Primary infertility is the inability to conceive a child after regular intercourse for at least one year. Secondary infertility is defined as the inability to achieve a second pregnancy. Women and men are equally affected here.

For woman’s fertility, her reproductive organs must be healthy and functional. The causes of infertility in women may be physical or emotional. Healthy egg and sperm must be there in the fallopian tubes for a possible union to conceive a child.

The causes of female infertility include:

• Ovulation disorders
• Fallopian tube problems
• Endometriosis
• Cysts in the ovary
• Pelvic infection
• Poor nutrition
• Sexually transmitted diseases
• Egg quality
• Hormone imbalance
• Tumour
• Uterine problems
• Fibroids – tumour in the uterus
• Polycystic ovarian syndrome
• Life style – smoking, alcohol and drugs abuse
• age

The failure to produce ripe eggs is the most common cause of female infertility. Excessive weight loss, stress, even slight hormone imbalances, thyroid problems. Irregular menstrual periods or no periods are the signs of this problem.

Inflammation or any other of the fallopian tube makes it blocked and the egg cannot move from ovary to the uterus.

Endometriosis is a condition when the tissue of the uterine lining grows excessively outside the ovaries or in the lining of the abdomen near uterus and fallopian tubes. This can prevent the period and inflammation is the result. Women with endometriosis have usually pelvic pain and infertility. Other symptoms are painful menstrual cramps, pain during sexual intercourse, heavy bleeding and unusual spotting.

Ovarian cysts may indicate advanced endometriosis and it affects fertility.

Excess androgen hormone production can produce many tiny cysts in the ovaries which prevent the production of mature egg. Here the symptoms include acne, irregular or absent periods and weight gain.

A woman’s peak fertility is in her early 20s. After the age of 35 the ability to produce eggs declines. After the age of 40, the chance of conceiving decreases.

Life style must be changed first with healthy food and less stress. There must be enough physical activity.

With personal interviews of both partners taking into consideration of the health history, sexual habits and menstrual cycle your doctor has to diagnose infertility.

Measurement of basal body temperature each morning over months is important to know exactly about ovulation.

Along with normal blood parameters the levels of the hormones luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, 17beta-estradiol and progesterone should also be estimated.

Fertility drugs and surgery are the possible treatments apart from other techniques.

Multiple pregnancy, low birth weight, birth defects, infection, bleeding and enlarged ovaries may be the possible complications.

Next: The role of food in fertility