Causes of Female Infertility
Several different factors can lead to female infertility. Some of these factors include Pelvic inflammatory disease (PID), Polycystic ovary syndrome (PCOS), Endometriosis, and Premature ovarian failure.
Endometriosis
Approximately 10% of women worldwide have endometriosis, a common gynecologic disorder that is characterized by ectopic endometrial tissue growing outside the uterus. It is also associated with a variety of symptoms, including pelvic pain, bleeding, dysmenorrhea, and infertility.
The majority of women with endometriosis have mild to moderate symptoms, which do not require treatment. However, more severe cases may require surgical intervention. Laparoscopy is the most common form of surgery.
Endometriosis and female infertility is associated with a variety of underlying pathophysiological mechanisms, including chronic inflammatory response, fibrosis, scar tissue, and excess estrogens. The underlying mechanisms of endometriosis are not fully understood. Organic toxicants, such as dioxin, may play direct mechanistic roles.
Endometriosis is commonly associated with pelvic pain, which can be debilitating. It can affect the lining of the fallopian tubes, causing them to become blocked. Occasionally, endometrial-like tissue grows in other areas of the pelvis, such as the ovaries. Depending on where the tissue grows, symptoms can vary greatly.
Patients with deep endometriosis (e.g., adenomyosis) have a worse prognosis than women without endometriosis. Deep endometriosis is also associated with advanced stages of the disease. The presence of endometrial-like tissue may also increase the risk of placenta abruption and significant bleeding.
Several studies have investigated the prevalence of adenomyosis in patients with endometriosis. The prevalence of adenomyosis is unknown, but it has been reported in about 40 percent of women with endometriosis. However, small sample sizes make it difficult to determine whether the presence of adenomyosis relates to the presence of deep endometriosis.
Polycystic ovary syndrome (PCOS)
Among women of reproductive age, polycystic ovary syndrome (PCOS) is the most common cause of infertility. It is a hormonal imbalance that can interfere with the body’s ability to ovulate and produce healthy eggs. This condition can also increase the risk of other health conditions, such as diabetes.
It is important to recognize the symptoms of PCOS and get treatment as soon as possible. If you have PCOS, you may need to work with a fertility specialist to get pregnant. You may also need to take fertility medications, such as gonadotropins.
Many women with PCOS experience irregular menstrual periods. They may also experience infrequent menstrual periods, abnormally heavy periods, fewer than nine periods a year, or no periods at all. They may also develop skin tags, hair growth similar to that of men, and darkening of the skin.
Ovulation occurs when one of your ovaries releases an egg each month. When ovulation occurs, your ovaries produce hormones that cause a follicle to break out of the ovary. The follicle contains fluid that looks black on an ultrasound.
Some women with PCOS may develop small cysts on their ovaries, which can interfere with the ovaries’ ability to produce and ovulate. Other women have no cysts on their ovaries.
Symptoms of PCOS can be diagnosed through physical examination and blood tests. Your doctor may also perform an ultrasound to check for cysts or tumors on your ovaries.
Uterine defects
Various studies have suggested that congenital uterine defects may have an adverse effect on fertility. However, it remains unclear how prevalent these anomalies are among infertile women. Several factors are likely to have contributed to the reported prevalence.
Class I studies estimated the overall prevalence of congenital uterine anomalies to be between 6.0 and 7.4%. Class II studies reported lower prevalences.
Several factors contribute to the difficulty in determining the true prevalence of these anomalies. Some of these include diagnostic bias and selective sampling. Some anomalies are highly asymptomatic, making it difficult to determine their prevalence. The accuracy of diagnostic methods also varies, contributing to the uncertainty of the true prevalence.
The most common congenital uterine anomaly is the septate uterus. This anomaly has decreased blood supply and is associated with poor pregnancy outcomes. Hysteroscopic metroplasty is often used to treat septate uteri, improving fecundity rates.
Other anomalies include the bicornuate uterus, unicornuate uteri, and hypoplastic uteri. These anomalies are more prevalent in infertile women. They are also associated with recurrent pregnancy loss.
