Female infertility

The Desire for Motherhood

The desire for motherhood is a natural aspiration for many women, and difficulties with conception can become a serious emotional challenge. However, thanks to advancements in reproductive medicine, the diagnosis and treatment of female infertility in Russia have achieved significant success, offering women and couples real chances of having a healthy baby.

Types of Female Infertility

Female infertility is classified according to several factors, including the cause and time of onset. The main types include:

• Primary infertility – diagnosed in women who have never been pregnant before.
• Secondary infertility – occurs in women who have had at least one pregnancy in the past but are now unable to conceive.
• Tubal infertility – associated with blockages or dysfunction of the fallopian tubes, which are responsible for egg transport and fertilization.
• Endocrine infertility – caused by hormonal imbalances that affect ovulation and the menstrual cycle.
• Infertility due to gynecological diseases – related to various pelvic pathologies that interfere with conception or normal pregnancy development.
• Immunological infertility – results from immune reactions that hinder fertilization or embryo implantation.
• Psychological infertility – linked to emotional or psychological factors that influence hormonal balance and reproductive function.
• Genetic infertility – caused by genetic abnormalities that impact fertility.
• Idiopathic infertility – diagnosed when no specific cause is identified even after comprehensive medical evaluation.

Symptoms of Female Infertility

In most cases, female infertility does not present with obvious physical symptoms. The main sign is the inability to conceive over a long period. However, some indirect symptoms may indicate possible issues:

• Menstrual irregularities, including absence of menstruation (amenorrhea)
• Painful periods (dysmenorrhea)
• Unusual vaginal discharge
• Pelvic pain
• Hirsutism (excessive hair growth)
• Acne
• Weight fluctuations

It is important to note that these signs do not always indicate infertility but may be reasons to consult a specialist.

Causes of Female Infertility

Infertility can result from a wide range of factors, often in combination:

• Ovulation disorders – such as absent or irregular ovulation due to hormonal issues (e.g., PCOS), premature ovarian insufficiency, stress, or other factors.
• Tubal pathologies – including blockage, damage, or adhesions caused by inflammation or surgeries that prevent egg passage.
• Endometriosis – the growth of tissue similar to the endometrium outside the uterus, causing inflammation, adhesions, and reduced fertility.
• Uterine fibroids – benign tumors that may interfere with embryo implantation or cause reproductive dysfunction.
• Uterine structural anomalies – congenital defects that complicate conception or increase the risk of pregnancy complications.
• Immunological factors – such as the presence of antibodies that hinder fertilization or implantation.
• Age – egg quality and quantity decline after the age of 35, reducing chances of conception.
• Lifestyle factors – smoking, alcohol use, being overweight or underweight, and stress can negatively impact reproductive health.
• Genetic abnormalities – certain genetic conditions may lead to infertility.

Diagnosis

The diagnosis of female infertility in Russia follows modern medical protocols and includes a comprehensive evaluation.

Physical Examination

The first step involves a general physical exam and patient interview to understand medical history, chronic conditions, and any gynecological concerns. A pelvic exam may also be performed to detect abnormalities or masses.

Ovulation Assessment

Ovulation is a key factor in conception. Several methods can be used to assess its regularity and quality:

• Measuring basal body temperature
• Hormone level testing
• Ultrasound monitoring of follicle development

Hormonal Testing

Hormonal imbalance is a common cause of infertility. Blood tests are conducted to determine the levels of key reproductive hormones:

• Follicle-stimulating hormone (FSH)
• Luteinizing hormone (LH)
• Estradiol
• Prolactin
• Thyroid-stimulating hormone (TSH)
• Anti-Müllerian hormone (AMH)

Instrumental Diagnostics

To thoroughly evaluate reproductive organs, several methods may be used:

• Pelvic ultrasound to detect abnormalities in the uterus, ovaries, or fallopian tubes
• Hysterosalpingography (HSG) – an X-ray of the fallopian tubes to assess patency
• Laparoscopy – a minimally invasive procedure that allows direct observation of pelvic organs to detect inflammation, endometriosis, or adhesions

Partner Evaluation

Since infertility may involve both partners, the male partner should also be evaluated. This includes:

• Semen analysis to assess sperm quality and count

Infection screening that may affect fertility

Female Infertility Treatment

Treatment may involve conservative or surgical methods, as well as assisted reproductive technologies (ART), depending on the underlying cause and the woman’s health condition.

Conservative Treatment

Aimed at restoring reproductive function using medications and physiotherapy, including:

• Hormone therapy – to regulate hormone levels for normal ovulation
• Treatment of infections and inflammation – with antibiotics or anti-inflammatory medications
• Psychotherapy – for patients facing stress or emotional barriers to conception

Surgical Treatment

If conservative methods are insufficient, surgery may be necessary to correct anatomical problems:

• Removal of fibroids or polyps that interfere with conception
• Surgical correction of tubal pathologies (e.g., adhesiolysis or tubal reconstruction)
• Treatment of endometriosis by removing lesions or restoring organ anatomy
• Ovarian cyst removal if it affects ovarian function

Assisted Reproductive Technologies (ART)

When conventional approaches are ineffective, ART may be used:

• Intrauterine insemination (IUI) – sperm is introduced into the uterus at the time of ovulation
• In vitro fertilization (IVF) – fertilization takes place in a lab, and the embryo is transferred to the uterus
• Intracytoplasmic sperm injection (ICSI) – a single sperm is injected directly into the egg
• Embryo biopsy and preimplantation genetic diagnosis (PGD) – used to select genetically healthy embryos for transfer

Each method is selected individually based on medical indications and the patient's condition.

Prevention

Prevention of female infertility includes regular gynecological visits, timely treatment of diseases, and proper hygiene. Maintaining hormonal balance through a healthy diet, moderate physical activity, and weight control is crucial. Avoiding stress, overexertion, and harmful habits also helps preserve fertility.

Care in Russia

Russia offers a well-developed network of medical facilities specializing in female infertility treatment. Patients can receive qualified assistance in clinics equipped with modern technology. The MARUS platform helps women find the right clinic and manage the diagnostic and treatment process, giving access to trusted institutions and professionals.