Premature ovarian failure is a term describing failure of the ovaries to function normally in a woman under the age of 40. Other names for the problem are primary ovarian insufficiency, or hypergonadism. The failure to function normally is not to be confused with menopause.

Premature Ovarian Failure Symptoms

• Irregular menstrual periods
• Infertility
• Low libido
• Painful intercourse
• Dry vagina

Diagnosing Premature Ovarian Failure

• Irregular menstrual periods
• Absence of menstrual altogether
• A blood test to measure follicle stimulation hormone

Causes of Premature Ovarian Failure

The cause is not clear, but for some reason the follicles in the ovaries cease to mature into eggs. If the follicles have a problem, they also stop forming the hormone estrogen, which is necessary for a woman’s good health. One of two scenarios may occur. A woman with follicle depletion has no follicles left and there is no way to make more. Or, the woman’s follicles do not mature into eggs.

Premature ovarian failure may be genetic. Somewhere between 10% to 20% for the woman who have the condition also have family members with the same problem. Other health problems created by premature ovarian failure are:

• Osteoporosis – Loss of bone density and strength. Getting enough exercise, vitamin D, and calcium can help reduce this risk.
• Addison’s disease – An autoimmune disorder in which the body has trouble handling physical stress, such as injury or illness, because of problems with the adrenal glands. About 3.2% of the women with premature ovarian failure also have Addison’s disease. This disease can be very dangerous, especially for women who do not realize the have it. Addison’s disease is not curable, but it is treatable.
• Low thyroid function – Affects metabolism and energy levels. This can be treated by replacement of the thyroid hormone.
• Heart disease – Reduce this risk by getting enough exercise, eating a healthy diet for weight control, and getting estrogen replacement therapy.

It is important to know that women who are carriers for the gene for Fragile X syndrome, or have the premutation for it, are more likely than other women to get premature ovarian failure. If you are a Fragile X carrier, or have the premutation, it is very important to get tested for Premature Ovarian Failure.

Premature Ovarian Failure Treatment

There are no treatments for Premature Ovarian Failure. Once the follicles cease to mature into eggs, there is no way to reverse the problem. However, there are treatments that can help some of the symptoms.

No related posts.

• Couples who have been trying to get pregnant for a year or more, but have been unsuccessful (this applies to women age 34 and under)
• Couples who have been trying to get pregnant for 6 months or more and are age 35 and older
• Women who have uterine fibroids
• Women who have endometriosis
• Women who have amenorrhea (irregular menstrual cycles or no cycle at all)
• Women who have had more than one miscarriage
• Women who have had a stillbirth
• Women or men who have certain genetic conditions

Fertility Testing

How can fertility be tested? Of course you must see your doctor in order for fertility to be tested. Usually the first tests focus on the man. A sample of the man’s sperm is tested for shape, mobility, and quantity. Blood tests are usually taken from both the woman and the man to check hormones, and to check for any infection. These tests on the male can include:

• A test to see if the sperm can swim through mucus (called a mucus penetrance test)
• An x-ray of the mans reproductive organs
• A hamster-egg penetrance assay (to see if the sperm can penetrate a hamster egg cell, similar to penetrating female egg cells)

The first consideration for the female is determining if her menstrual cycle is regular and if ovulation is actually occurring.

There are a few ways to determine whether you are ovulating:

• By using a home ovulation kit (available at a pharmacy) to chart changes in her morning temperature.
• Examination of her cervical mucus which changes throughout her cycle
• Ultrasound of her ovaries
• Blood tests for hormone levels

If no problem is found with the woman’s ovulation, other tests can be done:

• An exam of the fallopian tubes for disease
• An exam to verify the fallopian tubes are open
• An exam of the uterus to check its shape and position, or disease
• An exam of other reproductive organs for infection or disease
• A biopsy of the uterine lining

No related posts.

• If you believe you or your partner have fertility problems, talk with your doctor right away. Even if you are not planning pregnancy at the present time, age is an important issue in treating infertility, and you will be better off if you plan ahead.
• If you have been having unprotected intercourse for a year or more, and you are under the age of 35, and have been unsuccessful, it is time to see your doctor.
• If you have been having unprotected intercourse for 6 months or more, and are 35 years old or older, it is time to see your doctor.
• Or, as mentioned above, if you think you or your partner may have a fertility problem and plan to get pregnant in the future, consult with your doctor so you know what steps you can take now for a successful future pregnancy.

There are many ways to treat infertility. In some cases a prescribed medication may do the trick. Assisted reproductive technology (ART) has several procedural options for positive outcomes. Intrauterine insemination, either with your partner’s sperm or a donor’s sperm, has produced thousands of pregnancies. In some cases, a surgery may be needed. You just won’t know until you are tested which options are best for you.

