Before we focus on Infertility and its causes, it is important to first understand how the female reproductive system works during the menstrual cycle. The cycle is set in motion with the release of an egg from the ovaries, which is made possible by the action of ovarian follicles. These follicles are first stimulated by the brain’s pituitary gland, which releases a hormone, thus initiating the cycle.

During the course of the menstrual cycle, various hormones are produced to facilitate the process with Oestrogen (supports follicle growth) and Progesterone (to make the uterus ideal for pregnancy) being the most notable of the lot.

Following ovulation, the sperm cells and egg meet in the fallopian tube, with one of the sperm cells accepted by the egg. Fertilization is said to have occurred when the sperm cell penetrates the outer layer of the egg. This fertilised egg then continues its journey to the uterus and once the egg implants itself into the lining of the uterus, pregnancy is said to have occurred. If however, the egg isn’t properly fertilised or if the embryo fails to develop, the lining of the uterus is shed as a menstrual period about 14 days after ovulation.

Infertility fundamentally refers to the inability to conceive off springs. In more specific terms, it is the inability to achieve pregnancy by a couple of reproductive age after one whole year of unprotected sexual activity. Primary Infertility is a term used to define infertility in a couple who are yet to have their first child. Secondary Infertility is the failure to conceive after a previous pregnancy. However infertility is not the end of the road, for options like IVF Treatment can always lead to a successful pregnancy and it is wise to consult a doctor and understand the options available in every case.

Statistics suggest that roughly one in three cases of infertility can be explained by female causes. These causes may be physical, hormonal or simply age-related. Once the exact cause of infertility has been determined, the doctor will be able to make recommendations on the course of treatment that needs to be adopted.

• Physical Causes: The fertilized egg or sperm can be prevented from reaching the other in the Fallopian tube if the cells lining the tube have been damaged. The risk of an ectopic pregnancy – where the fertilized egg is implanted in the fallopian tube – is consequently higher in such cases. Fallopian tube damage can occur after suffering from pelvic inflammatory disease, endometriosis or after pelvic surgery. Once the cause and the extent of damage have been assessed, the necessity of IVF treatment can be decided upon or other options can be explored.
• Hormonal: Another common cause of infertility in women, ovulatory disorders can be seen in the form of irregular or absent periods. This phenomenon, known as amenorrhoea, is most commonly associated with PCOS (Polycystic Ovarian Syndrome) and can be treated through weight loss and medication. It is important to note that treating PCOS is a must, regardless of its link to fertility, given it could increase the risk of suffering from diabetes or heart disease. PCOS is mostly evident in increased growth of facial and body hair, acne as well as obesity.
• Age: Even though concrete reasons haven’t been discovered, it is certain that age has an effect on fertility in women. As they cross the age of 35, women are found to be more easily prone to miscarriages than younger women. A possible explanation for the same would be the deterioration of the genetic and chromosome make-up of the eggs and embryos. There is, however, no reason to lose hope as good fertility treatment can make a huge difference to one’s chances of pregnancy.

Many of the risk factors for both male and female infertility are the same. They include:

• Age:- A woman's fertility gradually declines with age, especially in her mid-30s, and it drops rapidly after age 37. Infertility in older women may be due to the number and quality of eggs, or to health problems that affect fertility
• Tobacco use:-Smoking also reduces the possible benefit of fertility treatment. Miscarriages are more frequent in women who smoke.
• Alcohol use:- For women, there's no safe level of alcohol use during conception or pregnancy. Avoid alcohol if you're planning to become pregnant. Alcohol use increases the risk of birth defects, and may contribute to infertility
• Being overweight:- An inactive lifestyle and being overweight may increase the risk of infertility
• Being underweight:- Women at risk of fertility problems include those with eating disorders, such as anorexia or bulimia, and women who follow a very low calorie or restrictive diet.
• Exercise issues:- Insufficient exercise contributes to obesity, which increases the risk of infertility. Less often, ovulation problems may be associated with frequent strenuous, intense exercise in women who are not overweight.

Diet can play a part in affecting a woman’s fertility and chances of pregnancy. Studies have shown that consuming low-fat dairy products more than twice a day face an 85% risk of suffering from ovulatory infertility, where in infertility is caused by a failure to ovulate.

An iron-rich diet, on the other hand, can go a long way in lowering the chances of ovulatory infertility. Beans, lentils, eggs, spinach, whole grains and fortified cereals can all be consumed, supplemented by foods rich in Vitamin C, like bell peppers, berries and citrus fruits to enhance iron absorption.

It is also recommended to avoid trans-fat and add foods containing monounsaturated fat to the diet. Avocados, nuts, whole milk and olive oil or sunflower oil are safe bets in this regard. In fact, it has been found that women who consume at least one serving of whole milk per day reduce the risk of ovulatory infertility by more than 50%, as opposed to women who don’t.

Calcium – rich foods need to be consumed while replacing animal-based protein with vegetable-based protein can improve fertility vastly by helping maintain a healthy weight without compromising on nutrition requirements. Leaving the usual suspects for the conclusion, nicotine, alcohol, and caffeine all need to be avoided at all costs.

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