What is the Biggest Cause of Infertility in Women?

infertility check up

Infertility is the inability to conceive after years of trying to get pregnant which can be due to a number of reasons. Women who can conceive but fail to carry the pregnancy to term are also diagnosed with infertility.

Infertility in women is mainly caused by failure to ovulate. Various other reasons or medical conditions can result in fertility problems. Getting pregnant and carrying the pregnancy to term is a very difficult and complex process and many things can go wrong during this process which can lead to female infertility. Following are the  causes of infertility in women:

  1. Ovulation problems – The most common cause of female infertility is the failure to ovulate and it results in almost forty percent of all fertility problems. The failure to ovulate can result from the following;

infertility in women

  • Polycystic ovary syndrome[PCOS] – it causes hormonal imbalance which can lead to infertility. The ovaries do not function normally and ovulation may not occur.
  • Premature ovarian insufficiency – the ovaries stop working prematurely before the age of forty.
  • Hypothalamic dysfunction – ovulation occurs every month by the action of FSH and LH [follicle stimulating hormone and luteinizing hormone] which are released by the pituitary gland under the influence of the hypothalamus. Hypothalamus and pituitary dysfunction interfere with ovulation which can lead to female infertility.
  • High prolactin levels caused by the pituitary gland reduces estrogen production which causes infertility problems.
  • Aging also causes decline in ovulation.
  • Thyroid dysfunction
  1. Problems in menstruation – Irregular menstrual cycle and missing periods can contribute to fertility problems.
  2. Endometriosis – The normal cellular lining of the uterus is known as the endometrium. When these cells start growing outside the uterus, the condition is known as endometriosis. This may cause the formation of scar tissue which interferes with the movement of the egg in the fallopian tube or obstruct the release of the egg after ovulation. The altered lining of the uterus also prevents the implantation of the embryo.
  3. Damaged fallopian tubes – The fallopian tubes can be blocked or damaged as a result of pelvic inflammatory diseases or previous surgery. It may prevent the sperm from reaching the egg or the passage of the fertilized egg into the uterus.
  4. Implantation failure- It is the failure of the fertilized egg to attach to the uterine wall. It may be due to embryonic defects or abnormalities in the uterus.
  5. Failure of the egg to mature – The egg may not mature properly due to hormonal conditions or other factors. It results in fertility problems.
  6. Structural problems in the reproductive system – Abnormalities in the fallopian tubes and the uterus can lead to infertility in women. It may be due to damaged fallopian tubes, uterine fibroids, polyps or scarring due to previous injury or infections.
  7. Autoimmune disorders – Conditions like thyroiditis, lupus, Hashimoto’s disease and rheumatoid arthritis can cause infertility in women.
  8. Infections – Infections like gonorrhoea, chlamydia lead to pelvic inflammation and scarring in the reproductive organs. Syphilis leads to risk of stillbirth. Other infections of the cervix and the vagina can lead to fertility problems.
  9. Unexplained infertility – In some cases , the reason for infertility is unknown. It may be due to a combination of factors and requires fertility treatment.

Some factors can increase the risk of infertility in women:

  • Age – the quantity and the quality of the egg declines with age which can lead to fertility problems.
  • Smoking – it increases the risk of miscarriage and ectopic pregnancy.
  • Alcohol – drinking can also lead to fertility problems.
  • Sexually transmitted diseases can damage the reproductive structures leading to infertility.
  • Being overweight or obese affects ovulation thus causing fertility problems.

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FERTILITY CHECK-UP FOR WOMEN

If a couple is trying to have a baby but are unable to do so, they should go for a fertility check-up by a specialist. It includes the physical evaluation and information like the age, period of trying to get pregnant, use of contraceptives or habits like drinking or smoking. The doctor may also ask about any previous infections or surgery, the history of any systemic disease or medications. Other significant information like if the woman has been pregnant before or if it’s the first pregnancy is also taken in account. The menstrual history is also asked to find out about the irregularities in menstruation. The doctor may recommend fertility tests to find the cause of infertility which are the following:

  • Ovulation testing – It consists of a kit which measures the surge in luteinizing hormone [LH]. A blood test for progesterone may be recommended.
  • Hysterosalpingography – It is the X-ray of the uterus using a contrast medium to detect any abnormality in the uterus.
  • Ultrasound of the uterus and fallopian tube is done to detect any abnormality.
  • Ovarian reserve testing – It determines the quantity and quality of the eggs.
  • Hormone testing for thyroid and pituitary is done to find any hormone dysfunction.
  • Laparoscopy is done to check the reproductive structures.

Genetic testing can be done to determine any genetic defects.

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