No related posts.

It is not uncommon to have trouble becoming pregnant or to experience infertility. Infertility is defined as not being able to become pregnant, despite trying for one year, in women under age 35, or after six months in women 35 and over. Or for men who are unable to impregnate a woman after at least one year of trying.

In women, the term is used to describe those who are of normal childbearing age, not those who can’t get pregnant because they are near or past menopause.

Women who are able to get pregnant but who cannot carry a pregnancy to term (birth) may also be considered infertile.

What causes infertility?

Infertility does not have a single cause because successful pregnancy is a multi-step chain of events.

Simply described, pregnancy includes the following steps: A woman’s ovaries must be able to release a viable egg, which then must be able to travel down the fallopian tube. The man must be able to ejaculate, and his sperm must be able to travel to the fallopian tube. The sperm and egg must unite to fertilize the egg. The fertilized egg must attach to the inside of a receptive uterus (or implant) and be nurtured by the body to allow the fetus to develop and grow until it is ready for birth.

Problems with any of these steps can lead to infertility.

The cause of infertility can rest in the woman or the man, or can be from unknown factors or a combination of factors. In some cases, environmental factors can contribute to infertility. In other cases, genetic conditions or other health problems are the main cause of infertility.

Reasons for infertility may include:

• Your age
• Female Infertility or health problems in women
• Male infertility or health problems in men

Treating Infertility

Infertility CAN be treated. Treatments include:

• Drugs
• Surgery
• Assisted Reproductive Technology (ART)
• In Vitro Fertilization (IVF)

No related posts.

Amenorrhea is the absence of a menstrual period.

• Primary amenorrhea is when a young women has not yet had her menstrual period by age 16.
• Secondary amenorrhea is when a women has had her menstrual periods but stopped for at least 3 months. This includes pregnancy.

Signs of Amenorrhea

• Of course the main sign of having amenorrhea is not having a period for 3 months
• Amenorrhea is expected during pregnancy. But regular periods when you are not pregnant is a sign of good health. If you miss a couple of periods, and you are not pregnant, see a doctor. Anything that may be going wrong is best dealt with as soon as possible.

Causes of Amenorrhea

Primary Amenorrhea Causes

• Chromosomal or genetic abnormalities can cause the eggs or follicles to deplete too early in life.
• Problems with reproductive organs, hypothalamic problems, or a malfunctioning pituitary gland can be the cause
• Eating disorders, such as anorexia or bulimia can cause amenorrhea
• Excessive exercise
• Extreme physical or mental stress, or a combination of the two

Secondary Amenorrhea Causes

• Pregnancy
• Breastfeeding
• Some medications
• Some contraceptives
• Hormonal problems involving the hypothalamus, ovary, adrenal glands, thyroid, pituitary gland
• Extreme mental or physical stress
• Low body weight, or eating disorders

Treatment for Amenorrhea

Treatment for amenorrhea depends on its cause. If stress, weight, or physical activity is the cause, a change in lifestyle can solve the problem. In other cases, medication can be the answer. For more information, talk to your doctor.

No related posts.

Most cases of infertility in women result from problems with ovulation.  Some conditions affecting ovulation include premature ovarian failure, in which the ovaries stop functioning before natural menopause, and polycystic ovary syndrome (PCOS), in which the ovaries may not release an egg regularly or may not release a viable, healthy egg.  Among women who have PCOS, even when a healthy egg is released and fertilized, the uterus may not be receptive to implantation of a fertilized egg, which results in infertility.

Other causes of infertility might include:

• Blocked fallopian tubes due to endometriosis, pelvic inflammatory disease, or surgery
• Physical problems with the uterine wall
• Uterine fibroids

A woman’s risk for infertility can also be affected by certain lifestyle and environmental factors, including (but not limited to):

• Age
• Stress
• Poor diet
• Being overweight or underweight
• Smoking, drugs, and alcohol
• Medication
• Environmental toxins
• Genetic conditions, such as being a carrier of Fragile X syndrome
• Other health problems, such as sexually transmitted diseases

No related posts.

Like female infertility, male infertility can result from physical problems, such as testes that don’t make enough normal sperm, hormonal problems, and lifestyle or environmental factors, including (but not limited to):

• Age
• Stress
• Exposing the testes to high temperatures, which can affect the ability of the sperm to move and to fertilize an egg.  For instance:
  • Cryptorchism is a condition where the testes do not descend into the scrotum.  Although it does not usually affect the ability to have and sustain an erection, cryptorchism means that the testes are still inside the body cavity, which has a higher temperature than the external scrotum.
  • Tight underwear-For some men, wearing tight underwear can also increase the temperature of the testes.
• Smoking, drugs, and alcohol
• Medications
• Environmental toxins
• Genetic conditions, such as Klinefelter syndrome
• Other health problems

But, in some cases, health care providers cannot determine a cause for infertility in the man or woman. In addition, some known causes of infertility do not have any treatments

No related posts.

