Female Infertility Literature Review: Symptoms, Causes, and Treatments

This literature review provides an in-depth analysis of female infertility, encompassing its various types, causes, and associated symptoms. The review explores the impact of age, lifestyle changes, and medical conditions such as Pelvic Inflammatory Disease (PID), ovarian cysts, and Polycystic Ovarian Syndrome (PCOS) on female fertility. It details common symptoms, including menstrual irregularities, miscarriages, and hormonal imbalances. Furthermore, the review examines various treatment options, including fertility drugs, surgical interventions, and in vitro fertilization (IVF). Statistical data and the impact of sexually transmitted diseases (STDs), autoimmune disorders, and certain medications are also discussed. The paper emphasizes the importance of early diagnosis and treatment for managing and potentially overcoming infertility challenges.

Running Head: FEMALE INFERTILITY
FEMALE INFERTILITY
Literature Review
Name of the Student
Name of the University
Author Note

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Table of Contents
Introduction................................................................................................................................2
Discussion..................................................................................................................................2
Types of Infertility.................................................................................................................2
Causes of Female Infertility...................................................................................................3
Symptoms of Female Infertility.............................................................................................5
Treatment of Female Infertility..............................................................................................7
Statistical Data of Female Infertility......................................................................................8
Summary....................................................................................................................................9
References................................................................................................................................10

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Introduction
Female Infertility is one of the rising issues across the globe. Infertility can be defined
as the decreasing tendency to have a child or to get pregnant. In most of the circumstances, it
has been observed that female Infertility leads to a problem during the production of eggs.
Throughout the time of pregnancy, if a woman suffers miscarriages quite frequently, then it is
a clear sign of Infertility. There are numerous factors, which influence the matter such as
physical issues, hormonal imbalance, lifestyle change, environmental elements and age. In
most of the cases, the root cause of Infertility is found in women, whereas in minimal cases,
the causes are established in men (Medlineplus.gov, 2017). Most of the women become a
victim of reduced fertility after the age of 40, but in many circumstances, women undergo
Infertility before the age of 40, which is termed as Premature Ovarian Failure. It usually
occurs when the ovaries stop working at an early age. Irregular menstrual is an early
symptom of Infertility. Certain internal complications such as difficulties with the fallopian
tube or with the uterus can also be a rising cause to Infertility. Too much consumption of
contraceptive pills can also lead to Infertility, and it can be a lifetime complication. Women
should also be aware of their medical history because it has been observed in a few cases that
women recovered from diseases like cancer can be a prey of Infertility (Hanson et al., 2017).
Fertility treatment can be useful to those women who had complications with ovulations.
Discussion
Types of Infertility
Infertility can be classified into two categories:

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Primary Infertility can be defined as a woman unable to get pregnant after several
physical interactions. A lifetime complication cannot be diagnosed after treatment
(Medlineplus.gov, 2019).
Secondary Infertility can be termed as a woman getting pregnant only once in a lifetime.
A lifetime complication that occurs after a certain period (Effectivehealthcare.ahrq.gov,
2016).
Causes of Female Infertility
Female Infertility, which can also be termed as female reproductive syndromes. There
are numerous factors responsible for such a disorder, and few of them are listed below.
Age is one of the most substantial aspect influencings of a woman's fertility. During the
time of birth, females ought to born with a specific number of eggs, and it gets affected while
ageing. The fertility of a woman starts to decay at the age of 30, and within the age of 35, it is
dropped by 40%. At age 40, it is further declined (nichd.nih.gov/, 2017). There looks to be an
absence of acknowledgement of the effect that age has on concerns of fertility.
Change of lifestyle is also one of the reasons that influence female Infertility. Too much
consumption of Junk Food, addicted to alcohol and smoking, poor nutrition, obesity and
excessive physical activities are some of the reasons that affect fertility.
Pelvic Inflammatory Disease (PID) that affects the reproductive organs because of
infection, comprising sexually transmitted diseases. Like an infection, the indications are
likely to be fever or pain in the affected part and leukorrhea, which is white vaginal discharge
(womenshealth.gov, 2019). If it remains untreated, there could be a development of swelling,
which may lead to blood poisoning because the infectious bacteria could enter the
bloodstream. Such infections might cause severe damage, and it could further lead towards
Infertility.

