Infertility, as we know, refers to the inability to get pregnant after at least 12 months of unprotected sexual intercourse. According to another statistic, it was found that 1 in 10 women between the ages of 15-44 deal with infertility of some kind. This figure only gets worse with age as female infertility directly depends on the number of eggs she has. The older you are, the fewer good-quality eggs you have left.
While age is one of the major factors that come into play, infertility can stem from multiple other factors dealing with the reproductive system.
In the female reproductive system, there are-
- A pair of ovaries, which are the site for egg development and growth.
- A pair of fallopian tubes attach each ovary to the uterus. These serve as pathways for the eggs to travel to the uterus after ovulation. And during fertilization, this is where the sperm meets the egg. A blockage in any of them results in fertility issues.
- The uterus holds the pregnancy after the fertilized egg attaches itself to its inner wall. A thin or irregular inner wall at the time of implantation of the embryo (i.e. the fertilized egg) can lead to failure of implantation that subsequently leads to pregnancy issues such as miscarriages.
- The cervix is an opening for the uterus that seals itself with a mucous plug once the fetus begins to grow inside, and
- A vagina is where the sperm cells are deposited during copulation.
For a natural pregnancy to occur, all of these channels must be clear and free from any obstruction-which can be physical or chemical in nature. If any of these structures is defective, establishing pregnancy becomes challenging.
The most common causes of infertility in females are as follows:
Problems with Ovulation- Conditions affecting the Egg Production
This is one of the leading causes of female infertility. But what does it even mean?
Ovulation or the ‘ability to ovulate’, basically refers to the process where an egg is released from an ovary. Ideally, this natural process should happen every month, right from the start of your first period at the age of about 13, till reaching the menopause stage at the age of around 50. If this cycle breaks down and an egg is not released, fertilization with the sperm does not take place and thus, pregnancy does not occur. Problems with ovulation can be caused due to many reasons. The most common ones include:
Hormonal imbalances occur in everyone at some point or the other. But when they are regular or continuous, they begin to disrupt the normal functioning of the body. The hypothalamus of the brain initiates the production of hormones called ‘Follicle Stimulating Hormone’ and ‘Luteinizing Hormone’ which play a huge role in egg maturation and ovulation. If these hormones are imbalanced, they can interfere with the egg ovulation cycle leading to either delay in, or even inability of the eggs to mature and be released, which further causes problems in fertilization.
PCOS stands for Polycystic Ovarian Syndrome. It is a hormonal disorder that interferes with the normal growth and release of eggs from the ovary. If the eggs are not released from the ovaries, fertilization is impossible, thus pregnancy in women with PCOS may not be easy. This condition is generally caused by the overproduction of hormones like testosterone and insulin.
Aging causes a condition called ‘diminished ovarian reserve’ which essentially means that the number of good quality eggs in the ovaries has reduced. As they age, they lose these eggs with every period cycle, till the time they reach menopause. Hence, the higher the age, the lower the probability of finding better-quality eggs in the ovaries that respond to the body’s hormonal stimulation and ovulate naturally.
- Other environmental and lifestyle factors such as smoking and drinking also affect a woman’s ability to ovulate periodically. Evidence also backs the influence of weight on the ability of a woman to ovulate regularly.
Structural Complications in the Female Reproductive System.
This refers to the presence of abnormal growths in different parts of the female reproductive tract. But the ability to get pregnant is affected the most when these growths are present in the fallopian tubes or on the inner walls of the uterus. These can be caused by:
Damage to the Fallopian Tubes-
Fallopian tubes are essential in the process of natural conception. They are the meeting place of the egg and the sperm for fertilization. If the tubes are blocked due to inflammatory conditions, endometriosis, adhesions caused by surgery, or other causes and conditions they prevent fertilization from happening which results in infertility. IVF in particular is often recommended for women diagnosed with tubal blockage problems.
This is a condition where the lining of the uterus grows outside the uterus. When it grows in the fallopian tubes, it blocks the transport of the egg toward the uterus whilst also preventing the sperm from reaching the egg, thus effectively impairing fertilization.
Presence of Fibroids and Polyps-
Fibroids are extra growth in the wall of the uterus composed of connective fibrous tissues (such as those found in the muscles). Polyps are non-cancerous growths made from the same cells as those that make up the inner lining of the uterus.
Presences of Pelvic Adhesions-
These are bands of tissues that form over a scar. They commonly occur after surgeries like D&C (which stands for Dilation and Curettage) and are also present in women diagnosed with endometriosis. Scar tissues often disrupt the ability of the embryo to attach itself to the uterine wall.
In rare situations, a girl may be born with an abnormal reproductive tract. Structural defects in the reproductive system, such as abnormalities in the shape of the uterus, can cause the failure of conception.
The cervix is the opening of the uterus present between the uterus and the vagina. Structural defects such as narrowing of its opening which can be Inherited or damaged due to trauma are also common causes of infertility in women. Sometimes, the mucous present around the cervix undergoes chemical changes, which stop the sperm from moving forward by creating a hostile environment for them. These issues are often bypassed with help from fertility treatment options such as IUI, where the sperm is directly deposited in the uterus.
Sexually Transmitted Infections like gonorrhoea and chlamydia, when left untreated, cause pelvic inflammatory disease causing swelling, damage, and scarring, which may result in blockages in the fallopian tubes. Genital Tuberculosis Infections can also lead to infertility, menstrual irregularities, and chronic pelvic inflammatory disease.
Problems with the Menstrual Cycle and Hormonal Complications
The menstrual cycle is a monthly occurrence in women after reaching maturity. The cycle prepares the female body every month for pregnancy and is entirely driven by hormones. Insufficient or overproduction of hormones and/or low reserves of eggs in the ovaries can cause an irregularity in the menstrual cycle.
To summarize, the prevalence of most common causes of female infertility are as follows
- Ovulatory disorders – 25%
- Endometriosis – 15%
- Pelvic adhesions – 12%
- Tubal blockage – 11%
- Other tubal/uterine abnormalities – 11%
- Hyperprolactinemia – 7%
Infertility can be incredibly stressful. If you have been trying to get pregnant for 12 months without success or six months if you are over the age of 35.
Take Ferticare’s assistance with natural conception, IVF, IUI, donor sperm donor egg, and surrogacy. For your needs and circumstances, we offer individualized care.
Get a free appointment with one of our doctors or visit our website right now at www.ferticare.in to find fertility treatment best suited to you.