Infertility In Female

Infertility In Female​ is the inability to successfully carry a pregnancy after at least a year of regular, unprotected sex.

Infertility  is a widespread problem that impacted 48.5 million couples globally in 2010. Between 2015 and 2017, the prevalence of infertility among married women aged 15 to 49 in the United States was predicted to be 8.8% according to Centers for Disease Control and Prevention (CDC).

According to reports, there is a 22% prevalence of infertility in Pakistan, with 4% of those affected suffering from primary infertility.

Infertility In Female​

Infertility In Female​

The following are some important considerations that illustrate the significance of Infertility In Female​.

 Table Of Contents

  1.  Causes of infertility
  2. symptoms of infertility
  3. Risk Factors
  4. Diagnosis
  5. Treatment of infertility
  6. Diet and Fertility in Female
  7. Macronutrients
  8. Micronutrients
  9. Minerals
  10. References

Causes of infertility

There may be specific physiological causes for the infertility.

The following are a few causes of infertility:

  • Ovulation abnormalities
  • Endometriosis
  • Blockage or injury to the Fallopian Tube
  • Disorders of the uterus and cervix
  • Lifestyle and Environmental factor
causes of infertility

Symptoms of infertility

  • Inability to conceive
  • Abnormality in menstrual cycle e.long (35 days or more), short (less than 21 days),
  •  irregular, or nonexistent menstrual cycle

Risk Factors

  • BMI ≥ 30 mg/kg2
  • BMI ≤ 18 mg/kg2
  • Alcohol
  • Cigarette smoking
  • Recurrent sexually transmitted infections
  • Caffeine

Diagnosis

  • Ovulation testing
  • Ovarian reserve testing, which identifies the number of eggs accessible for ovulation
  • Imaging testing
  • Hysterosalpingography
  • Sonohysterogram
  • Hysteroscopy
  • Laparoscopy

Treatment of infertility

Some women need only one or two therapies to improve fertility. Other women may need several different types of treatment to achieve pregnancy.

  • Stimulating ovulation with fertility drugs
  • Intrauterine insemination (IUI)
  • Surgery to restore fertility

Diet and Fertility in Female

Ovulation abnormalities are linked to infertility, as are dairy products, iron, and multivitamins.

Ovulatory disorder may be avoided by adopting an overall dietary and lifestyle pattern that increases the consumption of micronutrients and improves insulin sensitivity by food composition change, weight management, and increased physical activity.

Anovulation risk is higher in females with a BMI under 20. Weight reduction and improved physical exercise may be beneficial for women who are overweight or obese since these conditions raise the risk of subfertility.

It has been shown that dietary modifications may reduce ovulatory problems and increase fertility.

fertility diet for women

Macronutrients

  • Carbohydrates and Dietary fibers   Carbohydrates and dietary fibers impact glucose homeostasis, insulin sensitivity and ovarian androgen production. In NHS-II, total carbohydrate consumption and glycemic load were linked to higher ovulatory infertility risks. Fiber-rich diets may reduce estrogen levels. Whole grains and their constituents, such as phytic acid, vitamins, and selenium have anti-oxidant and anti-inflammatory properties, potentially boosting fertility. Lingan, a hormonally active compound in whole grains, may exert reproductive benefits through progestogenic and anti-estrogenic effects.
  • Fatty Acids Fatty acids, including saturated (SFA), monounsaturated (MUFA) and polyunsaturated (PUFA), play crucial roles in reproductive function. They are essential for energy during oocyte maturation, embryo development, and implantation. Trans fatty acids increase insulin resistance and have a negative impact on ovulation. Higher omega-3, PUFA, and lower trans fatty acid intake may improve female fertility.
  • Protein Consuming animal protein, such as chicken and red meats, increases the risk of infertility due to anovulation. The vegetable protein has the opposite effect.The NHS-II study found no relation between total dairy intake and ovulatory infertility risk. However, anovulatory infertility was positively associated with low-fat dairy intake and inversely associated with high-fat dairy intake.

Micronutrients

  • Folic Acid Folate is crucial for DNA synthesis, gametogenesis, fertilization, and pregnancy. It plays a role in germ cell development and reproduction. The US Public Health Service and Centers for Disease Control and Prevention recommend 0.4–0.8 mg daily folic acid supplements for women of childbearing age to prevent neural tube defects. Multivitamin users have a one-third lower risk of developing ovulatory infertility compared to non-users.
  • Vitamin D deficiency in women can lead to infertility due to uterine hypoplasia, impaired follicular development, and anovulation. Vitamin D stimulates ovarian steroidogenesis, and follicular maturation, and regulates HOXA10 expression, which is crucial for uterine development and endometrial development. Low 25-hydroxyvitamin D levels are associated with obesity, metabolic, and endocrine disturbances in PCOS women. Vitamin D supplementation may improve menstrual frequency and metabolic disturbances.
  • Vitamin E Oocytes have vitamin E (-tocopherol) in their cell membranes, which acts as a first line of defense against oxidative stress by breaking the cycle of fatty acid peroxidation.

Minerals

  • Zinc Due to its anti-oxidant, anti-mutagenic, and DNA repair activity, it is useful in the treatment of idiopathic infertility, dysmenorrhea (25-50 mg/day).
  • Iron deficiency is linked to ovulatory infertility, which may be a problem for those trying to have a family. The incidence of ovulatory infertility was shown to be lower in women who used iron supplements (more than 18,000).
  • Selenium may also help maintain the health of follicular fluid surrounding women’s eggs.

References

  1. Ahmed HM, Khan M, Yasmin F, Jawaid H, Khalid H, Shigri A, Nawaz F, Hasan CA. Awareness regarding causes of infertility among out-patients at a tertiary care hospital in Karachi, Pakistan. Cureus. 2020 Apr;12(4).
  2. Simi MS, Nayaki KS, Parameswaran M, Sivadasan S. Exploring female infertility using predictive analytic. In2017 IEEE Global Humanitarian Technology Conference (GHTC) 2017 Oct 19 (pp. 1-6). IEEE.
  3. Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC. Diet and lifestyle in the prevention of ovulatory disorder infertility. Obstetrics & Gynecology. 2007 Nov 1;110(5):1050-1058.
  4. Chiu YH, Chavarro JE, Souter I. Diet and female fertility: doctor, what should I eat?. Fertility and sterility. 2018 Sep 1;110(4):560-569.
  5. Gaskins AJ, Chavarro JE. Diet and fertility: a review. American journal of obstetrics and gynecology. 2018 Apr 1;218(4):379-389.
  6. Lerchbaum E, Obermayer-Pietsch B. Vitamin D and fertility: a systematic review. Eur J Endocrinol. 2012 May 1;166(5):765-778.
  7. Agarwal A, Sengupta P, Durairajanayagam D. Role of L-carnitine in female infertility. Reproductive Biology and Endocrinology. 2018 Dec;16(1):1-8.
  8. Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC. Protein intake and ovulatory infertility. American journal of obstetrics and gynecology. 2008 Feb 1;198(2):210-e1.