Getting Pregnant: Fertility:pregnancy
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Tubal disease affects approximately 25% of infertile couples and varies widely, ranging from mild adhesions to complete tubal blockage. Treatment for tubal disease is most commonly surgery and, owing to the advances in microsurgery and lasers, success rates (defined as the number of women who become pregnant within one year of surgery) are as high as 30% overall,
with certain procedures having success rates up to 65%. The main causes of tubal damage include:
Caused by both bacteria and viruses and usually transmitted sexually, these infections commonly cause inflammation
resulting in scarring and damage. A specific example is Hydrosalpnix, a condition in which the fallopian tube is occluded at
both ends and fluid collects in the tube.
(2) Abdominal Diseases
The most common of these are appendicitis and colitis, causing inflammation of the abdominal cavity which can affect the
fallopian tubes and lead to scarring and blockage.
(3) Previous Surgeries
This is an important cause of tubal disease and damage. Pelvic or abdominal surgery can result in adhesions that alter the
tubes in such a way that eggs cannot travel through them.
(4) Ectopic Pregnancy
This is a pregnancy that occurs in the tube itself and, even if carefully and successfully overcome, may cause tubal damage
and is a potentially life-threatening condition.
(5) Congenital Defects
In rare cases, women may be born with tubal abnormalities, usually associated with uterus irregularities.
Approximately 10% of infertile couples are affected by endometriosis. Endometriosis affects five million US women, 6-7% of all females. In fact, 30-40% of patients with endometriosis are infertile. This is two to three times the rate of infertility in the general population. For women with endometriosis, the monthly fecundity (chance of getting pregnant) diminishes by 12 to 36%.
This condition is characterized by excessive growth of the lining of the uterus, called the endometrium. Growth occurs not only in the uterus but also elsewhere in the abdomen, such as in the fallopian tubes, ovaries and the pelvic peritoneum. A positive diagnosis can only be made by diagnostic laparoscopy, a test that allows the physician to view the uterus, fallopian tubes, and pelvic cavity directly.
The symptoms often associated with endometriosis include heavy, painful and long menstrual periods, urinary urgency, rectal bleeding and premenstrual spotting. Sometimes, however, there are no symptoms at all, owing to the fact that there is no correlation between the extent of the disease and the severity of the symptoms.
The long term cumulative pregnancy rates are normal in patients with minimal endometriosis and normal anatomy. Current studies demonstrate that pregnancy rates are not improved by treating minimal endometriosis.
(1) Other variables that may cause infertility in women:
At least 10% of all cases of female infertility are caused by an abnormal uterus. Conditions such as fibroid, polyps, and adenomyosis may lead to obstruction of the uterus and Fallopian tubes.
Congenital abnormalities, such as septate uterus, may lead to recurrent miscarriages or the inability to conceive.
Approximately 3% of couples face infertility due to problems with the femaleís cervical mucus. The mucus needs to be of a certain consistency and available in adequate amounts for sperm to swim easily within it. The most common
reason for abnormal cervical mucus is a hormone imbalance, namely too little estrogen or too much progesterone.
NEXT: Lifestyle Factors That Impact Female Fertility
Fallopian Tube Problems and Female Infertility
Endometriosis and Female Infertility
Additional Physiological Factors Affecting Female Fertility