Did you know that a woman’s age is the leading cause of couples struggling to conceive? This is not the only reason that could be causing female infertility – the list of possible reasons could be extensive (from polycystic ovarian syndrome to tubal blockages).
If you’re having trouble conceiving, or you just want to get a better idea of your conception health, undergoing a fertility assessment at Create Fertility can help you take charge of your fertility journey.
For women, their fertility relies on the ovaries releasing healthy eggs. Multiple follicles (fluid-filled sacs) grow on the ovaries, which is where the eggs develop. The ovaries produce oestrogen as the eggs mature, the rising levels eventually helping to release an egg (ovulation). Progesterone then helps to prepare the lining of the uterus for the potential implantation of an embryo (or fertilised egg).
This whole process is known as the menstrual cycle. It’s counted from the first day of a woman’s period until the day before the start of her next period and can be split into four phases – menstruation, follicular phase, ovulation, and the luteal phase.
The average menstrual cycle length is 28 days, with ovulation occurring around day 14. It’s important to keep in mind that cycle length varies, so women with a shorter cycle will ovulate earlier, and those with a longer cycle will ovulate later.
Conception occurs when a sperm and egg successfully come together. During ovulation, the ovary releases an egg into the fallopian tube. It will only survive for 12 to 24 hours. If sperm are present at this time, the egg can be fertilised. As it continues along the fallopian tube to the uterus, the fertilised egg will begin to develop into an embryo. A few days after implantation in the uterus, the embryo will begin to produce human chorionic gonadotrophins (hCG) – the hormone that gives a positive pregnancy test.
There are many fertility tests that a specialist may perform to assess a woman’s reproductive health and identify any underlying causes for why she’s not falling pregnant (or able to hold onto a pregnancy). Depending on the results of initial tests, more testing may be required so that they can confirm a diagnosis and create a personalised care plan.
Genetic testing is recommended for both partners when struggling with conceiving naturally.
A doctor will ask questions about your lifestyle and medical history, including any medications you take or health conditions. They’ll also ask you details about your sex life (such as whether you’ve ever had an STI) and your period (such as whether you’ve been pregnant before). A cervical screening test may also be performed.
This is a simple blood test that can check whether or not you’re ovulating (producing an egg every month). It looks specifically at follicle-stimulating hormone (FSH) and luteinising hormone (LH), both of which stimulate the fertile growth of the follicle containing the egg. Your prolactin and androgen levels may also be measured.
Doctors use transvaginal or pelvic ultrasound scans to check the lining of your uterus (endometrium) for conditions that could cause infertility, such as fibroids or polyps and ovarian cysts. They will also check the size of your ovaries, whether you have any follicles, and how easy it would be to collect eggs.
Also known as the “ovarian reserve test”, this is a blood test that measures your anti-Mullerian hormone (AMH) and can provide a good estimate of how many eggs are left in the ovaries. As women age, their egg count and AMH levels naturally decrease.
Other hormones that may be looked at in blood tests include oestrogen, progesterone, and thyroid stimulating hormone (or TSH, which looks at your thyroid gland). A standard fertility panel may also be performed, which looks for the presence of cystic fibrosis, stag3, and MTHFR markers (to name a few).
These tests are more invasive yet may be advised. A laparoscopy involves two small incisions to view the ovaries, fallopian tubes, uterus, and pelvic cavity via a probe. A hysteroscopy is similar but instead looks for polyps, fibroids, adhesions, and abnormal anatomy.
Depending on the cause of female fertility challenges, different treatments may be appropriate. Surgery, for example, can be used to treat blocked or damaged fallopian tubes, as well as to remove growths (like fibroids or endometriosis). Fertility drugs, such as Clomid or follicle-stimulating hormone (FSH), can be used to correct hormonal imbalances or for ovulation induction. There are also ways to improve egg quality, such as avoiding caffeine and alcohol, maintaining a healthy weight, and exercising.
Assisted reproductive technology (ART) is used when there are no other options or when other treatments have failed. Intrauterine insemination (IUI) and in vitro fertilisation (IVF) are popular treatments when female infertility is the cause, but intracytoplasmic sperm injection (ICSI) and ovarian or uterine platelet-rich plasma (PRP) may also be used.
Your fertility specialist will advise you on the best care plan for realising your dream of starting a family.
Trying and failing to fall pregnant may cause a swell of emotions, from frustration to disappointment. With female factor infertility being the root cause for many couples struggling to have a baby, knowing where to turn for help can be a challenge.
If you suspect that you’re infertile or would like to undergo some testing to check your egg health, book an appointment with a fertility specialist at Create Fertility. Our friendly and compassionate team can take you through the process and help you take charge of your fertility health.
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