Female infertility

AGE

Although the direct relationship between a woman's age and fertility is generally well known, women still postpone their motherhood to later years. Age is an important factor that affects female fertility. Optimal fertile time is between the ages of 20 and 30. Age 25 seems to be the most optimal. Reproductive ability slowly decreases after age 30 and starts to decline rapidly around age 35.

About 10–15 years prior to the onset of menopause, the decrease in the number of follicles in the ovaries gradually accelerates. At the same time, the levels of follicle growth-stimulating hormone (FSH) is increasing. These changes are both reflected in the lower quality and potency of the follicles, leading to decreased egg production. The decrease affects not only the number of eggs in the ovaries but also their quality and suitability for fertilization. There are also changes in the menstrual cycle. The cycle can remain regular, but the first, follicular phase, during which the follicle with the egg cell matures, shortens over time.

Several various complications affecting female fertility occur more frequently with age – the number of menstrual cycles with ovulation decreases, more uterine abnormalities (myomas, changes in the vascular system, endometrial pathologies, etc.) occur, sexual activity declines, and spontaneous miscarriages occur more frequently.

From all couples around 30 years of age, about 7% are infertile; from all couples around 40 years of age, about 33% are infertile. Over 64% of all women older than 45 are infertile. The success of artificial insemination (IVF) also declines with increasing age.

Only 28% of women after age 40 and 9.6% of all women older than 43 give birth after one or more IVF attempt. At the age of 40-43 years, the success rate of 1 IVF attempt is between 5-10%. To this day, there are no published studies documenting pregnancy after IVF with self-oocytes in women over 46 years of age. These women are only able to conceive by using donated eggs.

Female infertility can also be caused by:

TUBULAR FACTOR

Pathological changes in the fallopian tubes and ovaries can also be the cause of female infertility.

OVULATION DISORDERS

One of the causes of female infertility can be ovulation disorders, which can occur for various reasons. These reasons may not all occur but may combine.

ENDOMETRIOSIS

Endometriosis is a disease in which some parts of the endometrium can be found outside the uterine cavity. Symptoms include painful menstrual bleeding, prolonged pain in the lower abdomen, painful sexual intercourse, and fertility problems. Endometriosis is the most frequent gynecological disorder during a female reproductive age. It is seen in 20 - 50% of infertile women and in 50% of women with pelvic pain.

POLYCYSTIC OVARY SYNDROM (PCOS)

One of the main diagnostic criteria for polycystic ovary syndrome is the chronic absence of ovulation or a menstrual cycle disorder.