There are many causes of infertility that may impact on the female partner’s ability to achieve a pregnancy. Galway Fertility Clinic offers a wide range of investigative tests which can identify any contributing factors in female infertility.
The consultant reviews the medical history at the initial consultation and schedules tests as deemed appropriate. Once the diagnosis has been identified, a suitable treatment plan is decided to address the issue. This can increase the chance of success for clients and allow them the opportunity to fulfil their desire to become a parent(s).
A number of factors can contribute female infertility, these are as follows:
The age of the female partner is an important factor when assessing the chances of success as pregnancy rates decline after 37 years of age.
Increasing female age relates to:
Reduced ovarian response
Ovarian reserve is the term used to describe the number of good quality eggs left within a woman’s ovaries. The rate at which eggs are lost varies and this determines the age of onset of the menopause.
Reduced chance of Success
Success rates decline with increasing female age, especially for those clients over the age of 40.
Increased risk of miscarriage.
In keeping with the general population of naturally conceived pregnancies approximately 20-25% of all pregnancies result in miscarriage. This rate increases for women over 40, to approximately 50%.
An increased chance of chromosomal abnormalities in embryos.
The incidence of Down’s Syndrome increases with female age. The chance of having a baby with Down’s Syndrome at age 30 is 1 in 900 births; for women aged 35 is 1 in 350; 1 in 100 births at age 40; and 1 in 26 at 45 years or older (from Irish Study).
Overcoming the above issues:
IVF and Ovulation Induction success rates drop considerably over the age of 43 years, and often these women will be referred for Egg Donation Programmes. Using donated eggs from a younger woman in IVF treatment will offer success rates of 60%+.
The fallopian tubes extend from the upper segment of the uterus to the ovary. These narrow tubes transport the egg from the ovary to meet with the sperm for fertilisation to occur. With tubal disease, one or both tubes may be blocked as a result of endometriosis, previous pelvic surgery or pelvic infection, due to appendicitis or pelvic inflammatory disease (PID).
Tubal factor infertility accounts for approximately 25-30% of all cases of infertility.
The condition can be identified using the investigative procedures, laparoscopy, dye & hysteroscopy and/or hysterosalpingogram (HSG) procedures. Our consultant will determine which test is appropriate as part of your assessment.
Endometriosis occurs when tissue, which normally lines the womb, is found at other locations in the pelvis. It is common for women with this condition to suffer with painful periods and pain during intercourse, however for others there may be no symptoms.
There are different grades of Endometriosis. Some women have a mild form of the condition with minimal spots of scar tissue occurring, while others have a severe form with extensive scarring and adhesions, affecting surrounding tissue in the pelvis.
The best way to diagnose this condition is by a surgical procedure known as a Laparoscopy which allows direct visualisation of the pelvis.
Where the condition is mild, women may conceive with the assistance of ovulation induction, however in severe cases, IVF may be recommended as the appropriate treatment.
Polycystic Ovary Syndrome (PCOS)
Polycystic ovary syndrome is a condition in which a woman has an imbalance of female sex hormones. This may lead to menstrual cycle changes, cysts in the ovaries, infertility and other medical conditions (eg diabetes). It is not completely understood why or how the changes in the hormone levels occur. The hormone imbalance makes it harder for a woman's ovaries to release fully grown (mature) eggs.
Normally during ovulation, one or more eggs are released. In PCOS, mature eggs are not released from the ovaries. Instead, they can form very small cysts in the ovary. These changes can contribute to infertility. Most of the time, PCOS is diagnosed in women in their 20’s or 30’s and there may be a family history of this condition.
Women with PCOS often have irregular periods or no periods, that may be heavy and prolonged when they do occur. They may also be prone to weight gain, acne on the face and / or unwanted facial hair (hirsuitism) on the upper lip, chin, around the nipples or on the tummy. Some women with (PCOS) have a reduced sensitivity to insulin and are prone to develop diabetes in pregnancy and later in life.
There are a number of treatment options available for clients diagnosed with PCOS including diet and, lifestyle recommendations to improve symptoms and improve your body’s response to the medication. Treatment options include ovulation induction and IVF. The consultant will determine a suitable treatment plan to address this condition.
If these fail to achieve a pregnancy there are other options that may be recommended. ie egg or sperm donation, adoption.