Female Factors
Many women who experience infertility will find they have problems with their reproductive organs. Some of these problems are a result of natural causes (e.g. underdeveloped organs), illnesses (e.g. cancer, diabetes, and sexually transmitted diseases), lifestyle and environmental factors (e.g. stress, smoking, and exposure to chemicals) or complications from surgeries. Below are some causes of female infertility:
In an ectopic pregnancy, the fertilized egg or embryo implants on any tissue other than the endometrial lining of the uterus (95% occur in the tube, 1.5% are abdominal, 0.5% are ovarian and 0.03% are cervical.).
In a typical ectopic pregnancy, the embryo does not reach the uterus, but instead adheres to the lining of the Fallopian tube. In some cases, the ectopic pregnancies will resolve without treatment. However, surgical intervention is still required in cases where the Fallopian tube has ruptured or is in danger of doing so. The cause of ectopic pregnancy is unknown. There are some speculative specific causes or associations. Smoking, advanced maternal age and prior tubal damage of any origin are well shown risk factors for ectopic pregnancy.
Endometriosis is a painful, chronic disease in which the tissue of the uterine lining is implanted and growing outside as opposed to inside of the uterus. With endometriosis, tissue from the lining of the uterus moves through the fallopian tubes and lands on the ovaries, in the pelvis (causing scarring and inflammation), and on the bladder. Tissue also adheres to other areas like the abdomen and ligaments that support the uterus; the area between the vagina and rectum; the outer surface of the uterus; and the lining of the pelvic cavity. Other places for these endometrial growths may include the bladder, bowel, vagina, cervix, vulva, and in abdominal surgical scars.
Infertility is also the inability to have a successful pregnancy. Miscarriage is defined as pregnancy loss within the first 20 - 24 weeks of pregnancy. Recurrent miscarriage is defined as the loss of three or more consecutive pregnancies. Miscarriage happens in as many as 25 percent of all pregnancies. One of the most common reasons a miscarriage occurs is due to a genetic defect in the fetus in which the body itself will end the pregnancy. Usually a fetus that is not developing properly and/or a placenta is not attaching to the uterine wall properly. Other possible causes are
- Blighted ovum, a condition that is usually genetic in which the placental sac may be developing without a fetus
- Uterine infection
- Certain medications taken by the mother (although this is a rare cause)
- Low hormone levels, particularly progesterone, which may signify an unhealthy pregnancy at the start
- Structural abnormalities of the uterus
- Fibroid tumors
- Immune system dysfunction
- Age
- Unknown
According to the IntegraMed Fertility Network, the miscarriage rate is not higher for IVF than it is for anyone else getting pregnant, and is considered to be actually lower with IVF because of the selection process.
- Pelvic Inflammatory Disease (PID)
Pelvic inflammatory disease (PID) is a serious infection of the female reproductive organs. These include the uterus, ovaries, and fallopian tubes. PID can cause scar tissue to form in the pelvis and fallopian tubes. This damage may result in infertility, a future tubal pregnancy, or chronic pelvic pain. This disease can lead to tubal occlusion which is the result of an obstructed fallopian tube, making it difficult for the fertilized egg to make the move through the fallopian tubes to implant into the uterus. PID usually stems from the same bacteria that cause sexually transmitted diseases such as Gonorrhea or Chlamydia (which causes 75 percent of fallopian tube infections). It is also possible for PID to develop from bacteria that reach the reproductive organs through abortion, hysterectomy, childbirth, sexual intercourse, use of an intrauterine (IUD) contraceptive device or a ruptured appendix.
- Polycystic Ovary Syndrome (PCOS)
Ovulation disorders are the most common female infertility factors. Polycystic Ovary Syndrome (PCOS) is an ovulation disorder and accounts for under 10% of female infertility. It is one of the main causes of infertility affecting an estimated 5-10 million women of reproductive age and nearly half of all female factor infertility causes can be traced to this condition. PCOS 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). PCOS is also associated with impaired glucose tolerance and insulin resistance; many women with PCOS are also diabetic or pre-diabetic.
Some women are unable to become pregnant because their wombs have been removed, are weak or damaged. For some, wombs were removed as part of treatment for cancer of the reproductive system or due to previous complications during pregnancy or birth. Others sufferring from uterine fibroids end up with a womb that has become distorted or damaged and is therefore unable to maintain a pregnancy. Although very rare, some women are born without a womb.
- Other Factors:
Illnesses - There are many illnesses which may result in infertility. For instance:
Sexually Transmitted Diseases such as AIDS, Chlamydia, and Ghonnorea impact ones ability to have children as the bacteria and/or medication can damage the reproductive organs.
Cancer patients are at risk for infertility as treatments such as chemotherapy, radiotherapy, hormonal therapy and surgery can cause infertility.Some cancer treatments can cause an early menopause by damaging the ovaries (reducing the number of eggs); stop you from producing hormones; involve losing your womb; and damage the womb lining (making it difficult to get pregnant or keep a pregnancy).
Diabetes can contribute to infertility for women. When a woman has diabetes, or any form of insulin resistance, a hormonal imbalance exist. When one hormone is out of balance, it affects other hormones, including estrogen, progesterone and testosterone levels. These hormone imbalances can cause a wide variety of side effects, ranging from ovarian cysts to erectile dysfunction and infertility.
Benign Uterine Fibroids - These are benign tumors that exist in the wall of the uterus and can interfere with the contour of the uterine cavity which can can cause some blockage of the fallopian tubes or changes in the position of the cervix. As a result, sperm cannot reach the uterus, where it can fertilize an egg. Benign uterine fibroids are common in women in their 30s.
Early Menopause - Early menopause is premature ovarian failure resulting in no menstruation and the early depletion of ovarian follicles before the age of 40. Several conditions are associated with early menopause including: low levels of some growth factors produced by the ovaries; radiation therapy and chemotherapy; and autoimmune disease, where the body produces antibodies that attack the ovary.
Elevated Prolactin Levels - This condition is called hyperprolactinemia. The hormone prolactin acts to stimulate breast milk production. Elevated levels of prolactin 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.
Hypothalamic-pituitary 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.
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. The cause is insufficient production of the hormone progesterone.
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