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Conditions that cause infertility, and how to test for them.
As much as somebody can make positive lifestyle changes, there are some conditions that affect fertility that may mean medical assistance is needed:
Pelvic Inflammatory diseases (PID):
- An infection of the upper female genital tract, which includes the womb, fallopian tubes and ovaries.
- Caused by Sexually Transmitted diseases, such as chlamydia, it can lead to scarring and blockage of the tubes.
Polycystic Ovaries (PCOS):
- The most common of the ovulatory problems which affects how the ovaries work.
- This results in irregular periods, high levels of male hormones (signs include excess hair), and ovaries having many follicles that surround the eggs.
Endometriosis:
- A condition where small pieces of the womb lining (the endometrium) start to grow in other places, such as on the ovaries or fallopian tubes, resulting in scarring or damage.
Uterine Fibroids:
- Common non-cancerous growth in or around the womb. Depending on the location of the fibroid, it can have an impact on fertilisation and on the implantation of an embryo.
Endometrial polyps:
- Also known as uterine polyps, these are soft fleshy outgrowths from the lining of the womb. Polyps are very common but as they often protrude into the womb cavity, they can also have an impact on the implantation of an embryo.
Early menopause:
- 1% of women will experience premature ovarian failure (POF) before the age of 40. This is often hereditary, so it can be a good idea to find out when your mum or sister started their menopause.
Medications:
- This may come as a surprise but some over-the-counter medications can interfere with our body’s ability to conceive. For example, some allergy medication as it causes body mucus to dry up, skin creams and gels containing oestrogen and progesterone, and some herbal medications such as St John’s wort can damage your fertility.
- The long-term use or high doses of non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen or aspirin can also make it difficult to conceive.
- Chemotherapy medication can sometimes cause ovarian failure. In this scenario, it is best to speak with the oncologist regarding freezing eggs or embryos’ or with a fertility specialist prior to starting treatment.
Tests to check for these conditions:
If you have any concerns regarding the above conditions, it is best to speak to your GP, a gynaecologist, or a fertility specialist. There are a number of tests that can be performed such as:
- Hysterosalpingography (HSG) to check if the fallopian tubes are blocked by inserting dye via a catheter through the cervix.
- 3D Saline Infused Scan (SIS) is a scan where saline is placed into the uterine cavity via the cervix. This test is performed to check the womb for any fibroids or polyps.
- Antral Follicle Count scans combined with an Anti-Mullarian Hormone (AMH) blood test (not usually done by the GP), can give a good indication of somebody’s fertility status at that present time. High numbers can be indicative of PCOS and low numbers can be indicative of possible POF.
Many clinics also offer female, male or couple ‘Fertility One-Stops’/ MOT to ascertain their fertility status, with advice and guidance if needed for the next steps.
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