Women who are diagnosed with infertility face a number of physical and emotional challenges, but they are not alone. Infertility is a more common problem than many may realize. About 6.1 million American women—roughly ten percent of those ages 21 to 44—have difficulty getting or staying pregnant. (U.S. Office of Women’s Health).
There are several factors that can influence fertility, and a woman’s chance of getting pregnant diminishes as she ages. For healthy couples in their 20’s there is a 25 to 30 percent chance that a woman will become pregnant during any menstrual cycle, but by age 40, that number decreases to less than 10 percent. (American College of Obstetricians and Gynecologists)
What are the main causes of infertility?
While there are several possible causes, many center on difficulties with ovulation, which may be indicated by irregular menstrual periods or amenorrhea (the absences of periods.) One of the most common causes of infertility is polycystic ovarian syndrome (PCOS), caused by hormonal imbalances which interfere with normal ovulation cycles.
Other causes of infertility include:
- Physical problems with the structure of the uterus
- Fallopian tubes that may be blocked due to conditions such as pelvic inflammatory disease or endometriosis
- Uterine fibroids
- Primary ovarian insufficiency, which occurs when the ovaries stop working before a woman is 40
- Male factors such as low sperm count
The role of the pituitary gland in ovulation
The pituitary gland produces a number of hormones that have a direct effect on ovulation. A healthy menstrual cycle is the result of several organs working in concert: the hypothalamus, pituitary gland, the ovaries and the endometrium. The pituitary gland releases a luteinizing hormone (LH) and follicle stimulating hormone (FSH) that “communicate” to the ovarian follicles when to release a mature egg. If there is a breakdown at any point in the process, the ovaries may not release eggs or may release eggs that are not fully developed. (National Institute of Health.)
At Chapel Hill OBGYN, we are fertility specialists and work closely with our patients to provide both medical and emotional support in their journey to become pregnant. There have been several innovations in infertility treatment that improve fertility success rates. Most of them center on supporting the function of the pituitary gland. We’ve outlined a few of those below.
Treatment with Letrozole
Letrozole, which is currently used for breast cancer treatment in post-menopausal women, inhibits estrogen production, which in turn affects how the pituitary and hypothalamus function in relation to ovulation. (National Institutes of Health) This may be particularly effective in helping women with polycystic ovary syndrome (PCOS).
Treatment with Gonadotropins
These medicines help women who don’t ovulate regularly each month or ovulate before the egg has matured. It works with the pituitary gland by adjusting when a woman ovulates to ensure a mature ovum.
Some women may be treated with both letrozole and gonadotropins during in vitro fertilization.
Treatment with Clomid
This medication also works with the pituitary gland by inducing ovulation in women who do not develop an egg.
Treatment with Clomid improves the way the ovaries respond to the follicle stimulating hormone (FSH), resulting in improved live-birth rates.
Innovative treatments for in vitro fertilization
There have also been several improvements with in vitro fertilization, including pre-implantation genetic screening and studies to determine if the endometria will be receptive to embryo placement. These methods improve oocyte quality. An oocyte is an ovarian cell that must undergo division in order to form an ovum, or a mature female reproductive cell (National Institutes of Health).
Our infertility treatments are tailored to fit your individual needs
At Chapel Hill OBGYN, we are always up-to-date on the latest breakthroughs with infertility treatments, and we’re able to provide the research-based sophistication of a university medical center with the “small-town feel” of a family practice where everyone knows your name. We’ve successfully cared for generations of women and have helped them overcome the emotional and physical challenges of infertility with compassionate, evidence-based care. Contact us today if you are having difficulty getting pregnant.
For more than 40 years, Chapel Hill OBGYN has served women in the Triangle area, sharing the joy of little miracles and supporting them during challenges. Our board-certified physicians and certified nurse midwives bring together the personal experience and convenience of a private practice with the state-of-the-art resources found at larger organizations. To schedule an appointment, please use our online request form or call 919-942-8571.
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U.S. Department of Health and Human Services. “Infertility.” Office on Women’s Health. Online.