Female infertility or male infertility , or both, is a common condition that, according to estimates, affects about 15% of couples. Infertility is defined as the failure to achieve pregnancy, despite attempting to do so through full and regular intercourse, without the use of contraceptive methods for one year or more.

About a third of infertility cases result from disorders in women, and the second third, as a result of disorders in men, while in the last third of cases the disorder is on both sides, or the reason for not having success is not known at all.

The cause of female infertility may not be diagnosable, but there are many treatments for different disorders. Treatment is not always necessary, because about half of the couples who suffer from infertility (or infertility), succeed in conceiving after two years of trying.

The main sign of female infertility is the inability to have children, where this situation is accompanied by menstrual disorders or menstrual cycles that continue, sometimes, for an abnormal period. What is meant here is a menstrual cycle that lasts more than 35 days, or less than 21 days. In general, there are no other symptoms that indicate fertility disorders.

The process of embryo formation (fertilization) is a complex and amazing process that requires the meeting of the sperm from the man with the egg cell from the woman, in order to produce the first fertilized cell, which forms their union, from which the fetus will grow. This process requires that the egg be released from the ovarian follicle into the fallopian tubes through a process known as ovulation, of course in addition to the need to produce healthy sperm in the man.

In 25 percent of couples, there is a problem with the woman’s ovulation process. This problem may be related to the length of the axis responsible for the ovulation process, starting from the hypothalamus, passing through the pituitary gland, to disorders of the ovary itself.

• The disorder may cause the secretion of LH and FSH hormones in the pituitary gland to irregular ovulation or even to improper ovulation represented by irregular menstruation and bleeding. Also, a very low weight, or very excess weight, or even a sudden and significant increase or decrease in weight can lead to an imbalance in the levels of the mentioned hormones. Moreover, psychological stress and extreme tension may also lead to disturbances in the ovulation process.

• Syndrome PCOS (Polycystic ovary syndrome) – occurs in this syndrome change several elements of the system hormonal. These changes lead to high levels of male hormones and impair ovulation.
• A defect in the development of the ‘luteal phase’ – when the ovaries do not produce enough progesterone after ovulation, the uterus is not able to receive a fertilized egg, so pregnancy cannot progress.
• Premature ovarian failure – This is an autoimmune disease that causes damage to the ovaries, resulting in no ovulation, as well as low levels of estrogen in the body.

Of the causes of infertility in women and other, blockage of the fallopian tubes which play the role of mediator between Mosul ovaries which produce eggs, and between the uterus , which is supposed to receive the fertilized egg. This blockage can occur following exposure to infection, an ectopic pregnancy (ectopic) in the same tube, or surgeries performed there that caused some adhesions. Also, the blockage in the cervix can occur as a result of a mechanical blockage resulting from an incorrect structure of the cervix, or a chemical blockage represented by the lack of secretion of the mucous substance that is supposed to help the sperm to move properly.

In most cases, the cause of the fertility problem is not identified, and therefore it is speculated that there are several small combined factors that led to the emergence of a serious fertility problem, including:

• Generation – With age, the quality of eggs decreases, and their quantity decreases significantly, which leads to an increase in the difficulty of pregnancy and childbearing, especially with the high risk of chromosomal disorders in the fetus.
• Smoking – as it damages the mucus in the cervix, and also leads to disorders of the fallopian tubes structure, which increases the possibility of an ectopic pregnancy. Also, there is a decrease in the number of eggs, and an early decrease in the ability of the ovaries to function properly appears. Many doctors insist on stopping smoking before starting fertility treatments.
• Weight – Excess weight, or too little, significantly affects the regularity of the ovulation process and increases the likelihood of infertility in women. A normal BMI greatly increases the ability to fertilize and get pregnant properly.
• Sexual activity – the more unprotected sex a woman has with more men, the greater the risk of contracting sexually transmitted diseases, and the emergence of PID may lead to more complications and cause reduced fertility and eventually infertility in women.
• Also, among women who drink too much coffee and alcohol, we notice a greater prevalence of fertility disorders and cases of female infertility.

If a long time has passed and the couple cannot have children, they must find out the reason for this. This clarification includes:

• Ovulation test – This test checks the level of hormones in the blood. It is able to diagnose sharp spikes in the levels of the hormone LH, which signals the ovulation process. This test can be done with a home-use kit that can be purchased from the pharmacy without the need for a doctor’s prescription. Also, a hormone test can be performed through a blood test that aims to test a wide range of hormones in various situations.
•  Hysterosalpingography – During this examination, material that can be distinguished by imaging is inserted into the cervix. Through the image, it is possible to see the structure of the uterus and fallopian tubes, and to diagnose various structural and anatomical defects that hinder pregnancy.
• Laparoscopy (Laparoscopy) – During this examination is a hole in the abdominal wall, under general anesthesia, and then the camera is inserted into the abdominal cavity through the hole. Through this examination, the structure of the uterus, fallopian tubes and ovaries can be seen.

It is normal for female infertility treatment to be tailored to the main cause of the condition. This treatment can be a single-drug treatment (using one type of medication) or a multi-drug treatment, depending on the severity of the problem.

• Ovulation – In women who suffer from lack or irregularity of the process of ovulation, there are some treatments that re-regulate the hormonal activity that leads to a healthy ovulation process. The drugs used for this process are: clomiphene citrate, which stimulates the secretion of hormones from the pituitary gland, drugs that increase the activity of pituitary hormones, FSH and LH, and metformin, which is usually used for the treatment of diabetes . Its effect of reducing insulin resistance is essential and vital for a healthy ovulation process. It is important to note that these drugs have side effects such as an increased risk of multiple pregnancies and swelling of the ovaries to the point of feeling pain and symptoms in the digestive system.
• Surgical treatments – When there is a mechanical obstruction in any part of the reproductive system including the cervix, uterus and fallopian tubes, a surgical procedure is needed in order to restore the ability to have children.
• In vitro fertilization (IVF) – in cases where normal treatments cannot help, and the couple is interested in conducting an external fertilization process (tubes) – (IVF), an egg is taken from the woman, and then a sperm sample from the man, then external fertilization is done In the laboratory, the fertilized egg is then returned to the mother’s uterus to continue its development there.

In order to prevent the occurrence of female infertility, you must refrain from smoking, refrain from consuming large amounts of caffeine and alcohol, refrain from falling under the influence of psychological pressure and maintain a reasonable weight within the normal limits.