Fertility Problems (Endometriosis, Fibroids, Blocked Fallopian Tubes, Male Factor Problems)

Infertility is defined as the inability to conceive after 12 months of unprotected intercourse, or the inability to carry pregnancies to a live birth. If you have been trying for 12 months or longer, or if you are over 35 years of age and have been trying for over 6 months despite the diagnosis of Polycystic Ovarian Syndrome….then it is recommended you and your partner be investigated for any problems that could be impacting on your chances of conceiving.

What Are The Possible Female Causes of infertility?

  1. Endometriosis: 1 in 10 women suffer from endometriosis, and most do not know they have it. Endometriosis is a condition where the lining of the uterus (endometrium) becomes implanted outside the uterus in areas on the fallopian tube, the ovaries, bowel, or tissue lining the pelvis. The main symptoms include heavy and prolonged periods, pain during the period and pain with sexual intercourse. It can also cause infertility. The gold standard for its diagnosis is a surgical procedure called a laparoscopy.  Click Here for more info on Endometriosis
  2. Uterine Fibroids: These are non-cancerous growths made up of muscle and fibrous tissue that form inside the uterus. It depends on their size and location in the uterus as to whether they can impact on a woman’s fertility. A pelvis ultrasound will diagnose the presence of fibroids.
  3. Endometrial Polyps: These are small growths arising from the ling of the uterus and are usually non cancerous. They are thought to affect fertility by acting like an intra-uterine contraceptive device (IUD) and prevent a fertilised egg called an embryo from implanting. A pelvis ultrasound will usually detect this. Treatment involves a simple day surgery procedure called a hysteroscopy.
  4. Blocked or damaged fallopian tubes: The fallopian tubes are important tubes arising from the uterus on either side. Their role is to pick up the ovulated egg and if sexual intercourse occurs around this fertile time, then the sperm should swim through the cervix to the fallopian tube and hopefully meet and fertilize the egg. If the fallopian tubes are blocked egg and sperm will not meet and therefore fertilisation cannot occur. Fertility testing for fallopian tubes can occur by the procedures HY-CO-SY or a Hystero-salpingogram (HSG), or with a laparoscopy.
  5. Declining Female Age: Age does have an effect on female fertility. Women are born with all the eggs they will ever produce. As we age our eggs decline in number, especially after the age of 38 years. By the time a woman is 40 years old her fertility is a quarter of when she was 30. The miscarriage rate increases with age as well.

What Are The Possible Male Infertility Causes?

  1. Low or no Sperm production:
  2. Sperm being obstructed from ejaculation; eg Vasectomy, or blocked Vas Deferens
  3. Poor Sperm Motility: sperm that don’t swim very well will therefore have a reduced likelihood of reaching and fertilising an egg in their partner.
  4. DNA Damage in the Sperm called oxidative stress resulting from factors such as injury, infection or smoking
  5. Presence of anti-sperm antibodies

A semen-analysis test allows us to look at the numbers of sperm, how the move, what their appearance is like, whether possible infection is present, and whether there are anti-sperm antibodies. This simple test can be performed in any andrology laboratory, speak to your family doctor about this.

Just to re-cap, if you are having trouble conceiving, there may be other reasons than just PCOS stopping you and your partner. If you are concerned be pro-active and see your doctor about having fertility investigations.