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Infertility, experienced by 10-15% couples, is defined as the inability to conceive in a couple who has been doing unprotected intercourse for 1 year. This is based on the largest study which reported 85% pregnancy was conceived in the first year. The WHO and Maternal Health Task Force 2010 statistical data stated that there were approximately 50 million people with infertility, of which 37% was contributed by the female factor.
The study by National Survey of Family Growth which interviewed 12,000 women in the United States, the prevalence of infertility increases with age. In women age 15-34 years old, the infertility rate ranged between 7.3-9.1%. In women age 35-39 years old, the infertility rate increases to 25%. Lastly, women age 40-44 years old have 30% chances of infertility. Globally, 2% of women age 20-44 years old will never give birth and 11% will only give birth once.
Main Causes of Female Infertility
Anatomical and Pathological Conditions
In a cross country WHO study, the most commonly identified causes of female infertility are anatomical and pathological conditions such as:
- Ovulatory disorder 25%
- Endometriosis 15%
- Pelvis fibroids 12%
- Tubal obstruction 11%
- Tubal or uterus disorders 11%
- Hypoprolactinemia 7%
Those disorders can be diagnosed by supporting examinations to obtain accurate information on the condition of uterus, ovaries, and tuba prior to management.
Besides the causes mentioned, there are many other conditions affecting female infertility such as sexually transmitted diseases (chlamydia and gonorrhea) and other diseases like sickle cell anemia, HIV/AIDS, and kidney disease.
Body Weight
Lifestyle factors were found to be very important in female infertility cases. Underweight and undernutrition are correlated with ovary dysfunction and infertility. Meanwhile, in women with obesity and polycystic ovary syndrome (PCOS), reducing weight as much as 5% can improve ovulation and increase pregnancy opportunity.
Exercise
Excessive exercise is found to affect ovulation and fertility. Besides, some lifestyle and habits that might be contributing in female infertility cases are:
- Physical and psychological stress
- Exposure to toxins and pollution
- Drug use, smoking, and alcoholism
- Medications such as antidepressants, relaxants, calcium channel blocker, and anticancer agents.
Because there are many causes of infertility involving general health and lifestyle, during preliminary examination by the doctor, it is important to perform a thorough history taking for proper and suitable management.
Source:
- https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/causes/lifestyle#
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937760/
- https://www.ncbi.nlm.nih.gov/books/NBK556033/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937760/
