Infertility in women

Infertility is a multidimensional global health issue that affects both developed and developing countries. There are so many different factors that influence fertility: from being born with reproductive dysfunctions to modern life and social context. The diagnosis of infertility impacts patients on a psychological level likewise, increasing the risk of developing depression and anxiety. Today we will be focusing on female infertility and share stories of women struggling with it. What is infertility, what causes it and how can it be treated? Let’s find out!

What is infertility?

Infertility is characterized by the inability to conceive after 12 months of regular unprotected intercourse in women before 35, and after 6 months for women after 35. Infertility can be classified as first infertility (difficulty to conceive) or second infertility (difficult to conceive the desired number of children).

Based on a study performed by the WHO (World Health Organization), female infertility is estimated to account for 37% in infertile couples, male infertility for 8%, and male and female infertility in the same couple for 35%.

Percentages and causes of infertility can differ by region and economical situation. 15% of the population in developed countries is struggling with infertility, while in developing countries the number can go as high as 30%. A study conducted between 1994-2000, shows the following percentages of secondary infertility in women aged 25-49 by region: Middle Africa (30%), South Asia (26%), USA (15%), Europe (15%), South America (14%). In developed countries, advanced age is the main responsible cause for infertility while in developing countries the main causes are sexually transmitted diseases.

Advanced age enormously affects the chances of conceiving. The chance of getting pregnant for a fertile woman is 20% per month and it decreases by age (with a significant drop after the age of 35). The period of time that it takes to conceive is associated with the increasing age of the couple. Studies show that women older than 35 years were 2 times more likely to get pregnant after 2 years of trying than women below 25.

What are the factors of female infertility?

Lifestyle factors

  1. Pregnancy at a later stage in life. The decision to get pregnant at a later stage in life, is influenced by the change of social and economic context, especially in developed countries. As women wish to pursue a career, be financially stable and independent before starting a family, the social and work environment context pushes them to decide between a career or having children at a suitable reproductive age. By the time these goals are achieved, women may be already in their 30s, when fertility is starting to drop. According to a study, the majority of people undergoing assisted reproduction programs had a high educational level and higher income.

  2. Low body weight. Low body weight disrupts the hormonal balance and ovulation with a negative impact on fertility.

  3. Obesity. Overweight and obese women have a higher risk of developing menstrual and conception dysfunctions. It is also associated with other conditions that can occur after pregnancy: gestational diabetes and hypertension.

  4. Smoking. Nicotine affects the function of the fallopian tube, preventing the transportation of the egg and the interaction with the sperm cell. Active as well as passive smokers are at a risk of developing ectopic pregnancies (pregnancy outside the uterus) and secondary infertility.

  5. Alcohol consumption. Alcohol is a teratogen (causes birth defects) if consumed during pregnancy. Moderate levels of consumption (around 7 drinks per week) has been linked to reduced infertility and miscarriages.

  6. Caffeine consumption in high quantities. Some studies suggest that for heavy consumers it is twice as hard to get pregnant and during pregnancy they are at risk of having miscarriages or give birth to babies with low weight. This effect is still controversial as other studies didn’t find any conclusive results.

  7. Psychological stress. Even though it is not completely proven, some studies suggest that a high level of stress might influence fertility negatively.

  8. Exposure to environmental pollutants and chemicals. Exposure to radiation and toxic substances can cause temporary or permanent infertility.

  9. Genital tract infections and sexually transmitted diseases (especially in developing countries).

  10. Cancer medicine. Annually, many children are diagnosed with cancer and their undergone treatment can have future consequences on their reproductive health. The fields of cancer and reproduction need to collaborate, in order to find ways to treat cancer and preserve fertility without affecting the survival chances.

  11. Use of oral contraceptives. Since the development in the 1960s of reliable contraceptive measures, women had the option to postpone their maternal plans. As a consequence of global use of oral contraceptives, a rapid decline in fertility happened. As the age of women to give birth increased so did the incidence of age-related infertility.