What Are The Success Rates Factors?

A woman’s age can be important:

Many women are aware that around the age of 35, their natural fertility starts waning. The success rates factors of pregnancy are diverse and varied for every woman. The exact time varies considerably but occurs when the ovaries start to produce less eggs. At the age of 25 it is likely that a woman has many functioning follicles in the ovaries. Every month, one of these follicles will produce an egg. As the follicles function declines, so it can be that an egg is produced not every month, but every couple of months. When this happens, from the early forties, the women has entered into early menopause. Therefore if a woman was trying to become pregnant, it could be that  it takes longer to become pregnant because not every month an egg is being produced.

Women’s fertility decreases with age from about the age of 35 onwards and their fertility reduction starts to become significant after the age of 40. This reduction is related to the decline in the number of “eggs” that remain in the ovaries as these are used up over the years from the finite number that are available from the onset of periods. It is possible that Mr Dobson may advise a blood test prior to you going ahead with a reversal procedure. He will discuss this with you at your consultation.

Also, other internal ageing takes place. The lining of the womb, the endometrium, can decline in thickness so if the woman is still producing healthy eggs, the depleted lining may prevent a pregnancy from occurring.

The fluid in the vagina also changes as a woman gets older and it becomes thinner which results in the sperm being unable to live for the length of time required to get to the egg and fertilise it.

Age As A Success Rates’ Factor

At around the age of 35, natural fertility starts waning, but it doesn’t suddenly stop! It is different for every woman and a persons fertility history is the best predictor of success. For example, if you conceive easily at the age of 36, your fertility at the age of 40 will likely still be very good. However, if you struggled to conceive at the age of 30, you may struggle more at the age of 40. This reduction in fertility with age occurs due to an increase in the likelihood of the egg that is released that month being less genetically normal as we age. At the age of 20 a woman has many healthy and genetically normal eggs in the ovaries (around 9 out of 10 eggs released will have the ability to make a healthy baby). But as the women gets older, the number of genetically normal eggs that she will release each year declines, so that by the age of 40 only around 10% of eggs released in a year have the ability to form a healthy pregnancy. It is for this main reason, that the chance of pregnancy each year declines. 

Condition of the fallopian tubes:

As women become older, the amount of oestrogen they produce reduces so all the female reproductive tract thins including the fallopian tubes. Fallopian tubes, one from each ovary leads to the womb or uterus can sometimes also become damaged and blocked. There are a few potential causes for this:-

* Pelvic infections (such as pelvic inflammatory disease)

* Use of an intrauterine device if it causes a pelvic infection (which is rare)

* A ruptured appendix, surgery in the pelvis or lower abdomen

* A mislocated (ectopic) pregnancy in the fallopian tubes

* Birth defects of the uterus and fallopian tubes

* Endometriosis

* Fibroids in the uterus

Pre existing conditions of the fallopian tubes:

The fallopian tubes (tubes connected to the uterus which facilitate the fertilisation of an ovulated egg with sperm, before transporting the fertilised egg into the uterus) may sometimes have been damaged, even before your sterilisation took place. If this is the case, this can mean the reversal surgery may not result in the success rate that we would otherwise expect.

There are a few potential causes for this:-

* A history of pelvic infections (such as pelvic inflammatory disease or any sexually transmitted infections)

* A history of a ruptured appendix, surgery in the pelvis or lower abdomen

* A history of a miss-located (ectopic) pregnancy in the fallopian tubes

* Birth defects of the uterus and fallopian tubes

* Endometriosis

* Fibroids located at certain places within the uterus 

The menstrual cycle:

As women become older, their ovaries naturally fail to produce oestrogen and progesterone. This is linked to the number egg cells that a woman has. Every woman is born with a pre-determined number of egg cells. From birth onwards, the number of egg cells declines very gradually at first but from puberty onwards this increases, partly as eggs are released but around the age of 40 there is a more rapid degeneration. With less egg cells, the ovaries are then less able to react to hormones from the pituitary gland in the brain, these are called follicle stimulating hormone (FSH) and luteinising hormone (LH) and so there is a decrease in the production of oestrogen. With this reduction, there is a rise in the levels of FSH and LH and a change in the menstrual cycle. Monthly periods become more erratic and eventually stop as the hormone levels continue to change. The monthly cycle’s regularity is one of the key success rates factors.

Ovarian reserve:

Another factor that affects our fertility as we age is the number of eggs left in the ovaries, or the ‘ovarian reserve’. Women are born with a limited number of eggs in the ovaries. Each month a group of eggs is recruited and lost. As the months go on and eggs are recruited and ovulated with menstrual cycles, the remaining number of eggs in the ovaries declines. Once the ovarian reserve reaches a certain point, an egg is not always released each month and so the periods can become less regular. Once there are no eggs left & the periods stop, this is called the menopause. It is important to remember though that there are other reasons for periods being irregular and stopping, which may not be due to the menopause.

If your cycle is irregular or there is a possibility that your ovarian reserve is low, Mr Dobson may discuss doing a blood test or ultrasound scan with you prior to your surgery. In the case of a normal ovarian reserve and irregular periods, Mr Dobson will be able to offer treatment in addition to reversal surgery to help improve your chances of conceiving. 

Male Fertility: One Of The Important Success Rates Factors

There are many factors that can affect male fertility

* obstructive problems (blockages in sperm-carrying tubes)

* testicular injury and disease

* varicocele

* sperm disorders

* genetic disorders

* problems with erection and ejaculation

* hormonal problems

* general medical disorders that reduce fertility

* drugs that reduce fertility

* environmental toxins and radiation.

Other unknown factors usually connected to the reproductive system.

There are, very occasionally, other factors that cause infertility or problems with fertility and it is only through working through the problems that the solution or cause is found.

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