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Ovarian cysts or tumour could be a reason behind female Infertility. Such complications
could lead to severe pain and swelling. At the initial stage, there could be a minor pain in the
pelvis or lower back, but one should not ignore such pain. Treatment of the tumour
completely depends on its size and structure. If not treated early, it may grow up in the form
of an orange and can cause twisting of the ovary (womenshealth.gov, 2019). It has also been
observed that severe pain lower down the abdomen can lead to repeated vomiting.
Polycystic Ovarian Syndrome is a phenomenon caused due to imbalance of hormone that
leads to irregular menstrual or ovulation stages. This is the most common reason for
Infertility when ovulation is not released. The reason behind such a phenomenon is due to the
existence of cysts on the external areas of the ovaries. Women with Polycystic Ovarian
Syndrome also suffer from other symptoms such as irregular menstrual cycles, excessive
weight gain near the tummy, facial hairs and baldness. Around 30% of the women suffering
from Infertility is due to Polycystic Ovarian Syndrome (Womhealth.org.au, n.d.).
Sexually Transmitted Diseases are one the rising cause behind the women infertility. The
diseases mainly target the tissues and organs of the reproductive system. In certain cases,
women suffering from chlamydia do not find any symptom, but if it remains untreated, then it
can cause a major threat to her life. The diseases can be termed as Pelvic Inflammatory
Diseases; it mainly targets the fallopian tube and makes it narrow, which blocks the path of
an egg (Medlineplus.gov, 2017). In severe cases, if the egg is trapped in the blocked path,
then it can cause severe pain and requires instant medical help. If a woman undergoes
treatment of STD for more than two times in her lifetime, then it can cause permanent
Infertility.
Complications inside the cervix or uterus could also damage fertility. Cervical disturbance
or the absence of cervical mucus frequently create it tougher for sperm to pass through the

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cervix and get into the uterus (my.clevelandclinic.org, 2019). Uterine fibroids or an irregularly
shaped uterus might interfere by means of conception as well.
Cancer and its treatment can also cause the female to be infertile at a certain period. The
radiation therapy and chemotherapy could lead to permanent damage to the female
reproductive organs over the long term (Cetin, Cozzi & Antonazzo, 2008).
Autoimmune disorders that impact the immune system of a woman is also a major cause
behind female Infertility. As per the observation, due to a weak immune system, women suffer
from numerous diseases and infections that affect the reproductive system as well (Carp,
Selmi & Shoenfeld, 2012). At a time, they find it quite troublesome to be healed up, which
influence their fertility and damages it for the long term.
There is a list of drugs that can cause Infertility, and most of the women do not have clear
transparency of drugs they consume during their illness, such as Misoprostol, Retinoids,
Methotrexate and painkillers including ibuprofen can cause serious and long term female
infertility (Bord et al., 2014). It is always recommended to have clear transparency of drugs
they consume and its impacts in their body.
Symptoms of Female Infertility
Miscarriage is one of the major symptoms that a woman experiences. If a miscarriage is
frequent and happens in the early stage of pregnancy, then it is a high indication that the
woman is suffering from female Infertility. There are various reasons behind miscarriage
such as it could be a genetic factor, excessive discharge of fluid, abdominal cramps or pain
and complications with the uterus. In few cases, it can be cured with the help of medicines or
doctors prefer to use dilatation and curettage, which is a surgical process to remove the thin
lining of the uterus (nichd.nih.gov/, 2017). Most of the miscarriages occur due to
abnormalities in chromosomes, but along with that a damaged sperm or an egg could also

