Infertility in Women: Available Treatment and Complications
Dhanusha. B*
Department of Pharmacology, JNTU Kakinada, Andhra Pradesh, India
- *Corresponding Author:
- Dhanusha.B
B.Pharmacy; Sri Sai Aditya Institute of Pharmaceutical Sciences and Research
Kakinada, Andhra Pradesh, India
Tel: +917382 702269
E-mail: dhanusha.cr@gmail.com
Received date: 07 March 2015 Accepted date: 19 April 2015
Visit for more related articles at Research & Reviews: Journal of Medical and Health Sciences
Keywords
Hyaluronic acid, wound, inflammation, cosmetic.
Introduction
Infertility is the major problem being faced by about 20% of the married couple all over the world. The reason for infertility varies depending on the partners. In some cases problem might be in the woman and in some cases it might be in man. Some are curable while some cannot be set in right. Infertility is not only a problem it also disturbs ones mental strength and ability to cross the hurdle. Here I would like to discuss the infertility problems that a woman faces its treatments and complications. The paper also gives a brief on the procedures that are followed by most of the couples now-a-days. Infertility means the inability of conceiving in spite of their try to conceive from more than 1 year [1]. Women attains their puberty at the age of 14 years, women are born with a definite number of eggs called ovum. These ova are located in two pair of ovaries on the either side of the uterus in the pelvic region [2]. Every woman undergoes ovulation in the middle of their menstrual cycle [3]. Ovulation is the process of release of the fully matured ovum from the ovaries into the fallopian tubes [4]. Fallopian tubes are the two tubes that carries ovum from the ovaries to the uterus. Maximum fertilization occurs in the fallopian tubes. Every menstrual cycle may not be ovulatory cycle, sometimes ovum may not be released and such cycles are called as anovulatory cycles [5,6]. The percentage of ovulatory and anovulatory cycles changes the chance of fertility in the woman. Woman reaches the end of their fertile period at the age of 50-54 by menopause. Menopause is the cessation of menstrual cycles [7]. The chances of getting pregnancy decreases gradually 3-5% for every year from the age of 30 years. Female infertility may be due to following reasons [8-12].
1. Damage of the fallopian tubes, or blocked fallopian tubes: Damage of the fallopian tubes may affect fertilization of the egg with sperm. Pelvic infections, pelvic surgeries and other damages in the pelvic region may cause damage to fallopian tubes or blockage.
2. Hormonal imbalance: Hormonal imbalance may lead to changes in ovulation, thickness of endometrium, and changes in the release of other hormones that are responsible for maintaining uterus for the embryo deposition may lead to infertility.
3. Cervical problems: In some women sperm couldn’t pass through the cervix due to poor mucus formation or narrowness. This condition can be treated by intrauterine insemination.
4. Uterine problems: Formation of Fibroids, polyps and abnormal formation of endometrium in the uterus may affect the chances of fertilization.
5. Vitamin Deficiency: Vitamins like folic acid, B6 and B12 are very important for the women who are trying for pregnancy, deficiency of proper vitamins intake may also affect the process of fertilization.
6. Increase in the percentage of male sex hormones like Androgen, Testosterone in woman is a condition rare but possible cause for infertility [13].
7. Behavioural factors are also responsible for infertility, it is well known that certain personal habits, physical exercise, and lifestyle affects human health, in the same way usage of certain drugs, alcohol consumption, smoking, diet and physical activity determines the health and fertility of the woman [14,15].
Diagnosis
Infertility in woman can be diagnosed by several tests like blood test to check the hormonal percentages, endometrial biopsy, hysterosalpingography, and laparoscopy. Based on the results of these tests the chances of fertility in a woman can be determined [16-18].
