Female Infertility

Female Infertility Overview:

Infertility is clinically defined as the inability to concieve after 12 months or more of regular unprotected intercourse.

 

Aetiology:

  • 10–15 % of all couples
  • Fallopian tubes—infection may close or partly obstruct (PID, endometriosis).
  • Ovarian dysfunction
    • (a) ovulation may not occur;
    • (b) ovulation is irregular with anovulatory cycles;
  • Vagina—congenital malformation.
  • Uterus—fibroids/congenital malformation.
  • Immunological rejection of sperm

+ Primary

Never pregnant.

+ Secondary

Has had previous conception

+ Ovulatory Disorders

  • HPO Axis Dysfunction
  • Genetic disorders
    • Turner's syndrome
  • Autoimmune conditions
  • Disorders of gonadotrophin regulation
    • Hyperprolactinaemia
  • Gonadotrophin deficiency
    • Pituitary tumor
    • Pituitary infarction
    • Pituitary ablation
  • Polycystic ovarian syndrome (PCOS)

+ Tubal Obstruction

  • STIs
  • Pelivc Inflamatory Disease (PID)
  • Ectopic Pregnancies

+ Endometriosis

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+ Other Causes

  • Uterine abnormalities
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Female Hormone Dysregulation

Hormone Excess Deficiency
Oestrogen Heavy periods, PMS, Menorrhagia, Endometriosis, Fibroids, Cyclic breast swelling/tenderness, Mastalgia, Fibrocystic breast disease, Breast or endometrial cancer. Low bone density, poor fertility, low libido, irregular periods, immature ageing, vaginal dryness, brittle/dry skin.
Progesterone NA Dysfunctional uterine bleeding, failure to ovulate, PMS, infertility, endometrial hyperplasia, benign breast disorders, early miscarriage.
FSH Menopause Polycystic ovarian disease, Anorexia, weight loss, excess exercise, hypothyroidism, cushings syndrome, adrenal tumour/hyperplasia
LH PCOS, Polycystic ovarian disease, Ovarian failure, menopause Anorexia, weight loss, excess exercise, hypothyroidism, cushings syndrome, adrenal tumour/hyperplasia
Prolactin PCOS, hypothyroidism, cushings syndrome, pregnancy, amenorrhea Low: pituitary destruction from tumour NA
 

Diagnostic Considerations: 

  • Symptomatic diagnosis

    • Considered infertile after 1 year of unprotected intercourse without successful conception.
  • Screening exams

    • Thyroid
    • Diabetes
    • Cushing
    • PCOS
    • Autoimmune
  • Hormone Testing:

    • Serum:

    • Urinary:

    • Salvary:

      • Oestrone (E1)
      • Oestradiol (E2)
      • Oestriol (E3)
      • Progesterone (P4)
      • Testosterone (TT)
      • DHEA-S
  • Referrals:

    • Gynae exam
    • Ultrasound
 

Therapeutic Aims:

1. Modify Risk Factors Associated With Lowered Fertility

  • Lifestyle Habits (Smoking, alcohol, caffeine, trans fats, sugar, environmental toxin expoure, sub-optimal weight)
  • Manage Underlying Conditions (PCOS, Fibroids, Endometriosis, PID, UTI, Stress)
  • Optimise nutritional Status (a-lipoic acid, Vitamins A, B, C, & K, CoQ10, Zinc, Iron, Calcium, Selenium, Iodine, Chromium, Magnesium, Lycopene, Essential fatty acids.

2. Regulate The HPO Axis

  • HPO Axis Modulators (Vitex agnus-castus, Paeonia lactiflora, Glycyrrhiza glabra, Asparagus racemosa, Tribulus terrestris)

3. Improve Fertility Potential

  • Uterine Tonics (Angelica polymorpha, Chamaeleriumm luteum, Actaea racemosa, Dioscorea villosa)
  • Antioxidants (Curcuma longa, Vitis vinefera, Camellia sinensis, Silybum marianum)
  • Ovarian Tonics (Chamaelirium luteum, Asparagus racemosa)
 

Differential Diagnosis:

  • Male partner infertility
 

Cautions:

Consider herbs that are contraindicated during pregnancy or herbs that may affect fertility:

  • Albizia lebbeck (Albizia)
  • Curcuma longa (Turmeric)
  • Andrographis panniculata (Andrographis)
 

Herbs For Female Infertility:

 

Author:

Justin Cooke

The Sunlight Experiment

Updated: April 2018


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