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lead to miscarriage. A blighted ovum is one such condition where there is no formation of the
embryo, whereas, in case of Molar Pregnancy, the father delivers both the groups of
chromosomes but leads to no growth of a foetus (Chaudhry & Siccardi, 2019). Lastly, in case
of Partial Molar Pregnancy, the genes from the mother persist; but along with that, the father
correspondingly delivers both the sets of chromosomes, and it leads to the development of an
uncharacteristic fetus.
Complications or irregularity in the menstrual cycle is also a major symptom indicating
female Infertility. However, it can be cured with proper medications if treated at an early
stage (womenshealth.gov, 2018). There can be numerous factors that affect the menstrual
cycle, such as ovarian cysts, bleeding disorders during menstruation, thyroid problems, issues
during ovulation and negative impacts of certain drugs (Medlineplus.gov, 2019).
Hormonal disproportion is an early symptom of female Infertility. A female body shows
some of the indications such as facial hairs, baldness, weight gain or fatigue. These are some
of the self-dependent concerns that could be cured properly (Seth, Arora & Singh, 2013). If
neglected or remain untreated, then it can lead to a major life frightening difficulty.
Long-lasting pelvic pain is an utmost important symptom that occurs suddenly. A pain
that occurs below the abdomen cannot be neglected; it may be due to blockage of the
fallopian tube or some other chronic diseases. However, it has been observed that doctors
prefer to give a painkiller to reduce the pain, but it serves no purpose (nichd.nih.gov/, 2019).
Therefore, it is always advised to undergo proper treatment as early as possible. Blockage of
the fallopian tube can cause immense pain, but if treated correctly, it can be healed.
Hygienic factors are also one of the issues that increase female Infertility. Due to hygienic
factors, many time women suffer from regular infections and illness that disturbs their
reproductive system. Consumption of fruits and vegetables with an excessive amount of

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chemicals, fertilizers and pesticides also hampers fertility due to excessive chemical
decomposition in the body.
There are certain indirect symptoms that give an indication of Infertility. The symptoms
could be severe acne, pimples, nausea, fatigue and whitish menstrual blood. Most of the time,
women tend to ignore these symptoms, but it is always recommended to consult a doctor and
undergo a required treatment.
Treatment of Female Infertility
There are several tests to be performed to check the fertility of women. Ovulation
testing, Hysterosalpingography, Ovarian Reserve Testing and Tests to be performed using
Ultrasound. Certain times doctor perform several other tests to check the fertility such as
Laparoscopy or Genetic Testing (Simpson, Beitia & Mester, 2016). Fertility drugs have a
different role to play; certain drugs trigger the natural hormone, whereas some are used to
stimulate or develop extra eggs. The drugs include Clomiphene Citrate, Gonadotropins,
Metformin, Letrozole and Bromocriptine (Davar, Javedani & Fallahzadeh, 2014). Drugs
should be recommended as per the guidance of a gynaecologist because long-term
consumption of such drugs can be lead to life-threatening diseases like Ovarian Tumors and
Ovarian Hyperstimulation Disorder.
A gynaecologist also prescribes surgical recommendation in case if there is any
abnormalities or disorders in the reproductive system of the female. These surgeries are
preferably done to correct the disorders and to recover the chances of developing a foetus.
Surgeries can be performed to correct the abnormality of the uterus, to remove any kind of
fibroids inside uterine or to remove any kind of pelvic disorders. These surgeries are mostly
done in the form of either Laparoscopic or hysteroscopic form of surgery (Zhang et al.,
2014).

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Tubal Surgeries are mostly done in case if there is any kind of disorders or blockage
in the fallopian tube. Mostly, surgeries are done to create a new opening using Laparoscopic
form of surgery. Surgeries are also performed to remove the blockage of the tube (Briceag &
Ispas, 2017). In recent past, in vitro fertilization has shown a high range of success rate,
which is a process to combine medicines and surgeries that will help the sperm to fertilize an
egg. The process involves medication that will mature the eggs and make those prepared for
Fertilization (Pandian, Gibreel & Bhattacharya, 2015). Those eggs are taken and mixed with
sperm in the lab. Then they put one or more fertilized eggs inside the uterus that leads to
pregnancy. Pregnancy occurs only if the embryos are placed in the uterus lining. The process
takes a lot of time to complete, and it is preferably done to women above the age of 35 years.
Reproductive assistance is also a technique to resolve the complications of Infertility.
The method mainly includes intrauterine insemination and Assisted Reproductive Equipment
(Cantineau et al., 2014). During the first process, millions of strong sperm are put inside the
uterus during the time of ovulation and, the second process involves the extraction of matured
eggs and fertilized in the lab with the help of healthy sperm. Both the treatments require
several stages and a definite period.
Statistical Data of Female Infertility
According to an observation, approximately 10% of women between the ages of 15 to
44 suffer Infertility; it can be either complication while getting pregnant or difficulty in
staying pregnant. Studies have also shown that approximately 12% to 15% of couples are
incapable of having a baby even after having one year of physical interaction (Chandra,
Copen & Stephen, 2014). Around 10% of couples are unable to perceive a baby after two
years, and this leads to permanent female Infertility. Infertility rates among women are much
higher than the infertility rates in men. Female Infertility is a major concern; therefore, it is