HRT, sometimes called estrogent replacement therapy or ERT, refers to a woman taking supplements of hormones such as estrogen alone or estrogen with another hormone called progesterone (progestin in its synthetic form). HRT replaces hormones that a woman’s body should be making or used to make.

Why would a woman take HRT?

Estrogen and progesterone normally regulate a woman’s menstrual cycle and reproductive health. Estrogen is also important for bone health.

Generally, health care providers prescribe HRT for two groups of women:

• Women going through menopause and who had already gone through it (called post-menopausal) – the natural levels of these hormones drop during menopause. This drop can lead to symptoms such as hot flashes, night sweats, vaginal dryness, and sleep disturbances. HRT may be used to help lessen some of these symptoms
• Women with certain health conditions – in some cases, women’s bodies don’t make normal levels of the hormones because of a medical problems, such as premature ovarian failure.  For these women, HRT replaces the hormones that their bodies should be making.

What are the risks of HRT?

The risks of HRT differ depending on the health status of the woman taking it, and on the type of HRT.

Risks for healthy menopausal and post-menopausal women

The NIH conducted the Women’s Health Initiative (WHI) trial to learn about the risks and benefits of continuous estrogen+progestin HRT for post-menopausal women.

• In one arm of this trial, researchers found that healthy post-menopausal women who took the therapy were at increased risk of invasive breast cancer, coronary heart disease, stroke, and blood clots. There were also benefits of estrogen plus progestin, including fewer cases of hip fractures and colon cancer.
• Because the harm of HRT for healthy post-menopausal women in this trial was greater than the benefit, the researchers stopped the trial.
• In light of the findings, the U.S. Food and Drug Administration noted that even though HRT effectively lessened some menopause symptoms in healthy post-menopausal women, it carried serious risks. Women should discuss the potential benefits and risks of HRT with their health care provider. The FDA recommends HRT for post-menopausal women be at the lowest doses for the shortest amount of time to reach treatment goals.

Risks of HRT for pre-menopausal women with certain health conditions

Women whose bodies have stopped making estrogen or don’t make enough estrogen often take HRT to reduce symptoms and maintain overall health.

• For instance, low estrogen levels in women with premature ovarian failure put these women at risk for osteoporosis and heart disease.  HRT helps maintain bone health and reduce the risk of heart disease.
• In these cases, HRT is actually replacing hormones that the women’s bodies should be making-hormones that they need for their overall health.
• HRT taken by women with certain health conditions is different than that taken my post-menopausal women.  The risks associated with post-menopausal HRT do not apply to pre-menopausal women taking HRT.

No related posts.

PCOS is a condition in which a woman’s ovaries and, in some cases, the adrenal glands produce more of the hormone androgen than normal.  High levels of these hormones interfere with the development and release of eggs as part of ovulation.  As a result, fluid filled sacs or cysts can develop on the ovaries. Because women with PCOS do not release eggs during ovulation, it is the most common cause of female infertility.

How does PCOS affect fertility?

A woman’s ovaries have follicles, which are tiny, fluid filled sacs that hold the eggs.  When an egg is mature, the follicle breaks open to release the egg so it can travel through the fallopian tubes and into the uterus for possible fertilization.  In women with PCOS, immature follicles bunch together to form large cysts or lumps.  The eggs mature within the bunched follicles, but the follicle does not break open to release them.  As a result, women with PCOS often have menstrual irregularities, such as the absence of menstruation (called amenorrhea) or they have only occasional periods (oligomenorrhea).  Because the eggs are not released, most women with PCOS have trouble getting pregnant.

Symptoms of PCOS

In addition to infertility, women may also have:

• Pelvic pain
• Excess hair growth on the face, chest, stomach, thumbs, or toes. (Called hirsutism)
• Male pattern baldness, or thinning hair
• Acne, oil skin, or dandruff
• Patches of thickened and dark brown or black skin
• Women who are obese are more likely to have PCOS

Although is it more difficult for women with PCOS to become pregnant, it is possible.  Many who cannot get pregnant naturally need to turn to assistive reproductive technology.  Women with PCOS are at higher risk for miscarriage if they do become pregnant.

Women with PCOS are also at higher risk for associated conditions such as:

• Diabetes
• Metabolic syndrome. This is sometimes known as a precursor to diabetes. This syndrome indicates that the body has trouble regulating insulin.
• Cardiovascular disease, including high blood pressure and heart disease.