Treatment
Fallopian blockade can be treated by hydrotubation, in which the lumps or blockage in the tubes will be cleared by forcing fluids through intravaginal route [19]. Laparoscopy is the process in which a small aperture is formed on the lower abdomen and by inserting one laparoscope cysts, polyps, fibroids, and other tumors can be removed [20]. To open blocked tubes, to remove fibroids and tumors of uterus hysteroscopy is performed, This process is also an intravaginal process [21]. In woman with narrow cervix or partner with oligospermia intrauterine insemination is done, with the means of one narrow catheter the sperm collected from the sex partner will be placed in the uterus of the woman at the time of ovulation with combination of drugs to enhance the ovulation process [22,23]. In vitro Fertilization (IVF) is a process which has been a miracle for the couple with no children, in this process the woman is given with gonadotropins that induces egg formation and the matured eggs are collected by means of a vaginal ultrasound probe. These eggs are placed in a petri dish and fertilized with the sperms that have been collected simultaneously from the sex partner. Fertilization and formation of embryo takes place in the petri dish, which will be transferred to the womb of woman by means of a catheter [24-28]. Multiple embryos are placed in one attempt, because the success rate of all the embryos is less and to make sure multiple embryos are placed [29].
i. Intracystoplasmic sperm injection (ICSI) is the process performed in sperm related infertility problem. The sperm collected from the partner will be directly ingested into the egg in a petri dish and the embryo will be placed in the uterus [30,31].
ii. Gamate intrafallopian tube transfer (GIFT) and Zygote intrafallopian tube transfer (ZIFT) are similar to IVF. Eggs and sperms are placed in the fallopian tubes in case of GIFT and zygote formed from fertilization is placed in the fallopian tubes in case of ZIFT [32,33]. For woman whose uterus is incapable of carrying the fetus or having incurable problem, surrogating is the only way to be a mother, in which the egg is collected from egg donor and it is fertilized with the partner’s sperm, the fertilized embryo will be placed in the womb of another woman who is capable and healthy. The woman who carries the fetus and not biological mother is known as surrogate [34,35].
Medication therapy is given for some woman who doesn’t have any major problem but faces problem with conceiving. The medication can be of multivitamins, or drugs that enhance ovulation or maintain hormonal balance. Medication will be commonly given to patients who are undergoing IVF, and other intrauterine procedures [36,37].
Complications
The range of complications varies from minor issues to severe health problems. Some of them are Ovarian Hyperstimulation Syndrome (OHSS), ectopic pregnancy, Pelvic infection, Multiple pregnancy, birth defects, congenital anomalies, miscarriage, pre-clampsia are the risks associated with Intrauterine treatments [38-40].
Conclusion
Every intrauterine treatment has its own risk factors, the intensity of the risk factors depends on the process and the physician. Every couple should think from every corner before selecting the physician and the procedure.
References
- Zaidi FF. Unexplained Subfertility. GynecolObstet (Sunnyvale). 2015;5:283.
- Kamal EM, Hafez AM. Effect of Uterine Flushing Leukemia Inhibitory Factor on Reproductive Outcome of Infertile Couple. GynecolObstet (Sunnyvale)2014;4:201.
- Guindia WE, Ellithyb A, Salem S, Badr I, Abdelsalam S, et al. The Role of 3-Dimensional Ultrasound for the Diagnosis of LPSVC and A Review of the Literature. GynecolObstet (Sunnyvale). 2014;4:202.
- Olugbenga Bello Adenike I, AdebimpeWasiu O, Olarewaju Sunday O, BabatundeOlaniyan A, OkeOlufemi S. Prevalence of Infertility and Acceptability of Assisted Reproductive Technology among Women Attending Gynecology Clinics in Tertiary Institutions in Southwestern Nigeria. GynecolObstet (Sunnyvale). 2014;4: 210.
- Machupalli S, Norkus EP, Mukherjee TK, Reilly KD. Abdominal Myomectomy Increases Fertility Outcome. Gynecol Obstet. 2013;3:144.