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always recommended to have stress free lifestyle with proper nutrition, regular medical
check-ups. Infertility is a problem, which is a global problem; however, North Africa and
West Africa have the highest rates of Infertility where infertility rates are low in Central Asia
and East Asia.
According to an observation, numerous long-term significances of In Vitro
Fertilization process, comprising augmented hazards of urinary tract infections (UTI),
infectious vaginitis, dyspareunia and obstetric difficulties (Cdc.gov, 2019). According to a
study, any modification in natural structure of vulva, such as elimination of the protecting
labia minora, can results to physical and biological changes, that includes disturbance in the
urethra, contiguous nerves and tissues during the phase of the process in addition to
development of scars then blinkers of skin throughout the process of healing.
Summary
The literature review has highlighted numerous complications and disorders during
female Infertility. Female Infertility is a major issue that is mostly neglected at early stages,
and it leads to severe complications at the end-stage. If treated within the time, it can be cured
completely, and the woman can have a child. However, individual perspective matters a lot
during such cases because Infertility is an issue, which arises mostly due to change in
lifestyle. The complications signal several symptoms at an initial stage, and one should not
consider them with least importance. Although the initial stage of Infertility can be cured
with proper nutrition and diet during a severe stage, one should consider taking guidance
from a gynaecologist. Medicinal drugs can be useful sometimes, but an overdose of such
drugs can also lead to other complications. However, surgeries and In vitro Fertilization are
mostly recommended during such case because it allows a woman to cure the disorder
permanently. There are times when one can avoid female Infertility by taking proper care, but

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one should not ignore any of the minor symptoms. Proper treatment of past medical
complications and to be aware of Sexually Transmitted Disease are some of the activities that
can be followed to avoid female Infertility. Women should also have clear transparency of
drugs they consume during illness because many drugs create a major impact on their
reproductive system. Approaching a hygienic environment is also a mandatory requirement
because it has been observed that unhygienic conditions hamper the immune system that
decreases the tendency to hold a foetus. Female Infertility is a rising complication in the
globe, but it can be decreased with the utmost care and treatment. Therefore, one should
always keep a close eye on the symptoms and complications in order to avoid female
Infertility.
References
Bord, I., Gdalevich, M., Nahum, R., Meltcer, S., Anteby, E., & Orvieto, R. (2014).
Misoprostol treatment for early pregnancy failure does not impair future fertility. -
PubMed - NCBI. Retrieved 20 September 2019, from
https://www.ncbi.nlm.nih.gov/pubmed/24455996
Cantineau, A. E., Janssen, M. J., Cohlen, B. J., & Allersma, T. (2014). Synchronized
approach for intrauterine insemination in subfertile couples. Cochrane Database of
Systematic Reviews, (12).
Carp, H., Selmi, C., & Shoenfeld, Y. (2012). The autoimmune bases of Infertility and
pregnancy loss. - PubMed - NCBI. Retrieved 19 September 2019, from
https://www.ncbi.nlm.nih.gov/pubmed/22284905
Cdc.gov. (2019). FastStats. Retrieved 20 September 2019, from
https://www.cdc.gov/nchs/fastats/infertility.htm

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Cetin, I., Cozzi, V., & Antonazzo, P. (2008). Infertility as a cancer risk factor - a review. -
PubMed - NCBI. Retrieved 19 September 2019, from
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Chandra, A., Copen, C. E., & Stephen, E. H. (2014). Infertility service use in the United
States: data from the National Survey of Family Growth, 1982-2010.
Chaudhry, K., & Siccardi, M. (2019). Blighted Ovum (Anembryonic Pregnancy). Retrieved
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Davar, R., Javedani, M., & Fallahzadeh, M. (2014). Metformin-letrozole in comparison with
Metformin-clomiphene citrate in clomiphene-resistance PCOS patients undergoing
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Hanson, B., Johnstone, E., Dorais, J., Silver, B., Peterson, C.M. and Hotaling, J., 2017.
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