Definition of Infertility
As per WHO, Infertility in females is defined as an inability to achieve pregnancy after 1 year of regular sexual intercourse & no predisposing cause such as lactation, Contraception etc.
Male Infertility is responsible for 20–35% of infertility cases, while 35% are due to female infertility, and 25–40% are due to combined problems in both parts. In 10–20% of cases, no cause is present. The most common cause of female infertility is ovulatory problems, which generally manifest themselves by sparse or absent periods. Male infertility is most commonly due to deficiencies in the semen.
Women who are fertile experience a natural period of fertility before and during ovulation, and they are naturally infertile for the rest of the cycle.
Causes of infertility in females
Ovulation disorders
Ovulation disorders, meaning you ovulate irregularly or not at all. Problems with the regulation of reproductive hormones by the hypothalamus and pituitary gland, or problems in the ovary, can cause ovulation disorders.
Polycystic ovary syndrome or PCOS causes a hormone imbalance, which affects ovulation. PCOS is associated with insulin resistance and obesity, abnormal hair growth on the face and body and acne. It’s the most common cause of female infertility, especially females in their 30’s.
Hypothalamic dysfunction:
Excess physical or emotional stress, a very high or very low body weight, or a recent substantial weight gain or loss can disrupt the production of the female 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. The ovary no longer produces eggs, and it lowers estrogen production in women under the age of 40.
Too much prolactin/hyperprolactinemia
The pituitary gland may cause excess production of prolactin (hyperprolactinemia), which reduces estrogen production(E2) and may cause infertility. Usually related to a pituitary gland problem, this can also be caused by medications you’re taking for another disease.
Damage to fallopian tubes (tubal blockage)
Damaged or blocked fallopian tubes keep sperm from getting to the egg or block the passage of the fertilized egg into the uterus. Causes of fallopian tube damage or blockage can include:
Pelvic inflammatory disease, an infection of the uterus and fallopian tubes due to chlamydia, other sexually transmitted infections like gonorrhea.
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 tuberculosis, a major cause of tubal infertility worldwide, especially India.
Endometriosis
Endometriosis occurs when tissue that normally grows in the uterus implants and grows in other locations. This extra tissue growth — and the surgical removal of it — can cause scarring, which may block fallopian tubes and keep an egg and sperm from uniting.
Endometriosis can also affect the lining of the uterus or endometrium, disrupting the implantation of the fertilized egg. The condition also seems to affect fertility in less-direct ways, such as damage to the sperm or egg.
Uterine or cervical causes
Several uterine or cervical causes can impact fertility by interfering with implantation or increasing the likelihood of a miscarriage:
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.
Endometriosis scarring or inflammation within the uterus can disrupt implantation.
Uterine abnormalities present from birth, such as an abnormally shaped uterus, can cause problems becoming or remaining pregnant.
Cervical stenosis
Unexplained infertility
Sometimes, the cause of infertility is never found, this accounts for almost 30 %of cases.
Infertility treatment by Laparoscopy
Laparoscopy is being done in all the leading hospitals in South Delhi. Dr Ruchi Tandon has received extensive training in laparoscopy from best hospitals in Delhi and Mumbai, such as Max hospital, Dr Ruchi Tandon is one of the best gynecologists, based in greater Kailash and doing all sorts of daycare and operative laparoscopic procedures. Infertility surgeries, Myomectomy, hysterectomy, Hysteroscopy are some of the procedures to name a few.