- Mohsen IA, Youssef MAFM, Elashmwi H, Darwish A, Mohesen MN, et al. Clomiphene Citrate plus Modified GnRH Antagonist Protocol for Women with Poor Ovarian Response Undergoing ICSI Treatment Cycles: Randomized Controlled Trial. Gynecol Obstet. 2013;3:158.
- Tulsiani DRP. Mechanisms of Mammalian Sperm-Egg Interaction Leading to Fertilization. Gynecol Obstet. 2012;2:e107.
- Theofilou P Infertility and Health Related Quality of Life. Gynecol Obstetric. 2012;2:e102.
- Osemwenkha AP, Osaikhuwuomwan JA. Correlation between Endometrial Thickness and IVF Outcome in an African Population. Gynecol Obstet. 2012;2:119.
- HachemLEl, Stein DE, Keltz MDM, Lederman MA. Ovarian Heterotopic Pregnancy after Ovulation Induction with Clomiphene Citrate. Gynecol Obstetric. 2011;1:107.
- Traub M. Has the Time come for Universal PGD with IVF? ReprodSyst Sex Disord. 2013; 3:e112.
- Mann M. Psychoanalytic Understanding of Repeated In-Vitro Fertilization Trials, Failures, and Repetition Compulsion. ReprodSyst Sex Disord. 2014;3:140.
- Wei S, Shi Z. Resolutions for Infertility-Far from Being Resolved. Reprod Sys Sexual Disorders. 2012;1:e104.
- Siristatidis C, Vogiatzi P, Varytimiadi A, Vrantza T, Iliodromiti Z, et al. Endometrium in Improving IVF Outcomes: Assessing its Behavior and Making an Ally from an Enemy. Reprod Sys Sexual Disorders. 2012;1:e105.
- Artini PG, Ruggiero M, Uccelli A, Obino ME, Cela V Fertility Management of Patients with Reduced Ovarian Reserve. Reprod Sys Sexual Disorders. 2013;S5:006.
- Kim CH. Strategies for Poor Responders in IVF Cycles. Reproductive Sys Sexual Disord. 2011;S5:001.
- Ooki S. Birth Defects after Assisted Reproductive Technology in Japan: Comparison between Multiples and Singletons, 2004-2009. Reprod Sys Sexual Disorders. 2012;S5:003.
- Lindenberg FB, Almind GJ, Lindenberg S. Low Ovarian Stimulation Using Tamoxifen/FSH Compared to Conventional IVF: A Cohort Comparative Study in Conventional IVF Treatments. Reprod Sys Sexual Disorders. 2013;S5:005.
- Gustin SLF, Lathi RB, Milki AA, Westphal LM. Frozen Blastocyst Transfer Has Similar Success Rates in Asian and Caucasian Patients. J Preg Child Health. 2014;1:122.
- Lucena E, Moreno-Ortiz H, Coral L, Lombana O, Moran A, et al. Unexplained Infertility Caused by a Latent but Serious Intruder: Trichomonasvaginalis? JFIV Reprod Med Genet. 2015;3:139.
- MarziehKargarJahromi, SomayehRamezanli. Coping with infertility: An Examination of Coping Mechanisms in Iranian Women with Infertility . J Psychiatry. 2015;18:188.
- Gustin SLF, Lathi RB, Milki AA, Westphal LM. Frozen Blastocyst Transfer Has Similar Success Rates in Asian and Caucasian Patients. J Preg Child Health. 2014;1:122.
- Manohar M, Khan H, Shukla V, Das V, Agarwal A, et al. Proteomic Identification and Analysis of Human Endometrial Proteins Associated with Unexplained Infertility. J Proteomics Bioinform. 2014;7: 359-366.
- Olarinoye AO, Oguntoyinbo WE. Is Hysterosalpingography Still Relevant in Workup of Infertility? A Review Article. J Women’s Health Care. 2014;3:176.
