The Effect of Abnormalities of the Uterus on Infertility

There are several abnormalities that can occur in the uterus and prevent a woman from conceiving a child. They also affect the ability of women to carry pregnancy till the full term. The septate uterus is one of the typical congenital uterine problems. In this condition, a wall or septum completely or partially divides the uterus into two separate cavities. One in four women experience problem conceiving because of this condition. Uterine X-ray (hysterosalpingogram or HSG) is used to detect this condition and a surgery is performed to remove the septum. 80% of women who have undergone the surgery have been able to conceive successfully.

DES or di-ethyl-stilbestrol used to be given to women to reduce the chances of miscarriage. Later, it was determined that it does not help in reducing the chances of miscarriage but leads to embryological abnormalities. It can cause numerous problems in the upper vaginal region, irregular lining of the uterus, ectopic pregnancy, hypoplastic uterus and cervical dilation. Usually it is not easy to treat this condition and a cerclage or a stitch around the cervical neck is placed to help women with a weak cervix.

Intrauterine adhesions which indicate the presence of a scar tissue in the uterine cavity can also lead to infertility. In cases where the entire cavity is scarred, then it is possible to experience complete absence of menstruation. This is also known as Ashley’s syndrome where the rich lining of the uterus is lost. It is not very easy to spot this condition and a hysterosalpingogram or HSG is done. Hysteroscopic surgical procedure is done as a part of the treatment process to remove the scar tissue and also to provide estrogenic hormone support. At times, an IUD is placed to prevent this condition from re-occurring.

Adenomyosis is another condition where the parts or components that should be restricted to the endometrium are discovered within the myometrium also. This condition is similar to endometriosis as the lining of the uterus spreads to regions it should not and it continues to grow. Women between the ages of 40-50 are affected by this condition. Pelvic pain and uterine bleeding also occur because of adenomyosis. Approximately 60% of women with this condition experience abnormal uterine bleeding which is a result of either metrorrgia or hypermenorrhea. Hypermenorrhea is performed on women suffering from this condition, hormone supplement GnRH (gonadotropin releasing hormone) is also given to women to decrease the size of the uterus and to improve the chances of conceiving.

Fibroids are usually benign in nature and are of three types: subserosal, intramural and submucous, out of which the submucous fibroids can cause infertility. They can push into the uterine cavity which leads to several problems including infertility. Laparoscopy is done to remove them.

These are few of the conditions that can occur in the uterus and can lead to infertility. It is important that women seek treatment as soon as possible in order to eliminate the conditions that lead to infertility.


PCOS and Infertility

Polycystic ovary syndrome (PCOS) is a disorder of the endocrine. Approximately 5% of women suffer from this condition. Though this condition is experienced by women of all ages and races, it is most commonly observed among women of reproductive age, causing infertility. It occurs mostly because of hormonal imbalance. Women with PCOS condition do not experience regular cycles and do not follow the same ovulation procedure as the others. They have ovaries with multiple cysts present on them. In a normal menstrual cycle, a follicle develops during the ovulation period. This follicle is a cystic structure. Women who suffer from PCOS are reported to develop numerous cystic structures in the ovary. This gives rise to extremely irregular menstrual cycles in a condition called as oligomenorrhea and even a complete lack of periods is a condition known as amenorrhea.

Most of the women suffering from PCOS do not even know that they have it. Less than 25% of women have been diagnosed with it. Most women learn about the condition after undergoing a diagnosis to determine the causes of them experiencing an inability to conceive. PCOS can affect a woman’s menstrual cycles, hormone production and levels, appearance and fertility.  During PCOS, excess of male hormones are produced in the body and these come in the way of ovulation. Most of the follicles of a woman suffering from PCOS do not mature because of her inability to generate enough hormones. They may grow and accumulate fluid but do not mature enough for ovulation. Progesterone which causes the lining of the uterus to be thick is not produced in good measures and without adequate amounts of progesterone in the body, it is tough or not possible for a woman to experience regular menstrual cycles.

The most common symptoms of PCOS are irregular menstrual cycles, infertility, increase growth of hair on face, chest or back, multiple cysts on ovaries, thinning of hair, obesity, Type II diabetes, acne and PMS or pelvic pain. Determining the ovulation period of a woman suffering from PCOS is very difficult as there is a lot of variation among the hormone levels. The exact causes of PCOS are not known at this time.  It is reported that PCOS can occur due to family history and hence could be genetic in nature. However, the symptoms of PCOS vary a lot among generations in a family and hence, there are other factors also involved. A combination of environmental factors and genes are said to be the most likely cause of PCOS. There are a lot of treatments available for PCOS. Women can choose to lose their weight to balance their hormones and get back normal menstrual cycles. Metformin which can reduce the number of male hormones in the body and restore normal ovulation is also prescribed for this condition. Clomid is used for PCOS related infertility.  Ovarian drilling is also done to regulate ovulation. IVM or IVF is also performed on women who do not respond positively to drug therapy.


