Infertility is defined as trying to get pregnant (with frequent intercourse) from six months to a year with no success. If a woman keeps having miscarriages, it is also called infertility.

Female infertility can result from age, physical problems, hormone problems, and lifestyle or environmental factors.   Female infertility, male infertility or a combination of the two affects millions of couples

A woman who is having difficulty getting pregnant should talk with her health care provider about possible treatments. There are many available treatments, which will depend on the cause of infertility.

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The main symptom of infertility is the inability to get pregnant. An irregular or absent of menstruation can mean that you’re not ovulating. There may be no signs or symptoms.

How to become pregnant:

You need to ovulate. To get pregnant, your ovaries must produce and release an egg, a process known as ovulation. Your doctor can help evaluate your menstrual cycles and confirm ovulation.

Your partner needs healthy sperm.

You need to have regular intercourse. You need to have regular sexual intercourse during your fertile time.

You need to have open fallopian tubes and a normal uterus. The egg and sperm meet in the fallopian tubes, and the embryo needs a healthy uterus in which to grow.

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For pregnancy to occur, every step of the human reproduction process has to happen correctly. The steps in this process are:

One of the two ovaries releases a mature egg.

The egg is picked up by the fallopian tube.

Sperm swim up the cervix, through the uterus and into the fallopian tube to reach the egg for fertilization.

The fertilized egg travels down the fallopian tube to the uterus.

The fertilized egg implants and grows in the uterus.

Some major causes of female infertility are:

Ovulation disorders: meaning you don’t ovulate at all. About 1 in 4 infertile couples experience problems with the regulation of reproductive hormones by the hypothalamus or the pituitary gland, or problems in the ovary, which can cause ovulation disorders.

Primary ovary insufficiency (POI):  the ovaries stop functioning before natural menopause.

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Sexual history: Sexually transmitted infections such as chlamydia and gonorrhea can damage the fallopian tubes. Having unprotected intercourse with multiple partners increases your risk of a sexually transmitted infection that may cause fertility problems later.

Polycystic ovary syndrome (PCOS):  the ovaries may not release an egg regularly or they may not release a healthy egg, because of hormone imbalance, which affects ovulation. PCOS is associated with insulin resistance and obesity, abnormal hair growth on the face or body, and acne. It’s the most common cause of female infertility.

Hypothalamic dysfunction: Two hormones produced by the pituitary gland are responsible for stimulating ovulation each month — follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Excess physical or emotional stress, a very high or very low body weight, or a recent substantial weight gain or loss can disrupt production of these hormones and affect ovulation. Irregular or absent periods are the most common signs.

Premature ovarian failure: Also called primary ovarian insufficiency, this disorder is usually caused by an autoimmune response or by premature loss of eggs from your ovary.

Chemotherapy: The ovary no longer produces eggs, and it lowers estrogen production in women under the age of 40.

High prolactin: breast milk comes out from your breast even when you are not breastfeeding a baby. The pituitary gland may cause excess production of prolactin (hyperprolactinemia), which reduces estrogen production and may cause infertility.

Tubal blockages: Damaged or blocked fallopian tubes keep sperm from getting to the egg or block the passage of the fertilized egg into the uterus. (Tubal infertility)

Tubal damage or blocked fallopian tubes is caused by infections or previous surgery in the abdomen or pelvis, including surgery for ectopic pregnancy, in which a fertilized egg implants and develops in a fallopian tube instead of the uterus.

Pelvic inflammatory disease (PID): is an infection of the uterus and fallopian tubes due to chlamydia, gonorrhea or other sexually transmitted infections. This can cause frequent miscarriages

Pelvic tuberculosis: a major cause of tubal infertility worldwide.

Endometriosis: occurs when tissue that normally grows in the uterus implants and grows in other locations. This extra tissue growth can block fallopian tubes and keep an egg and sperm from uniting.

Endometriosis can also affect the lining of the uterus, disrupting implantation of the fertilized egg. This condition also seems to affect fertility in ways, such as causing damage to the sperm or egg.

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Benign polyps or tumors (fibroids or myomas): are common in the uterus. Some can block fallopian tubes or interfere with implantation, affecting fertility. However, many women who have fibroids or polyps do become pregnant.

Uterine abnormalities present from birth, such as an abnormally shaped uterus, can cause problems becoming or remaining pregnant.

Cervical stenosis:  a narrowing of the cervix can be caused by an inherited malformation or damage to the cervix.

Sometimes the cervix can’t produce the best type of mucus to allow the sperm to travel through the cervix into the uterus.

Sometimes, the cause of infertility is never found. A combination of several minor factors in both partners could cause unexplained fertility problems. Although it’s frustrating to get no specific answer, this problem may correct itself with time. But, you shouldn’t delay treatment for infertility.

Factors which may put you at higher risk of infertility, includes:

Age: The quality and quantity of a woman’s eggs begin to decline with increasing age. In the mid-30s, the rate of follicle loss speeds, resulting in fewer and poorer quality eggs. This makes conception more difficult, and increases the risk of miscarriage.

Smoking: Besides damaging your cervix and fallopian tubes, smoking increases your risk of miscarriage and ectopic pregnancy. It’s also thought to age your ovaries and deplete your eggs prematurely. Stop smoking before beginning fertility treatment.

Alcohol: Stick to moderate alcohol consumption.

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