Endocrinology and Female Infertility

By Yemi Adesanya-Famuyiwa, MD

What Is Infertility and Why Is It a Concern?

Infertility is the inability of a sexually active couple, not using any contraception, to conceive during one year, the time in which about 90% of couples succeed. Over their lifetimes, approximately one in every five couples in the United States seek infertility care, resulting in more than two million office visits to health care providers each year. Just over half of all infertility is attributable to the female partner.

What Causes Female Infertility?

For pregnancy to occur, several things must happen: an egg must develop and ovulate properly each month, and a sperm must fertilize the ovulated egg. The resulting embryo must be transported to the uterus and implanted.

If any of these events does not occur or is disrupted, infertility will result. Some women are unable to produce eggs. Others produce eggs, but do not ovulate. In others, conception cannot occur due to blockage of the fallopian tubes, scarring of the uterus, or the inability to produce cervical mucous of sufficient quantity or quality. These problems account for just over half of all infertility.

How Is Female Infertility Treated?

Many treatments are available, depending on the cause of the infertility, and it is always important to investigate both partners. Fertility drugs, such as clomiphene citrate or recombinant human FSH (follicle stimulating hormone) may bring about ovulation in women. Insemination directly into the uterus can manage infertility related to problems in the cervical mucous. Blocked fallopian tubes can sometimes be surgically repaired. In-vitro fertilization, also called “test-tube baby” procedures, and related assisted reproductive technologies are the most dramatic treatments for female infertility. Although these techniques may be time-consuming and costly, they offer hope to many women who previously were unable to conceive.