As a gynaecologist, there are few things I have seen that are more heartbreaking than a couple who is unable to conceive, despite their most earnest efforts. There are many causes of infertility and it is due to problems faced by the man, or the woman, or both. Women suffer a great deal when they learn that they are infertile, as they feel that they are unable to fulfil their biological and social roles as a mother.
Some people in society unfairly blame women for all problems of infertility, saying hurtful things like, “It must be your fault you can’t have a baby.” or “There must be something wrong with your body.” The feelings of guilt and distress created by this kind of social stigma and ignorance can be very burdensome for women, making it even more difficult for her to accept the situation or seek treatment. Yet there is hope for infertile couples, as medicine produces more and more ways to help them overcome the problems and conceive despite the odds.
When a woman can’t conceive
A couple is said to be infertile if they cannot conceive after at least a year of trying. In one-third of the cases, the problem lies with the woman’s body. There are many different causes for infertility in a woman, for instance physical problems, hormonal problems or lifestyle factors. One of the most common problems lies with the woman’s inability to produce eggs. This can stem from several different conditions that disrupt the process of ovulation, such as polycystic ovary syndrome (PCOS).
In PCOS, a woman’s ovaries and, in some cases her adrenal glands, produce more androgens (a type of hormone) than normal. Due to these high levels of androgens, the woman’s eggs cannot develop and be released during ovulation. Another condition affecting ovulation is premature ovarian failure, where the ovaries stop functioning before natural menopause, before age 40. This condition is sometimes also known as early menopause or primary ovarian insufficiency.
Doctors still do not really know what causes the ovaries to fail prematurely, but they believe that it has a lot to do with the follicles in the ovary, which are depleted or not working properly. As the hormonal process is incredibly important to the ovulation process, any disruptions or imbalances in the system will cause problems with a woman’s fertility.
For instance, the hypothalamus is one of the main control points in a woman’s hormone system. However, if it malfunctions, then it is unable to regulate the hormones, which will affect the rest of the reproductive system. Sometimes, infertility is caused by purely physical problems with the mechanics of the reproductive system. One common instance is when the fallopian tubes are damaged or blocked, following pelvic infections, endometriosis, pelvic surgeries or previous ectopic pregnancy.
As the fallopian tubes connect the ovaries to the uterus, any problems with it would prevent the sperm from reaching the egg. Even if the egg can get fertilised, it may not be able to move down the fallopian tube to be implanted in the uterus. Other physical problems include malformation of the uterus, fibroids and polyps in the uterus, pelvic adhesions (when scar tissue forms between the organs of the reproductive system), or abnormalities with the cervical canal or mucous.
Many women don’t think about how their lifestyle habits can affect their ability to have children. Waiting until older age to have babies is one of the main lifestyle factors in infertility, as the number and quality of eggs in the ovaries deteriorate from age 35 onwards. Of course, habits like smoking and excess consumption of alcohol and caffeine can be detrimental to your fertility too. Other factors that increase the likelihood of infertility are being underweight or overweight/obese, doing excessive exercise, or having sexually transmitted diseases.
What next?
If you and your partner have not been able to conceive after trying for six months to a year, the first thing to do is to see your doctor or gynaecologist. The doctor should do a thorough checkup of both you and your partner, and run several tests to find out the root cause of the infertility. Thanks to advances in medicine, there are many options available to increase the chances of conception in a woman who is infertile.
If she is experiencing hormonal problems, certain medications may be effective to address the problem by correcting the imbalance in the hormones. Sometimes, treatment requires the injection of fertility drugs or hormones to stimulate ovulation. Artificial insemination is another option if the problem lies in the woman’s cervical mucous or the man’s sperm. In this procedure, a man’s sperm is specially treated and injected into the woman.
There are also a number of other methods to help infertile couples, made possible by assisted reproductive technology. One of these methods is in vitro fertilisation (IVF), where a woman’s eggs and a man’s sperm are removed from the body and combined in a laboratory dish. When one of the eggs has been fertilised, it will be transferred to the woman’s uterus for implantation. IVF can be used in cases where infertility is due to blocked or damaged fallopian tubes, endometriosis or unknown causes. Other assisted reproductive technologies similar to IVF are gamete intrafallopian transfer (GIFT) and zygote intrafallopian transfer (ZIFT).
Be good to your body
For some women, being unable to conceive may simply be because their bodies are not sufficient prepared for conception. Being healthy and changing certain lifestyle habits can go a long way in improving your fertility. Your diet plays such a crucial role, even if you can’t see the individual effects on your fertility. Eat a variety of fresh foods, including plenty of fruits and vegetables, as part of a balanced diet. Make sure you have sufficient vitamin B, folic acid and zinc in your daily diet, but do not take vitamin supplements without your doctor’s advice.
Maintain a healthy body weight and keep your Body Mass Index within the healthy range of 18.5 to 25. If you are underweight or overweight, this can reduce your chances of getting pregnant. Stay active and exercise regularly, as this will keep you healthy, maintain your weight and strengthen your body for your future pregnancy. Smoking and alcohol consumption are big no-nos. You should quit smoking immediately, as it is bad for your health, whether or not you are trying to conceive.
It is never easy to deal with infertility, whether you are a woman, a man or even the doctor treating the couple. But guilt and blame definitely do not have a place in this scenario.
Star newspape. Mar 20, 2011
By Datuk Dr Nor Ashikin Mokhtar