Studies of the prevalence of these anomalies in the general population have produced similar results. However, the prevalence among infertile women is higher than in the general population. The study conducted by Saravelos et al. estimated the prevalence of congenital uterine anomalies in the infertile population to be 3.5%. This estimate is higher than the prevalence among the general population estimated by Nahum.
Fibroids, cysts and scar tissue
Among the most common congenital anomalies of the reproductive system, fibroids, cysts and scar tissue in female infertility can negatively affect a woman’s ability to conceive. They are non-cancerous tumors that develop in the muscle walls of the uterus. They are benign, but they can cause severe pain during intercourse, periods, and menstruation.
In addition, fibroids can interfere with fertility treatments. For example, they can block the fallopian tubes and prevent egg and sperm from meeting. They can also cause internal bleeding. The symptoms vary depending on the size and location of the fibroid. Some fibroids grow gradually over the years while others can suddenly appear.
If you think you may have fibroids, your doctor may order a pelvic exam. This exam will determine if you have fibroids, and if so, how many. The exam can also help your doctor determine whether surgery is necessary.
If you do have fibroids, you may be able to manage them with medication. Some drugs that reduce the size of fibroids include acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs). Some women are able to prevent fibroids from growing after they become menopausal.
Other treatments for fibroids include uterine artery embolization and myomectomy. These treatments involve inserting small plastic particles into the arteries of the uterus to block the blood supply to fibroid cells. The particles shrink the size of the fibroids. This surgery may be performed with a traditional “open” surgical approach or using minimally invasive surgical methods.
Pelvic inflammatory disease (PID)
Approximately one in seven women in the United States will be diagnosed with pelvic inflammatory disease (PID) at some point in their lifetime. Pelvic inflammatory disease can lead to a number of complications, including infertility. In addition, PID can increase your risk of developing ectopic pregnancy. This is a condition in which an egg grows inside the fallopian tube. If this happens, the tube becomes damaged, causing severe pain and bleeding.
Pelvic inflammatory disease is caused by bacteria. The bacteria can enter the reproductive tract if you have unprotected sex or if you are exposed to a sexually transmitted disease (STD).
The symptoms of the pelvic inflammatory disease may appear similar to other conditions. However, it’s important to seek treatment for PID as quickly as possible. This can help avoid complications and prevent permanent damage to your reproductive organs.
The main treatment for PID involves antibiotics. These antibiotics are given in the form of tablets, injections, or intravenously. The type of antibiotic used depends on the cause of the infection. The course of antibiotics should last for fourteen days. You should also avoid sexual activity while you are taking antibiotics. If the infection doesn’t respond to the antibiotics, you may need to undergo surgery.
Pelvic inflammatory disease can be caused by a number of different sexually transmitted diseases, including gonorrhea and chlamydia. If you are at risk of having one of these diseases, you should get screened regularly.
Premature ovarian failure
Approximately 1% of women younger than 40 years of age have premature ovarian failure, a condition in which the ovaries stop producing eggs before the woman’s natural menopause. The condition can cause infertility, irregular menstrual cycles, and other menopause symptoms.
Premature ovarian failure can be caused by many different things, including autoimmune conditions, infections, and radiation therapy. Some women have a genetic predisposition to the condition.
One way to tell if a woman has primary ovarian insufficiency is to look at her follicle-stimulating hormone levels. This hormone is elevated in women with the condition, indicating decreased ovarian function. Approximately 5% of women who have primary ovarian insufficiency have a mutation in the FMR1 gene. This gene is located on chromosome 21.
Other causes of primary ovarian insufficiency include a type of cancer called ovarian germ cell cancer. A chromosome disorder called Turner syndrome can also cause premature ovarian failure.
Genetic tests can help identify the cause of ovarian failure. Research has found that about 50 different genes have been associated with this condition.
Women with primary ovarian insufficiency can have a variety of symptoms, including irregular menstrual cycles and lowered libido. They may also experience osteoporosis and changes in their mood. This condition can have a lasting effect on a woman’s fertility.
Some women with primary ovarian insufficiency are able to become pregnant naturally. This condition can be treated with estrogen and progestogen therapy. It can also be treated by surgery or radiation therapy. The goal is to restore the ovary’s germinative function.
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