Female Infertility

Female fertility can be complicated.  I understand it is frustrating and upsetting when you cannot get pregnant, and it doesn’t help to know that many people experience infertility problems.  You are not alone – I’m here to help.

What is Female Infertility

It can be a very emotional time when you go each month without those two lines appearing on a pregnancy test.

We also know that making that first fertility appointment can be hard, but sometimes it just takes some advice from someone who has the knowledge and experience to help you get your family started.

It’s also important to know that with fertility, there is no “one plan fits all” and IVF is not the only option.

Understanding your menstrual cycle and when you’re ovulating are a good place to start.  In reality, there is only a short time within the cycle that you can conceive.

Having accurate information to guide you through this stage and help with your treatment options is important.

Reasons for Female Infertility

It’s important to be aware that infertility doesn’t mean that you are unable to have children. Although it might mean that you’ll need assistance from a fertility specialist. 

A woman’s fertility can be affected by many factors, including:

• age
• irregular periods that may be linked to ovulation disorders
• gynaecological conditions such as PCOS and endometriosis
• fibroids
• blocked fallopian tubes
• sexually transmitted diseases
• body mass index and general health

There are two types of infertility. The first is known as primary infertility. This is where a couple has never achieved a pregnancy. Secondary infertility is where a couple is unable to conceive after they have already had a pregnancy or child.

How do I know How Many Eggs I have?

A woman is most fertile between the ages of 15 and 24.5.  More women are waiting till their 30’s before thinking of starting a family. Many of them are unaware that their fertility declines with age.  There is a deterioration in the quality and quantity of viable eggs at age 35, and by 40 this is very obvious.

A woman is born with all the eggs she will ever have.  On average, this is about 400,000 eggs.  It sounds a lot, until we take other factors into account.

The main reason for decreased egg reserves is your body slowly absorbs the majority of eggs, so that by the time you reach your 50’s you will have depleted the egg supply you were born with.

The anti mullerian hormone test (AMH), often called the ‘egg timer test’,  is a way to determine how many eggs you have left. 

What else effects fertility?

There can be other physical changes as you age that can play a part in not getting pregnant.  Menstrual cycles can become irregular and shorter, leaving a smaller window for conception.

Conditions of the uterus such as polyps, fibroids or adenomyosis provide structural challenges to fertility.  Undiagnosed medical conditions such as endometriosis or PCOS can damage the reproductive organs over time.

Problems with Ovulation

About 40% of women who are infertile suffer from ovulatory problems.  If your period is irregular or non-existent then your production and release of eggs may be affected.

Infrequent periods (oligomenorrhoea) or the absence of periods (amenorrhoea) are most often caused by deficiency in one of the controlling hormones. There are medications that can used to get your periods regular.

Blocked Fallopian Tubes

Blockages may arise as a result of scarring due to infection or previous abdominal surgery, or endometriosis.

Because they are so delicate, and about the thickness as a strand of spaghetti, fallopian tubes are easily blocked or damaged. This can interfere with the sperm reaching the egg,

Pelvic inflammatory disease (PID) due to sexually transmitted diseases such as chlamydia or gonorrhoea, is the main cause of blockages, or ‘tubal infertility’.

Tubal infertility can sometimes be treated by surgery, but if this is not possible, or if surgery is unsuccessful, in vitro fertilisation (IVF) is a viable option.

Gynaecological Conditions Affecting Fertility

Endometriosis, Polycystic Ovarian Syndrome (PCOS) and Fibroids can affect fertility.

Uterine fibroids or uterine myomas are a non-cancerous growth of the muscle in the uterus. These may require treatment if they are causing problems with fertility, usually by changing the area that embryos are trying to implant.

What Happens at A First Fertility Appointment?

At your very first fertility appointment, I will already have your test results.  These will give me a clear understanding of what is stopping you from getting pregnant.

At this first appointment, we will discuss all the results of your initial tests with you.  Together, we will develop a treatment plan to help you fall pregnant.

Not every treatment plan involves IVF, and my goal is to help you maximise your natural fertility.