Female infertility is defined as the inability to get pregnant after 1 year of unprotected intercourse. This stands true for women under 35. For women aged 35 and over, the period is 6 months. Infertility is becoming more common in women than one may think. Approximately 10 percent of women in the United States, aged between 15 and 44, have difficulty in conceiving or bearing a child. There are many different causes of infertility, as listed below.
Ovulation failure (ovaries fail to produce eggs) is the number one cause of female infertility. Ovulation failure is mostly caused by polycystic ovary syndrome (PCOS). The polycystic ovary has many small, fluid filled cysts, and inside each of these cysts there is a follicle where an egg tries to develop and ready itself for the process of ovulation. These immature eggs don’t mature and are never released from the ovary due to complex biochemical imbalances associated with PCOS.
In order for a woman to be diagnosed with PCOS, she must have two of the three conditions mentioned below:
- Anovulation or irregular ovulation (amenorrhea)
- Signs of excess androgen, either clinical or biological
- Presence of polycystic ovaries
In women diagnosed with PCOS it is still possible to get pregnant with the use of medication and surgery.
There are other causes of infertility that include:
- Malfunctions of pituitary gland
- Scarred ovaries
- Premature menopause (in rare cases)
- Thyroid disorders: Hypothyroidism and hyperthyroidism
- Chronic diseases: Cancer and AIDS
When a woman goes through rigorous testing in order to determine the cause of her infertility and nothing abnormal can be found, she is said to have unexplained infertility. The testing for female infertility entails assessing each ovary for the ability to ovulate, x-ray of the uterus, fallopian tubes and areas around them, as well as tests to monitor ovarian reserve and an analysis of the male’s semen. In some cases of unexplained female infertility, it is not the female at all, but rather the male with a low sperm count or some other malady relating to his testicles.
Tubal Infective Damage
Infected fallopian tubes are normally caused by an undiagnosed and untreated sexually transmitted infection. The most common culprit is Chlamydia trachomatis. It is estimated that 2 to 6 percent of males and females between the ages of 15 to 42 have Chlamydia. Chlamydia is the most common sexually transmitted infection, as well as the most curable infection. Chlamydia is so prevalent, because an infected person often has no signs or symptoms of the infection. If this infection is left untreated in a woman, it will eventually travel up the reproductive organs to the fallopian tubes and cause scarring. This scarring leads to tubal factor infertility.
It is estimated that 20 to 30 percent of women with endometriosis suffer from subfertility. Endometriosis is a lifelong condition that is marked by the growth of endometrial tissue outside of the uterus. Most commonly, endometrial tissue grows around the fallopian tubes and ovaries and inside the pelvic cavity. A common effect of endometriosis is fallopian tube damage. There are many signs and symptoms related to endometriosis, such as: pelvic pain, menstrual pain, and pain with intercourse. The severity of symptoms does not determine how bad the endometriosis is. A woman who has only mild endometriosis may experience all of the symptoms, but at the same time, a woman with sever endometriosis may have no symptoms at all. The symptoms and the severity of the condition don’t have significant correlation.
Cervical Mucus Defects
The purpose of cervical mucus is to transport sperm to the fallopian tubes unharmed. Sperm require a certain amount of clear fluid to protect them from the highly acidic environment in the vagina and to help them move up the genital tract. In order to determine if there is a cervical mucus defect, a sample of cervical mucus has to be collected 6 to 12 hours after normal sexual intercourse. The doctor will examine the collected mucus under a microscope to see how well the sperm functions in the mucus. Sometimes cervical mucus will contain antibodies that restrict the movement of sperm. A doctor may describe this as an unfriendly cervix.
If there is a problem with the uterus such as the formation of fibroids, adhesions or polyps, infertility can be the end result. Fibroids are benign growths in and on the uterus. They vary in size and a woman may develop many fibroids at a time. Surgical excision is performed in women who want to have children, although the most common treatment for fibroids is a partial hysterectomy. Adhesions are also known as scar tissue. There are different reasons for the development of scar tissue on the uterus. A previous abortion, an infection, c-section and DNC are just a few causes of adhesions. Surgical removal of adhesions is possible. Polyps are masses of tissue that stick out from the organ they are growing on or in. Polyps are also removable through surgical intervention.
Female infertility can be frustrating and heart breaking for women who want to have kids. Identifying the cause of infertility and working with a physician for treatment takes time, regardless of the method.
1. “Causes of Female Infertility.” Infertility Treatments for Women: a Review of the Bio-medical Evidence, 2009. Dublin: Women’s Health Council, 2009. 14-16. Web. 12 Sept. 2011.
2. Meletis, Chris D., and Liz Brown. “Causes of Female Infertility.” Enhancing Fertility: a Couple’s Guide to Natural Approaches. North Bergen, NJ: Basic Health Publications, 2004. Print.
3. “Infertility Fact Sheet.” Womenshealth.gov. Web. 12 Sept. 2011. <http://www.womenshealth.gov/publications/our-publications/fact-sheet/infertility.cfm>.