Women's Day 2023: Infertile women are often subject to social stigma which negatively impacts their mental health. They are often targeted by their family members, which leads to emotional stress, anxiety, depression and low self-esteem.
However, infertility in women can be treated by stimulating ovulation with fertility drugs if they are infertile due to ovulation disorders, through intrauterine insemination, or surgeries if they suffer from uterine problems such as endometrial polyps, intrauterine scar tissue, or fibroids.
Laparoscopic or hysteroscopic surgery is used to correct problems with the uterine anatomy, or remove endometrial polyps or some types of fibroids, according to Mayo Clinic. Tubal surgeries are conducted to remove adhesions from fallopian tubes that are blocked or filled with fluid, to dilate a tube, or create a new tubal. However, tubal surgeries are rare.
Infertile women can also opt for assisted reproductive technologies (ART).
It is important for women to know the exact cause of infertility to decide the appropriate treatment.
Infertility can be prevented by identifying warning signs, if any, and through lifestyle changes.
Causes of infertility
According to experts, causes of infertility can be hormonal, anatomical or lifestyle-related.
“Causes of infertility can be anatomical, hormonal or lifestyle-related. These can be prevented by following a healthy lifestyle,” Dr Mithee Bhanot, Senior Consultant – Obstetrics And Gynaecology, Apollo 24|7, and Apollo Hospitals, Sector-26, Noida, tells ABP Live.
Some common causes of fertility include ovulation disorders, the production of too much prolactin, and polycystic ovary syndrome, a condition where the ovaries produce an abnormal amount of androgens or male sex hormones, is characterised by the formation of small cysts or fluid-filled sacs in the ovaries, rendering them unable to release eggs, and results in few, unusual or very long periods.
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“Causes of infertility include ovulation disorders, polycystic ovary syndrome, hypothalamic dysfunction, primary ovarian insufficiency, production of too much prolactin, pelvic inflammatory disease, and endometriosis,” Dr. Manju Wali, Senior Consultant – Obstetrics And Gynaecology, Max Super Speciality Hospital, Patparganj, tells ABP Live.
Anatomical causes of infertility include polycystic ovary syndrome; pelvic inflammatory disease, which is an infection of one or more of the upper reproductive organs, including the uterus, fallopian tubes and ovaries, and can lead to the development of scar tissue and abscesses in the reproductive tract; primary ovarian insufficiency, which occurs when the ovaries stop functioning normally before age 40, and do not produce typical amounts of the hormone oestrogen or release eggs regularly; and endometriosis, which is a disease characterised by the presence of tissue resembling endometrium (lining of the uterus) outside the uterus, and causes chronic inflammatory reaction that may result in the formation of scar tissue within the pelvis and other parts of the body.
Polycystic ovary syndrome and primary ovarian insufficiency can also be classified as hormonal causes of infertility because these disorders are associated with the production of abnormal amounts of male sex hormones and insufficient amounts of female sex organs, respectively.
Other hormonal causes of infertility include hypothalamic dysfunction, a problem with a part of the brain called the hypothalamus, that controls the pituitary gland, which in turn controls the ovaries; and the production of too much prolactin, which interferes with the normal production of other hormones such as oestrogen and progesterone, can change or stop ovulation, and lead to irregular or missed periods.
Lifestyle-related causes of infertility include obesity, insufficient exercise, environmental and occupational exposures, excessive consumption of alcohol, smoking, and illicit drug use, among others.
Scarring from surgery, cervical mucus problems, and fibroids are other causes of infertility.
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“Major causes of infertility among women are scarring from surgery, cervical mucus problems, fibroids, endometriosis, pelvic inflammatory disease, sterilisation, and medicines and drugs,” Dr. Akta Bajaj, Senior Consultant and Head – Obstetrics & Gynaecology, Ujala Cygnus Group of Hospitals, tells ABP Live.
Cervical mucus problems refer to abnormal cervical mucus that can prevent sperm from entering the uterus and may result in the formation of scar tissue in the cervix. Fibroids are non-cancerous growths of the uterus that often appear during childbearing years, and can be affected by the levels of oestrogen and progesterone. Fibroids are a hormonal as well as anatomical cause of infertility.
“Coital problem, tubal damage and uterine anomalies can lead to infertility,” Dr. Indrani Salunkhe, Gynaecologist, Wockhardt Hospitals, Mumbai Central, tells ABP Live.
