Infertility in woman

A compete medical history and physical examination is the first step undertaken to investigate the cause of infertility. Menstrual history, family history of infertility and sexual factors are examined. Blood and urine tests to determine hormonal levels, prolactin levels, hyperthyroidism and diabetes are taken to evaluate the possible causes of infertility. Hormonal imbalances are sometimes caused by pituitary gland tumors.

Blocked fallopian tubes do not allow the egg to travel to the uterus and can be a cause for infertility. One of the primary tests for detecting infertility in women is to check whether she is ovulating correctly. This can be done by monitoring body temperature and checking the texture of the cervical mucus.

Hysterosalpingogram: In this test for checking the infertility of women, an x-ray of the fallopian tubes and uterus is taken after they are injected with dye. The x-ray displays the shape of the uterus and the state of the fallopian tubes. This diagnostic test is also useful in diagnosing conditions such as endometrial polyps, fibroid tumors and structural abnormalities of the uterus or fallopian tubes.

Laparoscopy: This is a test for checking the fallopian tubes and other female reproductive organs for disease. Chromosomal tests are conducted to detect sperm abnormalities and other abnormal patterns in the man and woman.

• Age is a factor that reduces a woman's chances for fertility. Women above 35 years have decreasing fertility. The decreasing fertility can be on account of the higher rate of chromosomal damage that eggs undergo as time goes by.
  
• The amount of fat in a woman's body may have a bearing on her ability to conceive. Most of the estrogen in a woman's body is manufactured in her ovaries but some of it is produced in the fat cells. Too high or low weight levels can be a cause for infertility. Decreased body fat in marathon runners and those who indulge in heavy exercise may result in irregular menstrual cycles. Similarly women with eating disorders and restrictive diets can experience infertility. Disturbance in the estrogen balance can throw the reproductive cycle out of gear.
  
• Occupational and lifestyle factors also play no small role in the process of reproductive health. Exposure to high levels of chemicals and toxic substances, radiation and high temperatures can have a bearing on a woman's fertility. Women who smoke one or more packs a day or consume caffeine or alcohol in excess are at a risk of infertility.
  
• Pelvic Inflammatory Disease (PID) is a term that covers a gamut of infections affecting the reproductive organs of a woman. Infection in the fallopian tubes (salpingitis) is a common cause of infertility in women. Frequent bouts of infection can lead to tubal damage.
  
• Ovulation problems caused by hormonal disorders account for nearly a third of all problems of infertility in women. Resultant disorders could range from empty follicles or failure of the ovarian follicle to rupture. The hormonal rhythm is a delicate balance; a slight imbalance of which can cause ovulation disorders.
  
• Endometriosis is a situation when fragments of the endometrial lining are implanted in other areas of the pelvis leading to cysts that can result in infertility in women.
  
• Polycystic Ovarian Syndrome is a major cause of infertility in women in America. This is characterized by high levels of male hormones - androgen and testosterone. This results in inability to produce mature eggs and also manifests in symptoms such as acne and increased facial hair.
  
• Some women's bodies develop antibodies to sperm, which cause infertility and miscarriage. Adrenal or thyroid deficiencies can result in premature ovarian failure resulting in infertility.

Hysterectomy

Hysterectomy is the surgical removal of the uterus that can sometimes save the life of a woman. Hysterectomies are usually performed abdominally or vaginally. Laparoscopic hysterectomy is also performed in some cases.

Reasons for hysterectomy

Gynecological cancer: Cancer of the uterus or cervix usually necessitates removal of the uterus and cervix. Endometrial cancer, cancer of the uterus or cervix or fallopian tubes usually requires hysterectomy surgery.

Endometriosis: In some cases of severe bleeding following endometriosis, a hysterectomy surgery is advised. This is the second leading reason for hysterectomies.

Fibroids: While most fibroid tumors can be treated by non-surgical methods, hysterectomy surgery may be the only permanent solution.

Uterine prolapse: When the uterus moves from its usual place down into the vagina, it can affect other organs such as the bladder. This can happen due to childbirth, obesity, loss of estrogen after menopause and weak pelvic ligaments and tissues.

Other reasons for going for a hysterectomy surgery range from heavy or irregular menstrual periods to dysmenorrhea. Severe pelvic inflammatory disease can sometimes necessitate a hysterectomy.

Types of hysterectomy surgery

Total hysterectomy involves removal of the cervix and uterus. It is known as Oopherectomy. Partial hysterectomy is a surgical procedure to remove only the upper part of the uterus, leaving the cervix in place. This type of hysterectomy is referred to as supra cervical hysterectomy or subtotal hysterectomy. Radical hysterectomy involves removal of the uterus, cervix, upper part of the vagina and the supporting tissues.

Hysterectomy surgery performed prior to menopause can bring about severe and prolonged symptoms as compared to natural menopause. A woman can experience bone loss, loss of libido, depression and anxiety. Many women may need hormone replacement therapy (HRT) following total hysterectomy where the ovaries are removed before menopause.