It is recommended if a woman is under 35 and has not successfully conceived after a year of trying to seek help from a fertility specialist, who can help evaluate and provide treatment plan options. Issues relating to the female reproductive system is one of the common causes of female infertility.
THE FEMALE REPRODUCTIVE SYSTEM
As the carrier of the baby, the female reproductive system plays a crucial role in starting a family. The female anatomy consists of both external and internal structures. Externally, the main parts include the labia majora, labia minora, Bartholin’s glands, and the clitoris. These function to allow sperm into the body while protecting the internal reproductive organs. The key internal structures include:
Also referred to as the birth canal, the vagina connects the lower part of the uterus, the cervix, with the external body.
Also known as the womb, the uterus is a pear-shaped organ that accepts a fertilized egg and houses the developing fetus. The uterus consists of 2 main parts: the corpus, which expands to hold the developing fetus and the cervix, which opens up into the vagina. The uterus has muscular walls and a thick lining. When not pregnant, a woman’s uterus is about 3 inches long and 2 inches wide. The fallopian tubes are connected at the top of the uterus and create a passage for eggs. The ovaries, which house the eggs, are at the other end of the fallopian tubes.
The ovaries, which are responsible for producing, storing, and releasing eggs, also known as ova or oocytes, are part of the endocrine system. They also produce the hormones estrogen and progesterone. Pregnancy would be impossible without help from the endocrine system, which stimulates the production of hormones in the body. A reproductive endocrinologist can often help diagnose and treat infertility that is the result of hormonal issues.
The female reproductive system has 2 fallopian tubes. These narrow tubes provide passage of eggs from the ovaries into the uterus. The eggs are transported down the fallopian tubes, which is typically where fertilization of an egg by a sperm occurs.
THE MENSTRUAL CYCLE
The menstrual cycle typically lasts 28 days and can be broken down into three phases, the menstrual phase, the follicular phase, and the ovulatory phase.
The menstrual phase is the time when the female is on her period. During this phase, the body will shed the lining of the uterus from your previous cycle. Estrogen and progesterone levels are low at this point.
The follicular phase is the first half of the menstrual cycle. It starts on day one of the period and extends for anywhere between 10 and 17 days. During this time, immature eggs in the ovary are maturing, with the healthiest and strongest being released at ovulation. The eggs that are not released are absorbed harmlessly back into the body.
While the eggs are maturing, the lining of the uterus is thickening. This is due to rising estrogen levels. While estrogen does much of the work during this phase, other hormones play a role as well, including testosterone. Rising levels of testosterone close to ovulation increase sexual desire.
Ovulation occurs midway through the menstrual cycle, typically any day between 10 and 17 from the start of your period. The egg is released into the fallopian tube, where it can be fertilized by sperm. This is the only point during the menstrual cycle when a woman can become pregnant. The egg will be viable for about one day from the time it is released, and sperm can remain viable for up to three. This means the most fertile period occurs shortly before ovulation.
The luteal phase occurs after ovulation. Progesterone levels rise while estrogen falls. If an egg is fertilized, the progesterone will encourage the implantation of an embryo. If there is no fertilized embryo attached to the lining of the uterus, progesterone levels fall, and the menstrual period begins.
While this is a general guideline, it is important to note that if your cycle is outside the norm in length, whether much longer or shorter than described above, you may not be ovulating regularly, which can lead to female infertility.
INFERTILITY CAUSES AND TREATMENTS
There are a variety of causes for female infertility. Fertility is complicated, and there may be several conditions that make conception difficult.
If the fallopian tubes have scar tissue from pelvic infections or endometriosis the sperm may have trouble reaching the egg. If the hormone levels are not within the necessary range, the female body may not release an egg or the lining of the uterus may not be hospitable to implantation. Some women have issues with their cervical canal which can obstruct the sperm on its journey to the fallopian tubes. Growths, such as polyps or fibroids, in the uterus, can create an atmosphere that makes it difficult for an embryo to implant. About 10% of reproductive age women don’t ovulate due to Polycystic Ovary Syndrome which is also known as PCOS.
Surgical procedures to remove obstructions in the uterus or fallopian tubes, medication to stimulate ovulation and reproductive assistance, such as IVF and IUI, can treat many of the causes of female infertility.
There are many treatment options available for women who are facing challenges getting or remaining pregnant. To boost the odds of a successful pregnancy, a couple should work with both a reproductive endocrinologist and reproductive urologist to get better accurate diagnosis of how much female and male factor is involved and to receive comprehensive care.