Infertility

What is Infertility?

According to the Department of Health and Human Services, approximately ten to 15 percent (10-15%) of couples in the U.S. are dealing with infertility, meaning they have not conceived after at least one year of regular, unprotected sex.  Studies indicate that slightly over half of all cases of infertility are a result of female conditions, while the rest are caused by either sperm disorders or unidentified factors.

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What are the Causes of Female Infertility?

Most cases of female infertility revolve around problems producing eggs. Ovulation disorders, where the woman ovulates infrequently or not at all, account for infertility in about one quarter of couples. Here are the causes of most ovulation disorders:

Ovulation disorders:

Polycystic ovary syndrome (PCOS)

PCOS causes a hormone imbalance, which affects ovulation. You may also know PCOS for its ability to trigger abnormal hair growth on the face or body.

Hypothalamic dysfunction

Two hormones produced by the pituitary gland stimulate ovulation each month. Excess physical or emotional stress, a very high or very low body weight, or recent substantial weight gain or loss can disrupt production of these hormones and affect ovulation.

Premature ovarian failure

This is caused by an autoimmune response or by premature loss of eggs from your ovary. The ovary no longer produces eggs, and it lowers estrogen production in women under the age of 40.

Too much prolactin

If the pituitary gland produces too much prolactin this reduces estrogen production. This can be a side effect from medications.

Fallopian tube problems:

Damage or blocked fallopian tubes keep sperm from getting to the egg or block the passage of the fertilized egg into the uterus. These are some causes of fallopian tube blockage:

  • Pelvic inflammatory disease

    This is an infection of the uterus and fallopian tubes due to chlamydia, gonorrhea, or other sexually transmitted diseases.

  • Previous pelvic or abdominal surgery

    This includes surgery for an ectopic pregnancy, where a fertilized egg develops in the fallopian tube instead of the uterus.

  • Pelvic tuberculosis

    This isn’t common in the U.S., but it is a major cause of tubal infertility across the globe.

Endometriosis:

Endometriosis is the condition where tissue that normally grows in the uterus instead becomes implanted and grows in other locations. The growth of this extra tissue, and its surgical removal, can cause scarring that can block the fallopian tubes, or it can affect the lining of the uterus and disrupt its ability for the fertilized egg to become implanted.

“The most personable OBGYN I have encountered as soon as I was greeted by Dr. Rielly I knew this was the place for me. She is genuinely concerned with what is going on. Everyone at the clinic is very pleasant; I am a forever patient because of their dedication.” - K.F.

Uterine or Cervical Causes:

There are different problems with the uterus or cervix that can interfere with the ability for the fertilized egg to implant in the uterus, or simply increase the odds of miscarriage:

  • Benign polyps or tumors

    Common in the uterus, these growths can block the fallopian tubes or interfere with implantation.

  • Abnormal uterus

    Congenital issues, such as an abnormally shaped uterus, can impact fertility.

  • Cervical stenosis

    If the cervix is too narrow, this can contribute to infertility.

  • Mucus production

    Sometimes the cervix doesn’t produce the quality of mucus that aids the sperm as they travel through the cervix to the uterus.

Are there signs of infertility?

The main sign of symptom of infertility is a woman’s inability to get pregnant. In some cases, there are not any other signs or symptoms. But issues to watch for are a menstrual cycle that is too long (35 days or more), too short (less than 21 days), irregular, or absent. All of these can indicate that you are not ovulating.

“This is the nicest, most clean, most professional OBGYN office in The Woodlands. I have been a patient of Dr. Westmorelands for a few years now. Her nurses are so sweet and knowledgeable. The front office staff are so polite and friendly and Dr. Westmoreland is the best! She truly cares about every single patient. If you're nervous for anything you can put your faith in her! She takes the time to talk to you and you can just tell she genuinely cares about all her patients. I also had my blood work done several times by the same tech, and I actually really like her as well. She makes you feel comfortable and shes the sweetest. Trust is a big factor in any office visit, so I highly recommend this place.” - L.H.

Do infertile women still have periods?

Infertile women may or may not have periods. If a woman has irregular periods, they will still occur, but they vary greatly. An average cycle is 28 days, and anything within a few days of that is considered “normal.” But if those cycles begin to vary to the degree that the woman can’t predict when her next period will be, this is a sign of hormonal problems or PCOS.

Also, an infertile woman may have very painful, heavy periods. This is a sign of possible endometriosis.

Otherwise, a period of months without a period is a telltale sign of infertility that should be checked out.

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What treatments are used for infertility?

Treatments for female infertility vary widely depending upon the cause, your age, how long you’ve been infertile, and personal preferences. These can involve taking fertility drugs, surgery, or reproductive assistance.

Fertility drugs

Medication is used to regulate or stimulate ovulation. These drugs work like your natural hormones to trigger ovulation. In women who do ovulate, they work to stimulate a better egg or to produce an extra egg or eggs.

Surgical fertility restoration

Surgery can be used to correct abnormalities or otherwise improve infertility. These surgeries may seek to correct an abnormal uterine shape by removing endometrial polyps and fibroids. Tubal surgeries may seek to clear blocked fallopian tubes.

Reproductive assistance

Reproductive assistance has become quite successful, and this has led to less and less surgical interventions. These are the two most common methods:

Intrauterine insemination

Millions of healthy sperm are placed inside the uterus close to the time of ovulation.

Assisted reproductive technology

In vitro fertilization involves retrieving mature eggs from a woman, fertilizing them with a man’s sperm in a dish in a lab, and then transferring the embryos into the uterus after fertilization. In vitro fertilization is the most effective assisted reproductive technology.

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A formal evaluation of infertility is started by reviewing your history and performing an exam.  Various diagnostic tests, including blood tests, ultrasound, and semen analysis may be ordered.

Additional testing may include a hysterosalpingography (to check for blocked tubes) laparoscopy (to treat endometriosis and fibroids), or genetic testing to see if there may be a genetic element in play that is preventing pregnancy from occurring.

Treatment will be based on the findings of these test results.  If you’ve been struggling with getting pregnant, it’s time to talk with your doctor.

Please call the office directly for an appointment at 281-364-9898.

If you have United HealthCare we are sure you are aware that as of 01/01/2020 Methodist Hospital is no longer in Network.

Our United HealthCare contract is NOT affected by this. We are a private practice so this will not affect our ability to see you for your appointments.

All current OB patients please speak to our staff if you have not already done so.

We are still hopeful that UHC and Houston Methodist will work out the issues and come to an agreement soon!