Diagnosing PCOS

Your physician will take a medical history and do a pelvic exam to feel for cysts on your ovaries.  A vaginal ultrasound may also be done. Your physician may recommend blood tests to measure hormonal levels.  Other tests may include measuring levels of insulin, glucose, cholesterol, and triglycerides.

Treating PCOS

There is no cure for PCOS.  Many of the symptoms can be managed.  It is important to have PCOS diagnosed and treated early to help prevent associated problems.  There are medications that can help control the symptoms, such as birth control pills to regulate menstruation, reduce androgen (hormone) levels, and clear acne.  Other medications can reduce cosmetic problems like hair growth, and control blood pressure and cholesterol.

Lifestyle changes such as exercise, can help weight loss and aid in the reduction of blood pressure.  Exercise can also help regulate insulin levels more effectively. Weight loss can help lessen many of the health conditions associated with PCOS and can make symptoms be less severe or even disappear.

Surgical treatment may also be an option, but is not recommended for the first course of treatment.

No related posts.

Invitro fertilization (IVF)

Invitro fertilization (IVF) is a tool of assisted reproductive technology (ART) that is often used when a woman’s fallopian tubes are blocked or when a man has a low sperm count. It is a process by which the eggs are fertilized outside the womb. When other methods of assisted reproductive technology have failed, doctors turn to IVF. The process involves hormonally controlling the ovulatory process, removing healthy eggs from the woman’s ovaries and introducing healthy sperm to fertilize in a fluid medium outside the body. The fertilized eggs are then transferred into the woman’s uterus.

Typically on the third day of menstruation, a regime of fertility medications designed to stimulate the development of multiple follicles of the ovaries are injected. This requires close monitoring. Usually ten days of injections are needed.

When adequate follicle maturation is deemed complete, human chorionic gonadotropin (hCG) is injected. This agent’s purpose is to cause ovulation about 42 hours after injection. A retrieval procedure takes place just prior to that in order to retrieve the eggs from the ovary. Ten to 30 eggs are typically removed. The eggs are retrieved from the patient using a transvaginal technique involving an ultra-sound guided needle piercing the vaginal wall to aspirate the follicles. The retrieval process takes about 20 minutes under general anesthesia or conscious sedation.

In the laboratory, the eggs are prepared for fertilization. Semen is prepared by removing inactive cells and seminal fluid. The sperm and the egg are incubated together in a culture media for around 18 hours. In the case of a low sperm count or motility, a single sperm may be injected directly into the egg. The fertilized egg is passed to a special growth medium and left for about 48 hours until it has reached the 6-8 cell stage. Typically embryos that have achieved 6-8 cell stage are transferred 3 days after retrieval. This is not always the case, but it is typical.

The embryos are graded based on a number of criteria indicating viability. The number to be transferred depends on the number available, the age of the woman, and other diagnostic results. Different countries have their own legal limits to how many embryos can be transferred. The embryos judged to be the ‘best’ are transfer to the woman’s uterus through a thin plastic catheter, which goes through her vagina and cervix.

IVF is a process that can be used on women who have already gone through menopause. The success rate is 35%. Due to the expense of this procedure, IVF is generally attempted after less pricey procedures have failed. This process bares the nickname test tube baby.

Gamete Intrafallopian Transfer (GIFT)

Gamete intrafallopian transfer (GIFT) is a tool of assisted reproductive technology. This process allows fertilization to take place in the female’s body. Many prefer this method on moral grounds. Eggs are removed from a woman’s ovaries and placed into one of her fallopian tubes along with a man’s sperm. The procedure is done using laparoscopy. A cycle of GIFT takes 4 to 6 weeks to complete. The female must first take a fertility drug to stimulate egg production within her ovaries. The doctor will monitor the growth of the ovarian follicles, and once they are mature, the woman will be injected with human chronic gonadotropin (hCG). About 36 hours later, the eggs will be harvested, male sperm added, and placed into the woman’s fallopian tubes using a laparoscope.

A woman must have at least one normal fallopian tube in order to be considered a good prospect for GIFT. This method is used on the occasions where there is a sperm dysfunction or where the cause of infertility is unknown. Success depends on the age of the couple and the woman’s quality of eggs. Approximately 25-35% of GIFT cycles result in pregnancy, one third of those being multiple births.

When there is a blockage in the fallopian tubes, zygote intrafallopian transfer (ZIFT) is used. Eggs are removed from the woman’s ovaries and in vitro (outside the uterus) fertilized. The zygote (newly fertilized egg) is placed into the fallopian tube by laparoscopy. This is a procedure born of the gamete intrafallopian transfer (GIFT) procedure. ZIFT has a success rate of 64.8%.

No related posts.