Ang female infertility ay tumutukoy sa hindi pagbubuntis kahit regular na pagtatalik sa loob ng 12 buwan. Sa Pilipinas, tinatayang 15% ng mga couples ay apektado—sa kalahati ng mga kaso, ang sanhi ay nasa babae. Sa blog na ito, malalaman mo ang mga pangunahing sanhi, diagnostic steps, therapy options, at practical tips para sa Filipino couples.
Definition: Primary vs. Secondary Infertility
Primary infertility: Hindi pa nagkakaroon ng pregnancy kailanman.
Secondary infertility: Nagkaroon na ng pregnancy, pero hindi na muling magbuntis.
Pangunahing Sanhi ng Female Infertility
- Polycystic Ovary Syndrome (PCOS): 6–10% ng kababaihan. Insulin resistance at mataas na androgen ay nagdudulot ng irregular o absent ovulation.
- Diagnosis: Rotterdam criteria—irregular cycle, hyperandrogenism, polycystic ovaries sa ultrasound.
- Therapy: Weight loss (5–10%), metformin para sa insulin resistance, letrozole para sa ovulation induction.
- Ovulation disorders (non-PCOS): Thyroid problems (hypo/hyperthyroidism), hyperprolactinemia.
- Diagnosis: TSH, fT3/fT4, prolactin (cycle day 2–5).
- Therapy: L-thyroxine para sa hypothyroidism, dopamine agonists para sa hyperprolactinemia.
- Endometriosis: Paglago ng endometrial tissue sa labas ng uterus, nagdudulot ng adhesions at pain.
- Diagnosis: Laparoscopy.
- Therapy: Minimal-invasive surgery, tumataas ang pregnancy rate.
- Tubal factor: Adhesions o blockage ng fallopian tubes, kadalasan dahil sa infection.
- Diagnosis: Hysterosalpingography.
- Therapy: Hydrotubation, tubal surgery, IVF kung severe blockage.
- Uterine anomalies at myoma: Septum, fibroids—nakakaapekto sa implantation.
- Diagnosis: 3D ultrasound, hysteroscopy.
- Therapy: Hysteroscopic resection.
- Genetic at immunologic factors: Chromosomal anomalies, antiphospholipid antibodies.
- Diagnosis: Karyotyping, antibody screening.
- Therapy: Heparin plus aspirin para sa APS.
- Idiopathic infertility: Walang nakitang sanhi kahit kumpletong tests. IUI o IVF ang options.
- Male factor: 40% ng couples, sperm analysis (WHO: ≥15M/ml, ≥40% motility, ≥4% morphology).
Diagnostic Steps
- Anamnesis at cycle tracking (cycle length, symptoms, lifestyle)
- Hormone profile (cycle day 2–5: FSH, LH, AMH, TSH, prolactin, estradiol)
- Transvaginal ultrasound (antral follicles, myoma, cysts)
- Hysterosalpingography (fallopian tube patency)
- Laparoscopy kung may suspicion ng endometriosis o adhesions
- Genetic analysis kung recurrent miscarriage
Success Rate ayon sa Edad
- Mas mababa sa 35: ~30% live birth rate per embryo transfer
- 35–39: ~20%
- 40 pataas: ~10%
Assisted Reproductive Techniques: IUI vs. IVF
IUI: 10–15% success per cycle
IVF: 25–35% live birth rate per cycle
Source: ESHRE ART Guidelines
Kailan Dapat Magpatingin?
35 pataas: Pagkatapos ng 6 buwan na walang pregnancy
Below 35: Pagkatapos ng 12 buwan
Checklist para sa Clinic Visit
- I-track ang cycle data (temperature, cervical mucus, ovulation symptoms)
- Ihanda ang medical records at listahan ng gamot
- Magpa-appointment para sa ultrasound at HSG
- I-check ang PhilHealth o insurance coverage
Lifestyle at Nutrisyon
BMI 20–24 at Mediterranean diet ay nakakatulong sa fertility.
- 400 mcg folic acid/day at 1g omega-3
- 150 min/week moderate exercise
- Iwasan ang trans fats at processed food
Environmental Factors at Toxins
Endocrine disruptors (BPA, phthalates) ay nakakasira ng egg quality.
- Gumamit ng glass o stainless steel na lalagyan
- Pumili ng organic food para iwas pesticide
- Filtered water para iwas PCB at heavy metals
Konklusyon
Ang female infertility ay maraming sanhi pero kadalasan ay nagagamot. Maagang diagnosis, tamang therapy, healthy lifestyle, at modern reproductive options ay susi sa mas mataas na chance magka-anak. Kumonsulta agad sa espesyalista at sundin ang evidence-based guidelines.