Endometriosis and it’s impact on Infertility

Endometriosis is a medical condition that causes infertility in women. In this condition, endometrial cells which usually cover the lining of the uterus, start growing in other areas as well. These cells are influenced by hormones and behave in a manner that is similar to the cells that outline the cavity of the uterus. Endometriosis occurs usually during the reproductive period and is observed in 5-10% of women. It is one of the most common symptoms of infertility among women.

It is a progressive condition and its impact on the body increases with time. It can also reoccur after treatment. The endometrial tissue that is outside the uterus responds to menstrual cycle in the same way as the tissue inside the uterus does. It swells and becomes thick and starts to shed to indicate the beginning of the menstrual cycle.  The blood generated by these actions, does not have a proper place to go, and accumulates, causing an inflammation that damages or affects the fallopian tubes and the entire process of ovulation.  Ovarian cysts can also be formed, in a condition known as endometrioma and they may restrict and interfere with ovulation.

The exact causes of endometriosis are not known and there are only theories available for researchers to work on. According to one theory, during menstruation a part of the menstrual tissue moves from the fallopian tubes to the abdomen from where it starts growing. According to another theory, during fetal development itself, endometrial cells develop outside the uterus and start growing.  There are several reasons about the impact of endometriosis on infertility. Women experience a lot of pain because of this condition during intercourse and they may choose to not have intercourse often, reducing their chances of becoming pregnant. The scar tissue which is formed due to endometriosis adheres to the ovary, thus restricting the overall area available for egg release.

These adhesions can also be found around the fallopian tubes and can hinder their ability to transport eggs from the ovary to the uterus.  It might even block the fallopian tube on certain occasions, making fertilization a distant possibility. The peritoneal fluid in women suffering from endometriosis contains a large number of scavenger cells, which destroy sperm cells and reduce the chances of fertilization. Endometriosis is also the cause for pelvic pain and is the reason behind people opting for laparoscopic surgery and hysterectomy. Nonsteroidal anti-inflammatory drugs are usually prescribed for women to help reduce pelvic pain and cramping during periods. NSAID’s are also prescribed for relieving pain. Gonadotropin-releasing hormone analogs (GnRH analogs) are also used to reduce pain and the size of endometriosis implants. They lead to a lot of side-effects such as hot flashes, mood swings, fatigue and osteoporosis. Oral contraceptive pills and also progestins are used to treat endometriosis. Aromatase inhibitors and even surgery are options that are considered for the treatment of endometriosis. Thus, endometriosis is a serious condition and can lead to infertility in women.


Causes of Infertility in Men

Infertility in men accounts for 30-40% of the reported infertility cases. Varicocele is a condition that affects 40% of the men, and it causes impairment of the testicles and can lead to infertility. Absence of the sperm happens to 6% of the men, and there are several reasons that can be attributed to low sperm count in men. Sertoli cell-only syndrome is a condition wherein, the cells that produce sperm are absent. Sperm problems can be congenital or can be a result of surgeries, injuries and medications.

Events or activities that cause a lot of strain and stress also reduce sperm count in men. Emotional stress can significantly reduce sperm count and in some cases conditions such as impotency, premature ejaculation and relationship problems lead to infertility. Testicular Overheating which can be caused due to infections, exposure to high temperatures in saunas and hot tubs can reduce sperm count. Use of drugs, narcotics, and smoking can reduce sperm count by almost 50%. Deficiencies in vitamins E and C, zinc and folate can cause infertility. The pressure exerted on the body while bicycling can have an effect on blood vessels and also nerves that trigger erections. 19% of all sperm count problems are basically genetic in nature and can lead to infertility. Sometimes, men are also observed to have a high count of damaged sperms.

Disorders such as Cystic fibrosis, Klinefelter syndrome, Kartagener syndrome and Polycystic kidney disease which are all genetic disorders cause infertility.  Infections and exposure to free radicals or oxidants, as a result of environmental hazards also lead to infertility. Exposure to Estrogen-Like and Hormone-Disrupting Chemicals decrease the sperm count and cause infertility problems. Exposure to heavy metals, radiation treatments, medications and surgeries can all contribute to infertility. Hypogonadism which refers to a deficiency of gonadotropin-releasing hormone (GnRH) can cause low levels of testosterone. Autoimmunity refers to a condition wherein, antibodies present in the body mistake sperms to be foreign bodies and launch an attack on them. Vasectomy is reported to have caused infertility in some people, and definite evidence for this report has not been found yet. Retrograde Ejaculation occurs when the urethra muscles do not work properly and the sperm traverses back into the bladder during intercourse rather than coming out of it.

Testicular Dysgenesis Syndrome occurs because of three specific conditions – reduced sperm production, testicular cancer and genital tract abnormalties. Undescended Testes (Cryptorchidism) is a condition wherein, the testes malfunction and it can have a severe affect on sperm production. Hypospadias, Anorchia, Syringomyelia and Blockage in the tubes that transport sperm are birth defects that lead to infertility in men. Infections such as Sexually Transmitted Diseases, Mycoplasma, mumps, glandular infections in the urinary tract or the genital areas and cancer treatment can all lead to infertility. Diabetes, HIV, heart conditions, liver or kidney problems and anemia can all cause infertility. Several medications, especially those used by weight-lifters and athletes are known to reduce sperm count and lead to infertility.


