Infertility Factors
For various reasons, many women wait until they’re in their 30’s before starting a family. This society shift over the last few decades has lead to women having children later in life. Fertility declines with age and as strange as it may sound, a pregnancy in women over age 35 is called a ‘geriatric pregnancy.’
Infertility is defined as the inability to become pregnant after a year of unprotected sex. About 7% of married women aged 15 to 44 in the United States are unable to get pregnant after 1 year of trying. Women over 35 are advised to see a reproductive specialist after 6 months of trying. If you do the math it works out to about one opportunity per month (depending on menstrual cycle time frame) to become pregnant so you have six chances before it is suggested to see a specialist.
Sometimes women may feel more stress or that they have a short time line to work with. Health experts however, suggest this for two reasons. It gives reassurance to individuals having trouble becoming pregnant. Secondly it helps to identify individuals that have fertility issues so these couples can get help early in the process thus shortening the time for interventions/treatment options.
Female infertility causes include:
Ovulation disorders
These account for infertility in about 1 in 4 infertile couples, can be due to problems with the regulation of reproductive hormones by the hypothalamus or the pituitary gland, or problems in the ovary.
- Polycystic ovary syndrome (PCOS)
- PCOS causes a hormone imbalance, which affects ovulation. It is the most common cause of female infertility.
- Hypothalamic dysfunction
- Excess physical or emotional stress, high or low body weight or substantial weight gain/loss, can disrupt production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) which are produced in the pituitary gland.
- Premature ovarian failure
- Also called primary ovarian insufficiency, this disorder is usually caused by an autoimmune response or by premature loss of eggs from your ovary (possibly from genetics or chemotherapy). The ovary no longer produces eggs, and it lowers estrogen production in women under the age of 40.
- Too much prolactin
- The pituitary gland may cause excess production of prolactin (hyperprolactinemia), which reduces estrogen production and may cause infertility. Usually related to a pituitary gland problem, this can also be caused by medications you’re taking for another disease.
Damage to fallopian tubes (tubal infertility)
Causes of fallopian tube damage or blockage can include:
- Pelvic inflammatory disease, an infection of the uterus and fallopian tubes due to chlamydia, gonorrhea or other sexually transmitted infections
- Previous surgery in the abdomen or pelvis
- Pelvic tuberculosis, a major cause of tubal infertility worldwide, although uncommon in the United States
Endometriosis
Endometrial-like tissue, and the surgical removal of it, can cause scarring and adhesions. These fascia structures may block fallopian tubes and keep an egg and sperm from uniting. Endometriosis can also affect the lining of the uterus or damage the sperm or egg itself.
Uterine or cervical causes
Several uterine or cervical causes can impact fertility by interfering with implantation or increasing the likelihood of a miscarriage:
- Benign polyps or tumors (fibroids or myomas) are common in the uterus and can block fallopian tubes or interfere with implantation.
- Endometriosis scarring or inflammation within the uterus
- Uterine abnormalities present from birth, such as an abnormally shaped uterus
- Cervical stenosis, a narrowing of the cervix, can be caused by an inherited malformation or damage to the cervix.
- Sometimes the cervix can’t produce the best type of mucus to allow the sperm to travel through the cervix into the uterus.
Unexplained infertility
A combination of several minor factors in both partners could cause unexplained fertility problems. An estimated 18-28% of women with infertility are affected with no medical cause.
Difficulty Carrying Baby to Term
An estimated 10 to 18 percent of couples have trouble getting pregnant or having a successful delivery. Also, about 12% of women aged 15 to 44 have difficulty getting pregnant or carrying a pregnancy to term. Some individuals are able to become pregnant but are unable to carry to term. This results in miscarriages at various stages of the pregnancy which can be traumatizing. It may be a factor for some couples to give up completely. There are many mental health therapists available to help individuals through what can be a very difficult time.
Other Factors
Female infertility, male infertility or a combination of the two affects millions of couples in the United States. In about 35% of couples struggling with infertility, a male factor is found with or without a female factor. About a third of the time a male factor is found (with or without a female factor). Blame or fault is not always found in females as was previously believed. In about 8% of couples with infertility, a male factor is the only cause found. Check out updates on this topic in the coming weeks.
How Can PT Help?
Evaluation by a pelvic health physical therapist specialist can identify tight structures, adhesions or malalignment of the reproductive organs. Treatment techniques for infertility consists of manual techniques, such as visceral mobilization to free up the connective tissue surrounding the pelvic organs. This will help to improve the mobility of the reproductive organs and allow for better function. The physical therapists at Body Harmony will be able to identify the mechanical restrictions as well as evaluate other factors such a poor posture or muscle imbalances, to prevent recidivism occurring in the future.
References:
- https://www.mayoclinic.org/diseases-conditions/female-infertility/symptoms-causes/syc-20354308
- http://www.alternative-therapies.com/index.cfm/fuseaction/Content.Main/id/103/AmandaRice21-3
- https://www.cdc.gov/reproductivehealth/features/what-is-infertility/index.html
- https://www.apa.org/monitor/2018/05/pregnancy-loss
