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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.
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.
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