Infertility & Ovulatory Disorders


When you consider the intricate process by which a fertilized egg, no more than 0.13 mm (0.005 inch) in diameter, and considerably smaller than the size of a full-stop on this page, grows and develops into a new human being, it is surprising not that some of us have difficulties in conceiving and bearing a child, but that it ever happens at all. Even so, for one in every 10 couples, regular unprotected sex for over a year will not result in conception. While nothing is more agonizing to a couple attempting to conceive than the dawning anxiety that one of them may be infertile, the fear of a childless future is often unfounded. The treatment of infertility is one of the most optimistic areas in medicine and is now coming to the rescue of six out of every 10 couples referred to infertility clinics for further investigation.

If you have been trying to conceive for two or more years or you are older and the pressure of time is upon you, make an appointment with your doctor. In a surprisingly high number of cases, a preliminary interview with both of you will be enough to bring on conception. It may be that a return to normal, non-anxious lovemaking works the magic. But the connection between consultation and conception, about 20 per cent, is too high to be coincidental. During the interview, your doctor may suggest that you try some simple, self-help methods to increase your chances of conception.

If these methods fail or the necessary premeditation for carrying them out is placing strains on the relationship, further investigation should be embarked upon right away. It is important that both partners should be tested for possible infertility. First, the incidence divides fairly equally between men and women at 40 and 50 percent respectively (in 10 percent of cases, no clear reason for infertility is found). Second, tests for male infertility (sperm count and clinical examination) are considerably simpler and less extensive.

Ovulatory Disorders:

Ovulatory disorders are the most common cause of female infertility and, therefore, tend to be investigated first. Such disorders maybe the result of inadequate hormonal stimula­tion or, less often, an imbalance caused by raised pro lactin levels (this can be treated by a course of tablets). Or they may simply reflect a temporary difficulty in conceiving. This is particularly possible in the late twenties or thirties, as fre­quency of ovulation declines past the age of 25. A blood test or endometrial biopsy (scraping taken from the lining of the uterus) taken in the second half of the cycle will establish whether or not ovulation has occurred by testing for levels of the ovarian hormone, progesterone. This is the key hormone because it is secreted by the ruptured follicle once ovulation has taken place.

In the event of ovarian malfunction, the ovaries can often be stimulated with a weak anti estrogen, chlomiphene citrate. This raises the level of naturally occurring ovarian stimulating hormones in the pituitary gland to induce ovula­tion in about 80 percent of women. There is a six percent risk of multiple birth, almost always twins and very occasionally triplets. If this fails, the stronger gonadotrophin hormones (LH and FSH) may be prescribed. As these act directly on the ovaries, excessive stimulation gives a higher (20 per cent) chance of multiple pregnancy. Although usually twins, these drugs are responsible for the dramatic incidences of quintuplets and sextuplets and careful assessment of the level of stimulation required is therefore essential.

Damaged Fallopian Tubes:

The second most common cause of female infertility, dam­aged Fallopian tubes, unfortunately, cannot usually be as easily or as successfully treated as ovulatory disorders. The Fallopian tubes are most commonly damaged by venereal infection, but other factors can be an ectopic pregnancy, in which part oral! of the Fallopian tube is removed with the growing embryo, any type of pelvic surgery and even a ruptured appendix. Sometimes, micro surgical techniques are used in order to free blocked or scarred tissue that might be interfering with the passage of the egg from the ovaries to the uterus. This, however, sounds much simpler than it is. The Fallopian tubes are so delicate that surgery can some­times aggravate, rather than mend, the damage.

In the future, correction of this type of infertility probably lies with the newly-developed methods of ‘in vitro’ (test tube) fertilization. The egg is taken from the ovary, either during natural or stimulated ovulation, fertilized by the sperm outside the body and then re-implanted in the uterus. But it is still a young science and several difficulties must be overcome before it becomes more widely available.


  1. Griffin says:

    I agree, it can be really hard to get a feel for results with just OR shots. The “frozen caterpillar” was after full healing, and it was muuuuuuch smaller than the comparable OR pictures (this was on Miro’s site). Overall though, you will generally have less length if you go for urethral hookup because the clitoris is brought down to minimize the amount of urethra that has to be created.

    Unless I think the results are “too good to be true,” I think that a surgeon site is a great place to get a good view of the average results that you can expect to have (healed photos are the best). Some people will have great results and there will be a few who won't have the best results for whatever reason. The key is to find a good middle-ground.

    This comes up a lot, over and over with MtFs especially. There is a constant running dialogue between women about which surgeon is “the best,” who does aspect XYZ the best, who gives the most depth etc. And the big thing — the big conclusion that most people come up with is that a picture doesn’t tell the whole story. Labia-wise, Biber wasn’t the absolute best his last year. But Biber had almost zero complications, great feeling, great depth. Basically he had the whole package, but one small area he was a tiny bit less good in.

    You’re already way ahead by knowing which aspects are most important to you. At this point, the only real advice I can give you is not to rush it. When people rush things, they tend to make big mistakes.

    The reason why I connect the vaginectomy with a fistula is that the urethra isn’t supposed to support itself, like the bladder it’s meant to have something else supporting it. Fistula is more likely if there has been an organ removal, like a hysterectomy or vaginectomy, but it can technically happen during any pelvic surgery or even during childbirth.

    Fistulas happen, they’re a complication with every type of pelvic surgery. It doesn’t mean that […]

  2. Jana says:

    Lacey, I thought I read somewhere that Marissa's fallopian tubes are still intact and she can produce an egg but can't carry a baby because she has no uterus. I could be wrong but never read that her eggs were frozen. Lisa, just because Marisssa and Judah used a surrogate does not mean they are not the biological parents. The surrogate simply carried Zev and is of no blood relation to him.

  3. hcgdietmum says:

    hi, i know what you are talking about because i have the same problems…. so any time i just can't go to the bathroom i just eat something with oil…. i gain lbs back but then i can go to the bathroom… so far i have lost 19 bls because i gaing some back…. i will start the hcg again but this time i will not take out milk and i will not restrict my self as much as the original protocol says, i notice that eat other foods and still lose weight.