitary gland.

Symptoms: anovulation and galactorrhea (when a woman produces breast milk without having a baby). Hyperprolactinemia is treated as follows: with clomiphene in order to induce ovulation, with bromocriptine to reduce the prolactin level. Tumors are eliminated by surgery.

8) Pelvic inflammatory disease (PID) occurs when the upper reproductive organs of a woman become infected. This condition affects the ovaries, the uterus lining or the fallopian tubes. It is believed that old types of birth control devices caused uterine damage, a scarring of the fallopian tubes and pelvic inflammatory disease due to bacteria. Another cause of PID is STDs such as Chlamydia that can cause serious damage if is left untreated. Symptoms: pain, fever, excessive bleeding, cramps. PID is treated using antibiotic therapy. In case that the uterus was affected a hysteroscopy is performed. If the uterus can’t be repaired using this procedure the woman should consider a host uterus.

9) Luteal Phase Defect (LPD). The period between ovulation and the next menstruation is called luteal phase. The woman suffers from luteal phase defect when she doesn’t have enough time between the ovulation and the menstruation to build the lining of the uterus.

What happens is that the woman’s body doesn’t produce enough progesterone and the fertilized egg can’t be implanted. Causes: hormonal imbalance. If the level of progesterone is small the conception becomes harder to accomplish. Symptoms of LPD can be suggested by the basal body temperature or endometrial biopsies. The treatment for LPD include: progesterone suppositories, drugs that induce ovulation, in vitro fertilization.

10) Polycystic ovarian syndrome (PCOS) occurs when the ovaries produce unusual quantities of male hormones (androgens) that affect ovulation. Women who suffer from this disease have big ovaries that contain small cysts. The main cause of PCOS is the increased production of androgens by the ovaries and sometimes by the adrenal glands. PCOS is associated with anovulation and sometimes women with this disease don’t react to insulin. Symptoms associated with PCOS are: amenorrhea (the absence of menstruation) or irregular periods, excessive body or facial hair, enlarged ovaries, acne, oily skin. However symptoms are different from one patient to another.

The treatment for PCOS depends on the stage of the condition. The treatment with insulin has proven to be very effective. It is advisable for overweight women with PCOS to have a diet low in fats and calories. Patients who are not trying to conceive at that time can’t follow a treatment with oral contraceptives, male hormone blockers or insulin sensitizers. Patients with PCOS that want a baby can take clomiphene citrate, gonadotropins or metformin. These are drugs that help the ovulation.

11) Occlusion means the blockage of an organ, on woman it can be the fallopian tubes, on men the duct system. Causes of occlusion: congenital conditions, STDs, fibroids, endometriosis, pelvic inflammatory disease. The disease can be diagnosed with the help of laparoscopy or hysteroscopy. Women with both fallopian tubes blocked can be treated using laparoscopy or hysteroscopy. If only one of the tubes is blocked the treatment consists in drugs tat induce ovulation. If neither of these treatments works another option would be in vitro fertilization.