The female causes contribute to infertility in about 45$ of couples. Two possible, well known causes include Endometriosis and Polycystic Ovarian Syndrome (PCOS).


What is Endometriosis?

Endometriosis is a common disease in which the tissue that is similar to the lining of the womb grows outside the uterus in other parts of the body.

Endometriosis commonly occurs within the ovaries, fallopian tubes and the tissue lining your pelvis. In some rare instances, the endometrial tissue may spread beyond the pelvic organs.

With endometriosis, the endometrial-like tissue acts as endometrial tissue would — it thickens, breaks down and bleeds with each menstrual cycle. This endometrial-like tissue, however, has no way of leaving your body and becomes trapped.

When endometriosis involves the ovaries, cysts called endometriomas may form. The surrounding tissue becomes irritated, eventually developing scar tissue and adhesions — abnormal bands of fibrous tissue that can cause pelvic tissues and organs to stick to each other.

Endometriosis causes pain – sometimes severe- especially during menstrual periods. While endometriosis can cause fertility problems, this is not always the case. Fortunately, there are effective treatments available to assist individuals with this condition.

How is Endometriosis diagnosed?

To diagnose endometriosis and other conditions that can cause pelvic pain, your doctor will ask you to describe your symptoms, including the location of your pain and when it occurs. You may also be asked to do further examinations or scans. These can include:

What are my treatment options?

Treatment for endometriosis usually involves medication or surgery. The approach you and your doctor choose will depend on how severe your signs and symptoms are and whether you hope to become pregnant. Doctors typically recommend trying conservative treatment approaches first, opting for surgery if initial treatment fails.

Pain medication

Your doctor may recommend that you take nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to help ease painful menstrual cramps. You may also be recommended hormone therapy in conjunction with pain medication if you’re not trying to get pregnant.

Hormone therapy

Hormone medication may slow endometrial tissue growth and prevent endometrial tissue from implanting in new areas within the pelvis.

Polycystic Ovarian Syndrome (PCOS)

What is PCOS?

PCOS is a common hormonal condition that can make falling pregnant more difficult. PCOS affects approximately 12-21% of women of reproductive age and is a combination of having polycystic ovaries (as diagnosed on an ultrasound scan) with hormone imbalance such as irregular periods or male hormone side effects such as abnormal hair growth, acne, or weight gain.

What are Polycystic ovaries?

Polycystic ovaries refer to the condition where many small cysts are present on the ovaries. The name “polycystic”, however, can be misleading as rather than multiple cysts, these sacs are small immature follicles that contain many eggs.

Rather than maturing and releasing an egg, however, these follicles cause irregular or absent periods which result in infertility.

Several factors may influence the onset of PCOS, including genetics, insulin resistance, and higher levels of inflammation in the body.

Higher levels of androgens, or ‘male hormones’, are present in women with PCOS. These high amounts of hormones can prevent ovaries from releasing an egg during each menstrual cycle and is the cause of extra hair growth and acne.

Higher levels of insulin are also present in women with PCOS. This is due to insulin resistance – a condition where the body does not respond to the insulin hormone and does not convert glucose into energy.

PCOS makes it harder to conceive due to lack of ovulation. Some women may occasionally ovulate and some women may not ovulate at all. If your periods are far apart or non-existent, you are probably not ovulating and therefore have little chance of conceiving without treatment.

How do I test for PCOS?

Testing for PCOS can include an ultrasound scan, which can show the presence of many small follicles.

Blood tests can confirm hormone irregularities, with higher levels of testosterone and lutenising hormone (LH) (often in conjunction with a higher LH to FSH ratio), than women with normal cycles. These levels can vary considerably and are often assessed on day 2 of the menstrual cycle. Blood tests may also indicate a change in blood glucose and insulin levels.

What are the fertility treatment options for PCOS?

There are a number of options available:

IVF treatment may sometimes be necessary but is not always required.

What Next?

If you know or suspect that you have PCOS and have been trying to conceive for more than 12 months, please call 08 9382 2388 or obtain a referral to one of our fertility specialists.

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