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What is female infertility?
Infertility, otherwise known as the inability to successfully reproduce, is a problem that affects people of all genders, including women. Some studies claim that for the 10-18% of couples who struggle with fertility, an estimated 30-60% of the causes are related in some part to female infertility. The list of possible factors and causes is long and multiple tests and consultations may be necessary before a diagnosis can be determined. In some cases, female infertility may be unable to be explained by doctors.
In order to become pregnant, women must ovulate, have open fallopian tubes, and have a normal uterus. The female partner also needs to have regular intercourse with a male partner who has healthy sperm. A problem with one or more of these aspects of reproduction may be an indicator of fertility issues.
Causes and influencing factors
The human reproductive process has many stages. For females, the ovaries must release an egg, which is then picked up by the fallopian tube. The male’s sperm cells must swim up the cervix, through the uterus and into the fallopian tube to reach the egg for fertilization. After fertilization, the egg must travel down the fallopian tube to the uterus and then implant into the uterine wall to start developing into a fetus. Any stage of this process can be disrupted or complicated by a number of factors. These include:
Ovulation disorders are those in which the female does not ovulate at a proper frequency. This reportedly accounts for infertility in 1 of 4 couples. These disorders can be caused by hormonal problems or issues with the ovaries themselves.
- Hypothalamic dysfunction. Excess physical or emotional stress, a very low or very high body weight, or a recent drastic change in body weight can disrupt the production of hormones responsible for regular ovulation. Symptoms of this are irregular or absent periods.
- Polycystic ovary syndrome (PCOS). This condition causes a hormone imbalance which also affects ovulation. This syndrome is related to insulin resistance and obesity, abnormal hair growth, and acne, and is the most frequent cause of female infertility.
- Premature ovarian failure. Also known as primary ovarian insufficiency, this problem is often caused by an autoimmune response or a premature loss of eggs. When the ovary no longer produces eggs, it lowers estrogen production.
- Too much prolactin. An excess of prolactin can reduce estrogen production and cause infertility. This can be caused by medications that are being taken for other diseases.
Damaged or blocked fallopian tubes prevent sperm from reaching the egg and/or close the passage between the fertilized egg and the uterus. This damage can be caused by pelvic inflammatory disease, an infection of the uterus and fallopian tubes due to sexually transmitted diseases; surgery in the abdomen or pelvis for conditions like ectopic pregnancy; or pelvic tuberculosis.
Endometriosis is a condition that occurs when tissue that grows in the uterus starts to grow elsewhere in the body. This extra tissue growth and the removal of it can cause scarring, which can permanently damage fallopian tubes and prevent sperm from reaching an egg. This condition can also disrupt the lining of the uterus, therefore preventing implantation of a fertilized egg.
Uterine or cervical causes
Several uterine or cervical problems can interfere with implantation or increase the likelihood of a miscarriage. These include:
- Benign polyps or tumors, such as fibroids or myomas. These can be common in the uterus and can block fallopian tubes or otherwise interfere with implantation.
- Cervical stenosis. This is a narrowing of the cervix that can result from damage or an inherited malformation.
- Problems with cervical mucus. Some women cannot produce the cervical mucus needed to allow sperm to travel into the uterus.
- Uterine abnormalities. These include an abnormally shaped uterus, which is present from birth.
Certain factors can increase the risk of infertility. These include age, weight, sexual history, alcohol consumption, and tobacco and drug use.
While the primary sign of infertility is the inability to conceive a child (such as lack of pregnancy), there may be other symptoms that signal difficulties with procreation. These include a menstrual cycle that is too long, too short, irregular, or absent, which can mean the female is not ovulating. A history of irregular or painful periods, pelvic inflammatory disease, repeated miscarriages, cancer treatment, or endometriosis can also be indicative of fertility problems. Any of these symptoms, coupled with failure to conceive after a year of regular, unprotected intercourse, may be a sign of infertility and should be brought to the attention of a medical professional.
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