Polycystic Ovaries (PCO) is a common female hormone imbalance, which can result in ovarian cysts and cause irregular (unpredictable) ovulation. Some women with PCO only have a period every second or third month making it very difficult to predict ovulation and ultimately making it difficult to become pregnant. Symptoms include weight gain, excess body hair and skin problems, such as acne. Although the cause is not known, it does seem to have some genetic links. Some women with PCO have Polycystic Ovarian Syndrome (PCOS), where the features mentioned above are also accompanied by disturbances in sugar balance, rather like diabetes. This is known as insulin resistance and is associated with a number of metabolic disturbances.
PCO is diagnosed primarily by an ultrasound scan of the ovaries, as well as blood tests to measure the hormones associated with ovarian function. It may also be necessary to test sugar and insulin levels if PCOS seems to be present.
Endometrial tissue is the inner epithelial layer or lining tissue that grows within the uterus to protect a fertilised egg early in pregnancy. Endometriosis is a condition wherein there is an unnatural growth pattern of the endometrial tissue. The endometrial tissue of a patient with endometriosis can grow in other areas (outside the uterus), interrupting the normal functioning of the fallopian tubes or causing a growth in the ovaries, called endometrioma, that can affect follicle growth and impact the chances of a woman conceiving.
Symptoms of endometriosis could be pelvic discomfort during monthly periods, heavy menstruation, pain during intercourse and problems during urination.
To confirm endometriosis, a laparoscopy is conducted, wherein a telescope is inserted into the abdomen when the patient is under anaesthesia. The presence of endometriotic cysts can be determined through ultrasound scanning.
Tubol Factor Infertility
During a natural pregnancy, the sperm and the egg fertilise to form an embryo, while in one of the fallopian tubes. The fertilised egg then moves to the uterus to attach to its lining. However, if there is tubal damage, this is unlikely to happen or, in some cases, the fertilised egg may actually implant into the fallopian tube. This condition is referred to as an ectopic pregnancy or tubal pregnancy, and can lead to serious complications.
Causes of blocked fallopian tubes include:
- Pelvic infections
- Previous pelvic surgery
Initially, an ectopic of tubal pregnancy looks like a normal pregnancy. However, if you are already pregnant and experience symptoms such as extreme pelvic or belly pain or vaginal bleeding, it could mean that that it is a tubal pregnancy and it is imperative that you consult with your doctor immediately.
Foetal loss occurs in as many as 25-30 % of recognised pregnancies and when this condition is recurrent, it becomes extremely difficult. It means that the couple has to repeatedly undergo disappointment, after having dealt with the initial excitement of a confirmed pregnancy. If you have had two or more consecutive miscarriages, medical advice must be sought immediately in order to determine the cause of these recurrent miscarriages, seek treatment and prevent further miscarriages from occurring.
The main reason of first trimester losses (50-60%) is because the foetus has chromosomal abnormalities. These abnormalities occur when the embryo divides and grows, and is significantly higher in older mothers as the egg quality is poorer.
Genetic testing of the embryos produced in an IVF procedure can help reduce the risk of miscarriage, as only chromosomally normal embryos would be placed into the uterus.
Secondary infertility refers to a condition when a couple who have already naturally conceived a child, face difficulties while trying to become pregnant again. Invariably, when a childless couple is unable to conceive, they tend to seek advice or treatment. This does not hold true always with couples who have secondary infertility, as they feel there is no cause for concern, having already had a child through natural conception.
Several lifestyle related factors such as smoking, drinking and obesity; injuries or diseases, which may have occurred since the past pregnancy, could impact fertility the second or third time around.
Irregular Menstrual Cycle
An irregular menstrual cycle, caused by hormonal imbalances, affects fertility amongst women. As eggs are not produced regularly on account of irregular ovulation, planning a pregnancy is not possible. However, for the most part, cases of irregular menstrual cycles are treatable.
Polycystic Ovaries (PCO) and Polycystic Ovary Syndrome (PCOS) and a sudden significant weight loss or weight gain in a short period of time, hormonal imbalance and co-existing medical problems, such as thyroid disease or diabetes can cause irregular menstrual cycles.
Diminished Ovarian Reserve
Diminishing ovarian reserve is another cause of infertility amongst women. Ovarian reserve refers to the capacity of a woman’s ovaries to produce healthy, viable eggs. Although eggs are still produced up until menopause, the ovarian reserve and the quality of available eggs naturally begins to decrease after the age of 35.
Symptoms of an impending menopause include hot flashes, irregular periods, night sweats, irritability, difficulty concentrating or decreased sexual drive. Though a diminishing ovarian reserve is something that occurs naturally as women age, external factors such as environmental toxins and lifestyle choices can also play a role in impacting the ovarian reserve in women.
Diminished Ovarian Reserve
Infertility can also be caused by growths such as adenomyosis, polyps and fibroids on the reproductive organs of a woman. Adenomyosis refers to the condition when endometrial tissue grows into the muscular layer of the uterus. Non-cancerous growths that occur in the vagina, uterine lining or cervix are known as polyps. Non-cancerous tumours of varying sizes that grow in or around the uterus are called Fibroids.
Spotting during sexual intercourse, heavy menstrual bleeding or irregular periods, are all symptoms of adenomyosis, polyps and fibroids.