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Female Infertility



Female Infertility

Investigating a Potential Problem

Although couples are generally not advised to consider full infertility investigations until after an entire year of attempting to conceive has passed, certain medial conditions necessitate early attention.


The Causes of Infertility

The causes of infertility may be specifically related to either the male or the female partner, or reflect a combination of male and female causes concurrently. However, any investigation must include both partners together. Not only is it important because of the psychological need partners have for each other during treatment, but for more practical purpose as well, since discovering a problem in one partner does not necessarily rule out the possibility of a problem in the other partner.


For Women

“If a woman is aware that there is something wrong with her and is not merely reacting to social pressure, then she should, by all means, not delay thorough investigations,” confirms Dr. Mohamed Osman, *Chairman and Head of the Department of Gynecology and Obstetrics, Cairo University, Kasr Al Aini Hospital, and owner of Dr. Osman Hospital in Maadi. “For example, a woman who menstruates infrequently (every few months, for example) should consider investigating her condition, since she cannot possibly predict the time of her ovulation. Moreover, it is quite possible that she is not ovulating at all. Also, a woman who has undergone abdominal, uterine, or ovarian surgery before marriage is afraid that she might have had an ovary damaged or accidentally removed in the process, is advised to consult a doctor as well. Furthermore, women who are extremes in weight or height should also seek medical consultation because such extremes could affect normal hormonal function in the body, which in turn may affect ovulation. Some women’s breasts produce milk secretions, even though they are not breast-feeding. Such women need to receive treatment since these secretions indicate that there is a high level of pituitary hormone prolactin in the bloodstream, and this may suppress ovulation and/or menstruation, thereby possibly preventing conception. Women over thirty, who are conceiving for the first time may also benefit from early investigation since a woman’s fertility gradually declines with age.”


Female Infertility

For a female, the more obvious starting point is to confirm that ovulation is taking place. “It is quite possible for a woman to be menstruating every month, but to not be ovulating each time,” says Dr. Osman. “Moreover, if a woman is having irregular cycles (e.g. 25 days one cycle, 32 days the next etc.), then she cannot easily pinpoint her day of ovulation in order to determine the best time to try to conceive.” Furthermore, when a woman discontinues the pill, ovulation may be disrupted temporarily. That is why many women experience some difficulty conceiving after they have stopped using this form of contraception. Ovarian activity and ovulation are best monitored with the aid of the ultrasound.

Among other major causes of infertility in women are blocked fallopian tubes, which could be the result of an infection (such as the sexually transmitted diseases chlamydia or gonorrhea), uterine fibroids, or endometriosis (a condition in which cells from the endometrium rapidly spread around the ovaries, fallopian tubes, and uterus causing major damage to the reproductive organs). To help in these types of diagnose, a doctor may use a hystersalpingogram. This consists of an x-ray performed before ovulation in which an opaque dye is injected into the cervix to provide a clearer depiction of the fallopian tubes and uterus. A doctor may also recommend a laparoscopy, a procedure whereby a tiny abdominal incision is made and a small telescopic camera is inserted for internal exploration and/or surgery of the reproductive organs.

In certain cases, a woman may also produce sperm antibodies which attack and destroy sperm cells, or she may have cervical mucous which is too thick to allow the sperm to swim up the vagina. In order to identify these cases, a doctors may do a post-coital test, which involves taking a sample from the woman’s vaginal and cervical discharge after intercourse.


[from our archives] *information accurate at time of initial publishing

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