According to the World Health Organisation (WHO), Clinical definition of infertility can be described as the failure to achieve clinical pregnancy after 12 month of regular unprotected sexual intercourse. Between 10-15% of couples experience infertility . In around 40 % of cases, male partner alone is responsible in 40% cases female alone, in 10% cases the cause remains unexplained.
The causes of female infertility can be divided as acquired, genetic and by location.
The acquired factors according to ASRM
According to American Society for Reproductive medicine (ASRM), Age, Smoking, Sexually Transmitted Infections and being overweight or underweight can all affect fertility.
There are many genes mutation which causes female infertility. Unknown number of genetic mutation also causes a state of sub fertility.
The defects could be at the level of higher centre like hypothalamus or pituitary at the level of ovary, tubes / peritoneal, uterine, cervix or vagina. Diagnosis starts with proper history, the test involves the semen analysis of male partner, tubal patency tests and hormonal profile of the female partner. To test the ovarian reserve AMH, D2 / FSH, E2 and AFC is done. Other tests like TSH, PRL also helps in diagnosis of thyroid or prolactin disorders as a cause of infertility. Diagnostic laparoscopy or hysteroscopy can be done in specific instructions.
Intrauterine Insemination is a procedure where the aliquot of processed semen is inserted into the uterus, bypassing the cervix at the ovulation. In Vitro Fertilization (commonly called as IVF, and known in the early days as “test tube baby”)combine egg and sperm in a laboratory. Embryos are formed and transferred inside the uterus. IVF does not guarantee that 100% pregnancy would be the result.
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