All About Female Fertility

The ability to have offspring in medicine, sociology is often denoted by the concept of "fertility". Women, for whom the issues of procreation are very important historically and by right of birth, attach great importance to this issue, while not every woman knows how to determine her fertility and increase it, if necessary.

What it is?

The term got its name from the Latin fertilis - fertile. In this way, fertility is the ability of a woman's body to reproduce viable offspring. The inability to bear children is called the opposite concept - “sterility”.

People far from medical science are accustomed to believe that women are of two types - fertile and infertile, that fertility is either there or not. In fact, there are three types of fertility in women:

high;
medium (normal);
low.

In simple terms, then a woman's fertility is determined depending on whether she is able to conceive, bear and give birth.

The absence of any of these factors indicates a woman's low fertility, since the lady does not come close to the desired goal (the child cannot be conceived, or endured, or give birth to a live baby).
If a woman is doing well with her health, and she is able to conceive, and endure, and give birth, they say that she has normal (average) fertility.
If the fair sex has not only the opportunity to become pregnant, carry a child and give birth, but she is able to do this with minimal interruptions without prejudice to the health of her and her children, they talk about high fertility.

Fertility as a concept is used not only by gynecologists, obstetricians, reproductive specialists and doctors of other specializations, but also by demographers. This term appears frequently in scientific disputes and statistics on the world's fertility.

To understand what is happening with the fertility of one woman, a doctor works. To understand what generally happens to the fertility of an entire population of women, a demographer works using the total fertility rate.

Thus, experts from the World Health Organization have calculated that up to 5% of women worldwide are infertile... In Russia, 40 million women account for up to 6 million infertile women. Experts say that soon fertility in Russia for one average woman will be even lower, and from 8% of infertile women registered today, it will drop to 15% (which happened long ago, for example, in the same Europe).

Today there is a lot of debate about at what age a woman can be considered fertile, and it should be noted that the age bar has increased. Today, according to statistics, women are considered fertile. between the ages of 15 and 49. The share of fertile women in society is given a solid share - up to 30%, which, most likely, has not yet allowed humanity to die out.

However, occasionally there are situations in which some women maintain normal fertility even after 49 years, successfully giving birth at 50, 55, and even 60 years and older. Physicians and scientists tend to believe that the increase in fertile age is a merit of progress. After all, today IVF, egg donation, various assisted reproductive techniques and technologies are available, which allows women to become mothers even after the average fertile period for them ends.

Ovulation factor

A man is able to conceive a baby on any day of his life upon reaching puberty and until very old age. It's different with women. Babies are born with the highest fertility in a lifetime - several million immature eggs in the ovaries of newborn girls are the ovarian reserve. It is not replenished, but during life it is only consumed, and fertility gradually decreases.

Some of the oocytes die under the influence of unfavorable factors - bad habits, diseases, ecology, part is spent on ovulatory cycles. The termination of the fertile period means a critical depletion of the ovarian reserve and the onset of menopause.

Fertility is largely determined by the ability for normal, healthy ovulation, which occurs in women mid-cycle. After menstruation, under the influence of hormones, several follicles mature, and only one (rarely two) becomes dominant. In the middle of the cycle, under the action of the luteinizing hormone, the follicle bursts, and the egg cell ready for fertilization comes out into the fallopian tube. Ovulation itself lasts no more than an hour, and the egg cell remains alive and capable of fertilization for another day.

If ovulation does not occur, which is quite possible in some cycles, a woman cannot conceive a child. If ovulation does not occur at all, the woman is considered infertile. She is given appropriate treatment. Today, drugs are used to stimulate ovulation.

Even in women who do not experience any problems with ovulation, the chance of getting pregnant in one cycle is about 30% (up to 33% at the age of 20-25, 20% - after 25 years, 10% - after 30 years, about 7% - after 35 years, about 3% - after 40).

