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 Infertility
Infertility refers to an inability to conceive a child within
a one year time span. Infertility is different from sterility.
If someone is sterile, they are unable to conceive a child. If
one is infertile, the ability to conceive a child is there,
but any number of factors are occurring that prevent pregnancy
from happening.
There are many potential causes of both male and female
infertility. Approximately 15% of couples are infertile. Of
this 15%, male infertility counts for approximately 20% of the
cases. Female infertility accounts for up to 70% of these
cases, largely due to the very complex processes involved in
the female reproductive system.
Most women are unaware that they may be infertile until they
begin trying to get pregnant. Some signals of potential
difficulties can be irregular menstrual periods or other
conditions that cause pain during intercourse or menstruation.
Causes of Female Infertility
There are a multitude of possible causes for female
infertility, and these may include the man, the women, or both
partners. There are situations where the cause of infertility
is more of a sexual problem, such as inability to obtain or
keep an erection. As well, certain infections and diseases can
cause infertility.
The most common causes of female infertility include:
1) Tubal occlusion
This is the most common cause of infertility in women, and is
the result of an obstructed fallopian tube. This makes it
difficult for the fertilized egg to make the move through the
fallopian tubes to implant into the uterus. Tubal occlusion is
very often brought on by pelvic inflammatory disease (PID).
Most women with PID don't know they have it.
2) Endometriosis
Endometriosis accounts for between 5-30% of female infertility
cases. Endometriosis is a medical condition in which the
tissue of the uterine lining is implanted and growing outside
of the uterus, most often on the ovaries or the lining of the
abdomen near the uterus, fallopian tubes and ovaries. This can
cause scarring and inflammation of the tissues of the pelvis.
3) Hypothalamic-pituitary disorders
Approximately 30% of female infertility is caused by ovulation
disorders. The hypothalamic-pituitary axis is the part of the
brain responsible for ovulation, and disruption of it can
cause deficiencies in luteinizing hormone and
follicle-stimulating hormone.
4) Polycystic ovary syndrome (PCOS)
Polycystic ovary syndrome accounts for under 10% of female
infertility. This syndrome causes high amounts of androgens
(male hormones), particularly testosterone, to develop. This
heightened androgen production stops the ovaries from
producing a mature egg. This inability to produce an egg
causes the follicles of the ovary to swell with fluid and form
into cysts. PCOS may also account for many problems involved
in menstrual disorders, including lack of menstruation
(amenorrhea) or infrequent menses (oligomenorrhea).
5) Early menopause
Early menopause is premature ovarian failure, and results in
the absence of menstruation and the early depletion of ovarian
follicles prior to 40 years of age.
A number of conditions are associated with early menopause
including:
-
Low levels of some growth
factors produced by the ovaries
-
Radiation therapy and
chemotherapy
-
Autoimmune disease, where the
body produces antibodies that attack the ovary
6) Elevated prolactin levels
This condition is called hyperprolactinemia. The hormone
prolactin acts to stimulate breast milk production, and
elevated levels in non pregnant or non nursing women can
affect ovulation. Certain medications can elevate levels of
prolactin. Elevated breast milk production should be discussed
with a doctor.
7) Luteal phase defect
Luteal phase defect is due to impairment in the
development of the lining of the uterus in preparation for
fertilized egg implantation, resulting from an insufficient production
of the hormone progesterone.
8) Benign uterine fibroids
These benign tumors exist in the wall of the uterus and can
interfere with the contour of the uterine cavity, causing some
blockage of the fallopian tubes or changes in the position of
the cervix. This prevents the sperm from reaching the uterus,
where it can fertilize an egg. Benign uterine fibroids are
common in women in their 30s.
9) Pelvic adhesions
Abdominal or pelvic surgery or infection can cause bands of
scar tissue to develop which can restrict the movement of the
ovaries and fallopian tubes, leading to infertility.
Women who suspect they are infertile should discuss their
suspicions with a doctor and remember that infertility does
not preclude pregnancy. Infertility means that becoming
pregnant may be more challenging than usual.
Internet Health Resources offers
excellent resources and information about both
male and female
infertility. The American Fertility Association
offers information and support services about
infertility. |
