Female infertility

For a lay person:

Female infertility means being unable to get pregnant after a year of regular unprotected sex, or after six months for women over 35. Common causes include problems with ovulation, blocked fallopian tubes, endometriosis and age, and sometimes no cause is found.

For a trained medical person:

Causes include ovulatory dysfunction such as polycystic ovary syndrome, hypothalamic and thyroid disorders, diminished ovarian reserve, tubal disease from infection or surgery, endometriosis, uterine abnormalities and fibroids, with male factors present in many couples. Work-up includes ovulation assessment, ovarian reserve testing, tubal patency imaging, pelvic ultrasound and semen analysis of the partner. Treatment depends on cause and may include ovulation induction, surgery, IUI or IVF.

In Chinese medicine:

Liu and Tseng's textbook differentiates this condition into these patterns: Chong and Ren Blood Deficiency, and Failing to Nourish the Uteru s; Phlegm-Damp Obstructing Chong and Ren Channels, and Obstructing the Uterine Channels; Infertility Due to Obstruction in Fallopian Tubes (Postsurgery or After Inflammation); After Menstruation, before Rising of Basal Body Temperature; Before or during Menstruation; Yin Deficiency with Hyperactive Yang; Kidney Deficiency and Blood Stasis. Treatment follows the pattern a patient presents with, not the Western diagnosis alone.

When to get help: See a doctor after a year of trying, or after six months if over 35 or with irregular periods or known pelvic problems. If you are having fertility treatment or may be pregnant, tell your clinic about all herbs, as some interfere with treatment or are unsafe in early pregnancy.