A woman has the highest fertility only during ovulation and during the day after it, while the egg is alive. That is why women planning to conceive are advised to take measures to establish the day of their ovulation, to use special ovulation tests.

Ovulation can not occur for various reasons - stress, fatigue, hormonal disorders, age. After 35 years in women it is considered completely normal if there are up to 6 anovulatory ("empty") cycles per year, while in women under 35 such cycles per year occur from a strength of 1-2. Therefore, women under 35 are considered more fertile than women who have crossed this age line.

Fertility predictions - how is the test done?

To determine the fertility of a particular woman, a special test was created, which was called "fertility prediction." Women who are interested in this issue may well take advantage of it.

On the 5-6th day of the female cycle (on the last or penultimate day of menstruation with a six-day duration) do an ultrasound of the ovaries The doctor fixes the size of the gonads in the first phase of the cycle, estimates how many active follicles are seen at this stage. In a healthy woman, the normal size of the sex gland is in the range from 20 to 120 mm, in one ovary at least 5 follicles mature at this stage. This is how the ovarian reserve is determined.
Additionally, laboratory tests can be carried out - blood test for hormones FSH, LH.

In conclusion, the doctor indicates a few strange and incomprehensible for the majority of the fairer sex values: "-2", "0" or "+2". What does this mean:

«-2» - the ovarian reserve is depleted, fertility is low, independent conception is almost impossible if a miracle does not intervene;
«0» - normal reserve, normal ability to conceive, carry a fetus.
«+2» - high fertility, rich reserve, the likelihood that pregnancy occurs within 1-2 planning cycles is very high.

A blood test is also reflected in the test. With the predominance of FSH (follicle-stimulating hormone) over LH, ovarian depletion is suspected, and fertility is low.

This test allows the doctor to initially determine whether a woman can become a mother without his help and turning to reproductive technologies or whether she will need medical help.

Low fertility, according to the predictive test, is not a verdict. The woman is to undergo treatment, a set of measures to increase fertility. Such measures usually allow 94% of women to conceive and carry a baby in whom the initial test showed low results. Only 6% of women, according to statistics, require the help of reproductive specialists (IVF, ICSI, etc.).

To determine your own high fertility period (ovulation period), tests that are available at any pharmacy help. They act similarly to tests to determine pregnancy, but allow you to establish ovulation, and not pregnancy by the concentration of completely different substances (hCG - during pregnancy, LH - during ovulation).

Such tests are light and easy to use at home, the error and probability of error is not so high.

Is high ability a phenomenon?

High fertility is often referred to as a phenomenon in medicine. Indeed, some women manage to get pregnant even while taking contraceptives. The likelihood of a phenomenal pregnancy increases if not only a woman's fertility is estimated at "+2", but also a man's fertility is very high.

This is not very common, but it increases the likelihood of an unplanned pregnancy. Therefore, contraception with 100% effectiveness does not exist: when taking oral contraceptives, about 1% of women become pregnant, when using a condom - 5%, with an intrauterine device installed - 3%.

For these ladies, doctors almost cannot find a remedy that would help protect against unwanted pregnancy, they are recommended surgical sterilization, if there are already children and their number is completely satisfied with the lady, she does not agree to a new birth.

The reasons for increased female fertility have not been established by science; it is considered a natural phenomenon. It is believed that the predisposition to it can be genetically inherited in the female line.

Fertility rate

As already mentioned, the concept of "fertility" is used not only by doctors, but also by sociologists and demographers. And so there is a so-called fertility rate, which is not used for planning pregnancy, as many women think. This is a macroeconomic indicator necessary in order to correctly assess the birth rate in a region, country, and the world. It shows the average number of live children per woman in the selected area. An important condition is that a woman in these statistics must be of reproductive age.

The formula for calculating the coefficient is simple: K = N n * 1000. K is the same desired fertility rate, N is the total number of newborns over a certain period of time, for example, for a year or for 5 years, n is the number of women who are of reproductive age (15-49 years).