Tubal damage, which refers to damage in the fallopian tube, and uterine anomalies, which refer to congenital malformations of the female reproductive tract, can lead to infertility. Tubal damage and uterine anomalies are some anatomical causes of infertility.
Primary and secondary infertility
Infertility can be main or secondary. A woman who is unable to conceive after having had at least one pregnancy is said to have secondary infertility, while a woman who has never been able to conceive is said to have primary infertility.
“Infertility in women can result from a variety of conditions that affect the ovaries, uterus, fallopian tubes, and hormonal system among others. You can have main or secondary infertility. An individual has secondary infertility if at least one previous pregnancy has been achieved, while primary infertility is when a pregnancy has never been achieved,” Dr Rashmi Baliyan, Consultant – Obstetrics & Gynaecology, Primus Super Speciality Hospital, tells ABP Live.
Warning signs of infertility
A woman may not ovulate if her menstrual cycle is too long, too short, irregular or absent, and these may be warning signs of infertility.
A menstrual cycle is said to be too long if it lasts 35 days or more, and too short if it lasts less than 21 days.
“The main symptom of infertility is the inability to get pregnant. A menstrual cycle that is too long (35 days or more), too short (less than 21 days), irregular or absent can mean that you're not ovulating,” says Dr Bajaj.
If a woman is suffering from hormonal problems, such as excessive hair growth, she should consult a doctor because this can be a warning sign for factors that can lead to infertility.
“Hormonal problems, such as changes in hair growth or sexual function, are some warning signs of infertility,” says Dr Wali.
How infertility can be prevented
Infertility can be prevented by reducing stress, quitting smoking and maintaining a healthy weight and lifestyle, and identifying the warning signs of infertility.
“Women can prevent infertility by quitting smoking, avoiding alcohol, reducing stress, maintaining a healthy weight and monitoring the glycemic index of the foods they consume,” says Dr Wali.
The glycemic index is a rating system for foods containing carbohydrates, and shows how quickly each food affects the blood glucose levels when that food is eaten on its own, according to the National Health Service (NHS).
Not only should women avoid alcohol during pregnancy, but also if they are planning to conceive.
“Women should avoid alcohol, and must not drink alcohol while they are pregnant, or if they are planning to become pregnant. In addition, they can reduce stress, as some studies have shown that stress can cause couples to have poorer results with infertility treatment. It is best to reduce stress in your life before trying to become pregnant,” says Dr Bajaj.
If a woman notices some warning signs of infertility, she must visit a gynaecologist at the earliest so that infertility can be prevented.
“Infertility can be prevented by an early visit to a gynaecologist, followed by a detailed physical and hormonal evaluation,” says Dr Salunkhe.
Reproductive healthcare is one of the most important rights for women, and something every woman should have access to. However, low- and middle-income countries often have poor or no access to reproductive healthcare.
“The prevention, diagnosis, and therapy of infertility are all included in fertility care. In the majority of nations, especially in low- and middle-income nations, obtaining equal and equitable access to reproductive healthcare remains difficult. Rarely do national universal health coverage benefit packages give priority to fertility treatment,” says Dr Baliyan.
Women’s Day messages from female doctors
It is crucial for women to give utmost importance to their health and accept themselves the way they are. Speaking to ABP Live, experts have encouraged women to love themselves and speak up against gender discrimination.
“As an important influencer of society, I would like to ask women to prioritise their health and also indulge in self love and care,” says Dr Salunkhe.
“You are complete however you are! A healthy woman leads to a healthy family and a healthy society,” says Dr Bhanot.
“Women's Day is an occasion to honour those who have been at the vanguard of the fight against gender discrimination and inequities in legal, civil, and human rights as well as those who have lost their lives or freedom in the process. It serves as a warning that we need to step up our efforts and mobilise our efforts to support the empowerment of women at all levels and across all spheres of society,” says Dr Baliyan.
“Women’s day is the celebration of the spirit of womanhood across the globe and acknowledgement of their contributions to society every day. My message on this day would be to encourage women to empower themselves with the knowledge to take care of their mental and physical well being and maintain work-life balance,” says Dr Bajaj.
“Women's Day is an opportunity to remember that gender equality is a human rights issue,” says Dr Wali.