Babies Tale

The other major causes of infertility in women are scarring of the reproductive organs by past disease or surgery, or structural abnormalities present from birth.

• Untreated sexually transmitted diseases, especially gonorrhea, can result in infertility. As many as 80% of infected women never have any severe symptoms with the disease, and may not realize that they have it and that infection has spread to the Fallopian tubes, causing damage.
• PID (pelvic inflammatory disease), which can start after an induced abortion or miscarriage, after childbirth, after surgery in the pelvic region or after infection with a sexually transmitted disease, can cause tubal scarring and blockage.
• Other infections that can affect fertility are chlamydia and mycoplasmas. Chlamydia, a bacterium that closely resembles a virus, has deceptively mild symptoms. An untreated “silent” infection can destroy the inside of a woman’s Fallopian tubes. Mycoplasmas, another organism, may affect fertility and has been held responsible for miscarriages.

Other causes

Endometriosis is a disease that may affect as many as 5% to I0% of women at some stage of their reproductive lives. Normally endometrial tissue lines the womb, or endometrium. The condition is caused by patches of the endometrial tissue becoming deposited outside the womb. This tissue, like the womb lining, thickens and bleeds with each menstrual cycle. Scar tissue is formed that may block the ends of the Fallopian tubes, or adhesions may form that prevent the tube from picking up the egg on its release from the ovary.

Endometriosis can be treated by a number of drugs: birthcontrol pills, progesterone or a drug called Danazol’v, which blocks production of the two pituitary hormones, and now new drugs called LHRH analogs, which are given as a nasal spray or an injection. These treatments serve to “switch off” the menstrual cycle, stopping the patches of endometrial tissue from bleeding; then they fade away and any adhesions or scar tissue can be removed by careful surgery.

About one-third of all women have fibroids or polyps by the age of 40. These are benign swellings in the womb, usually only the size of a grape but sometimes swelling to the size of a grapefruit. Fibroids seldom cause symptoms in women who are not pregnant and rarely cause problems in pregnancy, but women with fibroids may find their fertility is affected. They can be removed by surgery. Malformations of the womb, such as the presence of a dividing wall or septum, can sometimes be corrected by surgery.

Previous surgery in the abdominal region can also be a cause of damage to the tubes. Bleeding or injury to the tissues may cause scar tissue or adhesions to form, which may block or freeze the tubes, ovaries or uterus in unnatural positions. That makes it impossible for the egg to pass from the ovaries into the Fallopian tubes, so conception becomes impossible.

More women with blocked Fallopian tubes have a better chance to achieve pregnancy today because doctors are practicing delicate microsurgeries with increasing skill. However, if surgery is not effective, there is still hope through the test-tube baby treatment or IVF.

Occasionally a fertilized egg fails to move through the tube and into the uterus. Instead, it grows in the tube. Eventually the pregnancy will abort, or the egg may burst the tube, causing considerable bleeding and damage. This is called an ectopic or tubal pregnancy. It results in both the loss of one pregnancy and a possible barrier to future conception. One Fallopian tube is often lost. The other may be damaged by bleeding caused by the ruptured tube, or by the surgery to remove the pregnancy. It is estimated that about half the women who have an ectopic pregnancy may never conceive again. Increasingly, delicate surgery by laparoscopy may be able to save a tube, however.

Often an ectopic pregnancy occurs when there has been some damage to the tube, perhaps caused by past infections or surgery. Tubal pregnancy is also more common if a woman becomes pregnant with an IUD in place or has been using the progestogenonly (or “mini”) Pill. An ectopic pregnancy is very painful and can be life-threatening. However, prompt medical attention to remove the developing embryo before the tube can burst avoids many risks and improves the chances of successfully reconstructing the damaged tube.

Leave a Reply