The result is estimated in ppm. In order for society to remain stable and there is no overpopulation or extinction, K must be equal to 2.0 - 2.33. If K = more than 2.4, they speak of population growth, if the value is less than 2.0, they speak of a decrease in the population. Today (according to 2017 data) in Russia, the female fertility rate is 1.82. Draw your own conclusions.

What influences?

Every woman who thinks about offspring is interested in the question of what can affect her fertility. There are several such factors of influence, they are diverse, and, of course, all deserve close attention.

Age. This is the main factor. Female fertility declines much faster than male fertility. As the female body ages, not only the number of full-fledged menstrual cycles with ovulation decreases, but the quality of the eggs themselves becomes lower, which also affects the ability to fertility (both to conception and to prognosis for live birth, sometimes poor quality oocytes cause DNA mutations and chromosomal abnormalities of the fetus, incompatible with life).
Excess weight... A very common reason for the inability to become pregnant with a healthy and favorable gynecological history. Extra pounds shift the hormonal background, which increases the likelihood of a violation of ovulatory processes. Losing weight by even 5% increases a woman's ability to conceive.
Psychological instability, stress - a woman under stress increases the production of stress hormones, which partially block the production of sex hormones, which affects the nature of the cycle. The most intractable form of infertility in women, in particular, is idiopathic psychogenic infertility, in which a woman is healthy, and conception does not occur for psychosomatic reasons - fear of childbirth, unwillingness to give birth from a particular man, etc.
Genital trauma - ruptures of the vagina, cervix, scars.
Any diseases that cause hormonal imbalances - polycystic ovary disease, increased or decreased thyroid function, diabetes mellitus and a number of others.
Diseases of the reproductive organs - obstruction of the fallopian tubes, prolonged and advanced inflammatory processes in the uterus, eggs, appendages. Adhesions, synechiae.
Multiple penetrations into the uterine cavity - abortion, curettage, including diagnostic. At the same time, the functionality of the endometrium decreases, due to which, even with the conception that took place, the ovum cannot fix and develop normally further, it dies and is rejected.
Eating and drinking disorders - It is very important for a woman to consume enough liquid, and fast food and food with an abundance of preservatives and dyes cause mutations in the DNA of oocytes.
Non-inflammatory diseases of the reproductive organs - fibroids, endometriosis, cysts, polyps, hyperplasia of the endometrial layer of the uterus.
Unfavorable environmental conditions - multifactorial effects are exerted by zones of increased radiation, polluted large cities, constant inhalation of dirty air, exhaust gases.
Risks of professional activity - work in enterprises with a high level of vibration, electromagnetic radiation, contact with poisons, paints, varnishes, and other toxic substances.
Bad habits - smoking, alcohol, drugs.
Immunological disorders - diseases and conditions in which a woman's body produces antisperm antibodies that destroy sperm like foreign bodies. This often develops against the background of the recognition of sperm as a foreign body, for example, when practicing anal sex with ejaculation into the rectum.

There are many reasons for the fertility of a particular woman. And they must be taken into account. This is important if she is found to have reduced fertility. Here it is important, first of all, to eliminate harmful factors. Very often, this alone is quite enough to help a couple solve the problem of infertility.

Why is decreasing?

Reduced or impaired fertility in women is a condition in which the likelihood of conceiving and bearing a baby decreases under the influence of unfavorable factors or is completely absent. Signs and symptoms of decreased fertility are obvious - conception does not occur or pregnancy cannot be carried out. A fertile woman with unprotected intercourse becomes pregnant for about a year. If this does not happen, after a year of planning, she and her spouse are advised to see a doctor to determine the reasons for the decline in fertility. Remember, we are not talking about infertility as such, it is about determining the causes and factors of reduced fertility of partners.

The violation can be temporary, surmountable, and maybe irreversible. It all depends on what cause caused the changes that prevent procreation.But even with an irreversible violation, there is a way out - it will not work to conceive naturally, but IVF and other assisted reproductive technologies will come to the rescue.

