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Female Infertility

Causes | Diagnosis | Treatment

Treatment

Treatment options depends on the cause, duration of infertility and the age. Most infertility cases can be treated with drug therapies (fertility drugs) or hormone therapy to promote ovulation. Depending on the problem and diagnosis, surgery and assisted reproductive technologies may be used. 

Fertility drugs
Fertility drugs are the primary treatment for women who are infertile due to ovulation disorders. These drugs can be used to regulate or induce ovulation. Injectable fertility drugs significantly increase the chance of multiple births. The use of these drugs requires careful monitoring with a combination of blood tests of hormones and ultrasound measurement of ovarian follicle size. 

Surgery
Depending on the cause, surgery may be a treatment option for infertility. Blockages or other problems in the fallopian tubes usually can be surgically repaired. 

Assisted reproductive technology (ART) 
Improvements in fertility treatment have made it possible for many women whose male partner is infertile, to become pregnant. ART has revolutionized the treatment of infertility. The most common forms of ART include: 

Artificial Insemination (AI): It is performed when the male has a low sperm count or a high number of abnormal sperm or the woman has sperm antibodies present in her cervical mucus.  Sperm is treated in the laboratory to increase the chances of fertilisation. Large numbers of sperm are then inserted directly into the uterus for easy access to the f Fallopian tubes. It procedure is also used when couples are producing sperm and eggs, but have a problem bringing them together. In this situation, the sperm and  eggs are physically placed together in the woman's womb and then left for nature to run its course. The advanced procedure of artificial insemination is called In- vitro fertilization. 

In Vitro Fertilization (IVF): IVF, is the most effective form of ART, refers to the fertilization taking place outside the body in a laboratory. The procedure involves retrieving mature eggs from a  woman, fertilizing them with a man's sperm in a dish under controlled conditions in a laboratory and implanting the embryos into the woman's uterus (womb) three  to five days after fertilization. IVF treatment commonly known as 'test tube baby' is used to treat infertility blockages of the fallopian tubes, endometriosis, abnormal  sperm, and some cases of unexplained infertility. 

Intracytoplasmic Sperm Injection (ICSI):This consists of a microscopic technique (micromanipulation) in which a single sperm is injected directly into an egg with a microscopic needle to achieve  fertilization.  
The fertilised eggs can be transferred to the fallopian tubes of the woman or grown in the laboratory for a couple of days and then transferred to the  uterus of the female partner. Eggs are obtained the same way as for IVF.  

Gamete Intra-Fallopian Transfer (GIFT): GIFT is suitable for women with no abnormalities in the fallopian tubes. This procedure is the same as that for IVF except that fertilisation takes place inside the body of the woman. The eggs and sperm (gametes) are collected and placed directly into the fallopian tubes for fertilisation. 

Zygote Intra-Fallopian Transfer (ZIFT): ZIFT involves the same procedure as IVF except that the very early embryo (zygote) is placed directly into the fallopian tube. This procedure is undertaken when there are abnormal sperm or problems with the ability of the sperm to fertilise the eggs. 

Complications of treatment include Multiple pregnancy, bleeding, infection, low birth weight, birth defects and ovarian hyperstimulation syndrome in which the woman's ovaries may enlarge and cause discomfort. 


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