What is female infertility?

Generally female infertility is defined as the impossibility to conceive with unprotected intercourses during the potentially fertile days of a menstrual cycle. From a medical point of view, infertility occurs after at least 12 months of unsuccessful attempts at pregnancy or 6 months for women over 35, or in case of further risk factors that may reduce the capacity of conceiving.

INFERTILITY  STERILITY

Even though “infertility” and “sterility” are often overlapping terms in collective imagination, there is a clear distinction between them. The latter indeed is defined as the impossibility to conceive, due to irreversible causes. Whereas infertility is a condition which causes might be solved.

Female infertility: possible causes

Once the 12 or 6 months have passed with no success, women, led by their gynecologists are likely to start investigating the causes of infertility and intervening when possible. Likewise, male partners will start their investigation too, to measure their degree of fertility.

Female infertility may be caused by a range of factors, classified and summarized as follows:

Tubal factor: malformations or malfunctions of the Fallopian tubes
Uterin factor: congenital or acquired malformations or alterations (myomas, polyps) of the uterus
Cervical factor: alterations of the cervix that make the journey of sperm into uterus and tubes more difficult
Hormonal factors: hormonal alterations prevent ovulation, which is at the root of conception. Some dysfunctions, like PCOS and thyroid problems may interfere with ovulatory cycles.

OTHER possible causes

Adehesions, due to previous inflamations or surgery
Endometriosis: a frequent condition in fertile women implying an abnormal growth of endometrial tissue in other organs (like for example the ovary). Such condition is often without symptoms, but it may severely reduce the chances of conceiving
Idiopathic Infertility: unexplained infertility, when no cause has been detected in spite of the analyses carried out
Infections, age and lifestyle

PCOS among the most frequent causes of infertility: WHY?

PCOS stands out as one of the most frequent hormonal causes of infertility.

PCOS stands out as one of the most frequent hormonal causes of infertility.

PCOS affects 5 to 10% of women

PCOS affects 5 to 10% of women in their reproductive age, and it is characterized by:

hyperandrogenism
menstrual/ovulatory disorders
morphological alterations of the ovary

Women with PCOS might be overweight/obese or have a metabolic syndrome which determines insulin-resistance with compensatory hyperinsulinemia, often regardless the weight.
An excess of insulin in blood stimulates the production of androgens and LH, with a consequent unbalance of the cycle hormones.

Unbalanced
ratio LH/FSH
and hyperandrogenism

ANOVULATION

INFERTILITY

Unbalanced
ratio LH/FSH
and hyperandrogenism

ANOVULATION

INFERTILITY

This is why PCOS is often at the root of female infertility.

THE PROFESSOR
ALESSANDRO GENAZZANI, SPECIALIST IN GYNECOLOGY AND OBSTETRICS HELPS US TO UNDERSTAND OVARIC POLICYSTOSIS AND THE BOND WITH FEMALE FERTILITY, AS WELL AS THE BENEFIT ROLE OF DCI IN THE TREATMENT OF THE SAME.

DCI as an aid for fertility:
why?

1. Its role in the treatment of PCOS

The treatment of PCOS should first of all aim at improving the metabolic pattern, that is why alongside a change in lifestyle, insulin sensitizers are used to reduce compensatory hyperinsulinemia.

It is not rare however, that such medications lead to side effects, especially gastrointestinal problems.

The discovery that inositols have a positive effect on the glucose metabolism has broadened the horizons of the possible therapies, reducing the side effects and reaching the therapeutic objective at the same time.

It has been pointed out that under a condition of insulin-resistance there is a deficit of DCI, normally involved in the transduction of the insulin signaling.
A lack of DCI might result in the onset of insulin-resistance. Women with PCOS have low levels of DCI, due to a poor conversion enacted by the enzyme epimerase, which is more evident in obese women or women with familiar diabetes.

WOMEN WITH PCOS

REDUCED CONVERSION OF THE DCI TO THE ENZYME EPIMERASE

DCI DEFICENCY

WOMEN WITH PCOS

REDUCED CONVERSION OF THE DCI TO THE ENZYME EPIMERASE

DCI DEFICENCY

Absorbing a complementary amount of DCI by means of specific supplements helps halting the vicious circle and restoring a correct response to insulin, overcoming the obstacle represented by the deficit of the enzyme epimerase.

From the point of view of fertility, this can be translated into:

Reduction of the levels of insulinemia, decreasing Hyperandrogenism, decreased secretion of androgens
Improving insulin sensitivity with an increase of the hepatic synthesis of SHBG, a protein that carries sexual hormones. When the androgens bind to SHBG, they do not produce dysfunctions
Decreased production of LH and a restored ratio LH/FSH, might help to restore regular ovulation
Better chances of conceiving

2. Dci to improVe ovarian egg quality

Besides the benefits in the regularity of the menstrual cycle and thus on the fertility of women affected by PCOS, lots of research have demonstrated the positive effects of DCI also on the ovarian quality. A benefit that makes DCI an ally of fertility also because:

Some research has shown that DCI improves the ovarian response as it reduces the oxidative stress in follicular fluid
It improves the quality of ovocytes and prepares women to techniques of assisted fertilisation
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