Temporary reductions are reversible and a woman can increase fertility, which will completely solve the problem of procreation in a natural way. That is why temporary problems are called decline, and irreversible problems are called violation.

Age features

The age of fertility in women is the period of time during which a woman can become a mother. This usually refers to the time interval from about 13 years to the onset of menopause, when ovulation does not occur due to the depletion of the ovarian reserve. As soon as a girl begins her period, she theoretically enters reproductive age, that is, she is capable of conceiving. The average age of menopause is 50-55 years.

Sociologists and demographers consider the reproductive age to be from 15 to 55 years, but doctors have a different opinion - adolescents, despite the presence of menstruation, are not physiologically and psychologically ready for gestation and childbirth, and women after 40 years have difficulties with conception due to changes in the quality of oocytes. That is why doctors, speaking about a favorable reproductive age, usually mean the age from 20 to 40 years.

The entire fertile life of a woman is divided into several periods.

Early reproductive stage. It starts with the first menstruation and ends at the age of 20 - ovulation is infrequent, the cycle is irregular, the hormonal background is unstable, however, the probability of getting pregnant in girls who are already having sex is very high.
Average reproductive period. It starts at 20 and ends at 40 - ovulation is quite regular, hormonal levels, if there are no concomitant diseases, is stable, good health, the ability to bear and give birth to a child is high, but the probability of getting pregnant is somewhat reduced.
Late reproductive period - from 40 to 45 years old. At this time, ovulations are still quite regular, menstruation goes evenly, clearly, but the hormonal background begins to rebuild, the first premenopausal changes begin to affect the body. The likelihood of conceiving is reduced, but the ability to bear and give birth is quite high.
Fertility subsidence - from 46 to 58 years old. At this time, the woman enters the climacteric period. The cycle becomes irregular, ovulation occurs less and less often, the hormonal background is characterized by reduced levels of sex hormones. The likelihood of becoming pregnant is low, but even if this happens, carrying it necessarily requires supportive hormonal therapy - a woman's own hormones are no longer enough for pregnancy and childbirth.

Doctors consider the period from 20 to 40 years old to be the best age for childbirth.

How to improve fertility?

A set of measures will help to increase fertility, which implies a change in lifestyle. But you should start with a visit to the doctor and examination. If you do not treat all infections, inflammation, no other measures will help conceive a baby, no matter how accurate the calculations in the calendar are, no matter how striped the ovulation tests, etc.

That's why it is important to find a reason or several reasons why fertility has decreased... As long as the negative factor acts, there can be no question of increasing the ability to conceive.

The following steps can help women increase their fertility.

Sex life should be regular, changing partners is not encouraged, it is better to have sex with a regular partner at least twice a week.
There is no diet to increase fertility, more precisely, the recommendations relate to the abolition of all diets. Low-calorie foods, lack of meat, carbohydrates, mono-diets reduce the ability of women to conceive. When planning, attention should be paid to adequate nutrition.
Quitting bad habits can significantly increase fertility rates.
Vitamins should only be taken as directed by a physician. Selenium, magnesium, vitamins E, C, B, folic acid predominate in complexes to increase fertility.
Reasonable, moderate exercise should not be avoided.
During ovulation, the use of anesthetic drugs is contraindicated, they disrupt the ovulation stages.
At the stage of planning a child, a woman is not recommended to drink coffee and strong tea.

If you are overweight, you should reduce it.

All drugs that are positioned as a means of increasing fertility are not a panacea. In most cases, these are dietary supplements. But they should be taken only with the permission of a doctor.... These include "Pregnoton", "Tribesan", "Ovariamin".

Hormones to stimulate ovulation should not be taken without the knowledge of the doctor. Such cycles are supervised by a doctor and ultrasound. For these purposes, apply "Clomiphene", "Klostilbegit", "Metrodin", "Pregnil" and other means.