Fertility Prediction or Ovulation Prediction Kits

Trying to conceive can prove to be a difficult process for many women. To help women who are experiencing signs of infertility and to make the process simpler for all of them, fertility aids can be used. There are several fertility kits available on the market that can help women conceive in a easy manner. Some of them are discussed below:

Ovulation Prediction Kit: One egg is produced by every woman every month. Determining the ovulation period can prove to be a good step for a couple trying to conceive. Ovulation kits determine the LH hormone level. It is observed that women experienced a surge in the LH hormone before the ovulation period and this can be observed in the urine. Women can use these predictors to determine their ovulation period and improve their chances of conceiving.

Pre-seed: A woman’s body responds to variations in the cervical mucus during the ovulation period. It is essential that the cervical mucus is clear, slimy and stretchable as having cervical mucus that is thick can actually block the sperms or slow them down and prevent fertilization. Pre-seed will provide extra cervical mucus and makes sure that the sperm travels smoothly.

Vitex: This has being used by women for a very long time to regulate their menstrual cycles and help combat premenstrual syndrome. It should not be taken along with other medications as it might affect the fertility adversely.

Evening Primrose Oil: It is used by women to help with pre-menstrual syndrome and to also enhance the quality of the cervical mucus. It can also lower cholesterol levels and natural labor induction.

Robitussin: Robitussin is used for the same purpose as Pre-seed. It can help smooth the cervical mucus as it not only thins down the cervical mucus but it also makes it slippery and helps to reduce infertility.

Instead Softcups:  A softcup is inserted after intercourse to prevent sperms from escaping. By doing so, sperm is kept near the cervix. The more time sperms stay close to the cervix; the more sperm will reach the egg.

The Conception Kit: The conception kit is a new product that has been developed to help couples to conceive. This kit includes several components such as ovulation kits, lubricant to help in the movement of sperm, pregnancy tests, semen collector and conception cap. Couples need to use the semen collector in a manner similar to that of a condom during intercourse and then shift the semen to the conception cap.  The cap is inserted into the woman’s vagina and kept near the cervix. This is useful in many ways as it can create a favorable environment for the sperms, help men who have low sperm count and mobility problems and also enhance and improve the chances of conception in women who are experiencing a lot of trouble conceiving.

These are a few of the many fertility kits available in the market and different people choose kits according to their various requirements and needs.


Acupuncture and Infertility

Acupuncture is an ancient Chinese method used to prevent and treat diseases. It has been used for the past five thousand years and has been found to be very effective in curing many ailments and even infertility.  It is essential that a couple undergoes all the physical examinations needed to determine the causes of infertility before opting for acupuncture. Acupuncture along with herbal medicine has been reported to yield good results among people suffering from infertility. It can work wonders on only certain aspects related to infertility. Acupuncture involves stimulating certain points in the body in order to provide relief. It might not be able to cure adhesions which occur due to pelvic inflammation or endometriosis but they can enhance and improve ovarian and follicular functions. Acupuncture can also increase the flow of blood to the endometrium.

Acupuncture treatment is given to patients for at least three to four months prior to an insemination in IVF transfer.  Receiving acupuncture treatment is said to provide a relaxing effect on the patient and helps to prepare him in a much better and calm way for the process ahead. Women are requested to have acupuncture treatment both before and after the embryo transfer. Usually a combination of herbal medicine, other medical practices and acupuncture, are found to yield the best results.  Patients are given acupuncture treatments until the very last week of their pregnancy to relieve their stress and to prevent miscarriage.

Pressure is also applied to specific points on the hands and feet to stimulate the ovaries, uterus, thyroid glands, pituitary and parathyroid glands to help balance the hormone production in the body. The spots where acupuncture treatment is given are identified with respect to the organ and a number assigned to them. The acupuncture points that are mostly used to provide relief during the preconception stage include the spleen (3), large intestine (11), triple warmer (7) and conception vessel (3).  Even liver 3, spleen 6 and stomach 36 are used to improve blood circulation and are regarded as important acupuncture points.

According to the five element theory in Asian Medicine, water element and the earth element cause infertility. The water element is present in the kidneys and the bladder and the earth element is present within the spleen and the stomach. This is the reason many acupuncture points are concentrated among these areas. There are several resources available for acupuncture treatment. There are people specializing in acupuncture treatment that we can consult for help and this can even be done at home. Acupuncture manuals and videos are widely available; it is an easy procedure to perform and can easily be done at home at your convenience. The effectiveness of acupuncture on infertility is not exactly determined to date and still being studied by researchers all over the world. Though the exact impact remains undetermined, acupuncture cannot be simply dismissed as many people have experienced good results and have conceived after receiving acupuncture treatment for a period of time.