- Sahin AE, Cayir Y, Akcay F. Positive Effects of Acupuncture on Menstrual Irregularity and Infertility in a Patient with Polycystic Ovary Syndrome. Fam Med MedSci Res. 2014;3:121.
- Pieta W, Wilczynska A, Radowicki S. Hydrolaparoscopy - as an Alternative Method after a Failure of the Pharmacological Therapy for PCOS Induced Infertility. GynecolObstet (Sunnyvale). 2014;4:222.
- Yenkie KM, Diwekar UM, Bhalerao V. Modeling and Prediction of Outcome for the Superovulation Stage in In-Vitro Fertilization (IVF). JFIV Reprod Med Genet. 2014;2:122.
- Olugbenga Bello Adenike I, AdebimpeWasiu O, Olarewaju Sunday O, BabatundeOlaniyan A, OkeOlufemi S. Prevalence of Infertility and Acceptability of Assisted Reproductive Technology among Women Attending Gynecology Clinics in Tertiary Institutions in Southwestern Nigeria. GynecolObstet (Sunnyvale). 2014;4: 210.
- Pan XP, Zhang YP, Hu YC. Clinical Research for the Treatment of Tubal Obstructive Infertility by Fallopian Tube Recanalization Combined with Traditional Chinese Medicine. J Med Diagn Meth. 2013;2:143.
- Yegezu RT, Kitila SB. Assessment of Factors Affecting Choice of Delivery Place among Pregnant Women in Jimma Zone, South West Ethiopia: Cross Sectional Study. J Women’s Health Care. 2015;4:211.
- Gavin R Armstrong and Alastair JS Summerlee. The Etiology, Treatment and Effective Prevention of Iron Deficiency and Iron Deficiency Anemia in Women and Young Children Worldwide: A Review. J Women’s Health Care. 2014;4:213.
- Taye A, Woldie M, Sinaga M. Predictors of Long Acting Reversible Contraceptive use among Married Women Visiting Health Facilities in Jimma Town. J Women’s Health Care. 2015;4:217.
- Yoshimitsu A, Sriareporn P, Upalabut S, Khiaokham P, Matsuo H. Current State of College Women’s Coping Behaviors against Peri-menstrual Symptoms and Educational Challenges in Thailand . J Women's Health Care. 2015;4:218.
- Hurissa BF, Tebeje B, Megersa H. Prevalence of Pre-marital Sexual Practices and Associated Factors among Jimma Teacher Training College Students in Jimma Town, South West Shoa Zone, Oromiya Region, Ethiopia-2013. J Women’s Health Care. 2015;4:221.
- Dossett EC, Shoemaker EZ, Nasatir-Hilty SE, Daly JP, Hilty DM. Integrated Care for Women, Mothers, Children and Newborns: Approaches and Models for Mental Health, Pediatric and Prenatal Care Settings. J Women’s Health Care. 2015;4:223.
- Kalampokas T, Shetty A, Maheswari A. Vitamin A Deficiency and Female Fertility Problems: A Case Report and Mini Review of the Literature. J Women’s Health Care. 2014;3:317.
- Zongo A, Kouanda S, Fournier P, Traore M, Sondo B, et al. Trends in Institutional Caesarean Delivery among Low-Risk Patients in Senegal and Mali: Secondary Analysis of a Cluster-Randomized Trial (Quarite). J Women’s Health Care. 2014;3:192.
- Olarinoye AO, Oguntoyinbo WE. Is Hysterosalpingography Still Relevant in Workup of Infertility? A Review Article. J Women’s Health Care. 2014;3:176.
- Wesley Y, Parello CAK, Campbell M. Correlates of Loneliness among Adults of Childbearing Age. J Women’s Health Care. 2014;3:166.
- Twarozek AM, Eggert T, Puca ZG, DuPont N, Erwin DO, et al. Promoting Tobacco Cessation in a Community-Based Women’s Health Centre. J Women’s Health Care. 2015;4:225