Female Infertility

About a third of the time the causes of infertility are related to the female. Some of the barriers faced by women trying to get pregnant may include ovulation disorders, such as polycystic ovary syndrome (PCOS) or premature ovarian failure (POF), or physical issues with the reproductive system, such as fibroids or damaged fallopian tubes.

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Causes of Female Infertility

Some of the barriers faced by women trying to get pregnant may include ovulation disorders, such as Polycystic Ovary Syndrome (PCOS) or Premature Ovary Failure (POF). Infertility issues can also stem from problems with the reproductive system, such as fibroids or damaged fallopian tubes.

Learn more below.

Reproductive Age

When it comes to overcoming infertility, age is your biggest barrier to success. For example, at birth, you will have all the eggs you will ever have in your lifetime, nearly one million. But by the time you’re in your early thirties, your pool of eggs will have decreased substantially to less than half that.

A secondary challenge for women is one of egg quality: by the time a woman is in her late thirties, nearly 40% of her eggs will be low-quality due to genetic imbalances or other issues related to age.

According to the American Society for Reproductive Medicine (ASRM), women under age 35 who have been trying to get pregnant for twelve months or more without success are strongly encouraged to see a reproductive specialist. ASRM recommends women over 35 see a specialist after six months of trying without success.

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Ovulatory Dysfunction

Ovulatory dysfunction describes a group of disorders in which ovulation either occurs irregularly or not at all. It is one of the leading causes of infertility.

Anovulation (no ovulation) is a disorder in which eggs do not develop properly or are not released from the ovaries. Women who have this disorder may not menstruate for several months. Others may menstruate even though they are not ovulating. Although anovulation may result from hormonal imbalances, eating disorders, and other medical disorders, the cause is often unknown.

Female athletes who exercise excessively may also stop ovulating. This condition, called amenorrhea, often coexists with eating disorders and osteoporosis, a condition referred to as the “female athlete triad.” This condition, and its resulting infertility, is often treated with estrogen therapy, a change in diet, and psychological counseling.

Additional Causes of Female Infertility

Endometriosis is a condition in which endometrial tissue (tissue that lines the inside of the uterus) grows outside the uterus. It attaches to other organs in your abdominal cavity, such as the ovaries and fallopian tubes, and can act as a physical barrier to conception.

The endometrial tissue inside and outside the uterus responds to menstrual cycle hormones in a similar way, swelling and thickening, then shedding to mark the beginning of the next cycle.

Unlike the menstrual blood from your uterus that is discharged through your vagina, the blood from the endometrial tissue in your abdominal cavity has no place to go. Inflammation occurs in the areas where the blood pools, forming scar tissue. This scar tissue can block the fallopian tubes or interfere with ovulation. In addition, endometrial tissue growing inside the ovaries may form a type of ovarian mass called an “endometrioma,” which may interfere with ovulation.

Endometriosis is a progressive disease. It tends to get worse over time and sometimes recurs after treatment. Endometriosis usually improves after menopause.

Learn more about the impacts of endometriosis.

Uterine fibroids, also known as leiomyomas, are non-cancerous growths that develop in or on the uterus. Uterine fibroids develop from the smooth muscle cells of the uterus and can interfere with pregnancy in many ways. The ones that grow on the inside wall of your uterus can cause changes in the endometrial tissue, making it difficult for a fertilized egg to attach to the uterine wall. Fibroids that develop outside your uterus can interfere with pregnancy by compressing or blocking the fallopian tubes, thereby preventing the sperm from reaching the egg.

Premature Ovary Failure (POF) is the medical term used to describe early menopause. Menopause usually occurs in women between the ages of 42 and 56. POF is a condition in which menopause occurs before the age of 40. Women who develop early menopause usually have run out of eggs in their ovaries.

The cause of POF is generally unknown. However, there are a few reasons why the ovaries may stop producing eggs at an early age. Exposure to certain chemicals or medical treatments can damage or destroy the ovaries.

These may include chemotherapy and radiation therapy. Autoimmune diseases such as rheumatoid arthritis are sometimes associated with early menopause because the immune system forms antibodies that attack and damage the ovaries. Heredity can also play a role — some genetic disorders lead to early menopause.

Tubal disease is a disorder in which the fallopian tubes are blocked or damaged. Scar tissue resulting from endometriosis or abdominal or gynecological surgery (bowel surgery, cesarean section, ruptured appendix, etc.) can block the egg from entering or traveling down your fallopian tube to meet the sperm.

Infections, such as chlamydia, can damage the cilia (tiny hairs lining the fallopian tubes) that help to transport the egg. Without normal cilia, the egg may not meet the sperm, or if an egg becomes fertilized, it may not be able to travel to the uterus. This can result in an ectopic pregnancy, which can further damage your tube.

Tubal ligation (having your “tubes tied” to prevent pregnancy) can also leave your fallopian tubes damaged. However, reconstructive surgery to reverse tubal ligation is often successful.

Polycystic Ovarian Syndrome (PCOS) is a disorder in which the ovaries produce excessive amounts of male hormones and develop many small cysts.

PCOS is caused by hormonal imbalances that prevent ovulation. Your body produces too much of some hormones and not enough of others. Women who are diagnosed with PCOS usually have low levels of follicle-stimulating hormone (FSH), yet have high levels of luteinizing hormone (LH).

FSH is the hormone that’s responsible for stimulating the growth of follicles in the ovaries that contain maturing eggs. If you lack FSH for a long time, your follicles will not mature and release their eggs, resulting in infertility. Instead, the immature follicles in your ovaries develop into small cysts.

High levels of LH cause your body to produce too much estrogen and androgens (male hormones) — testosterone and DHEAS (dehydroepiandrosterone sulfate). High levels of estrogen can cause the endometrial tissue in your uterus to get very thick, which can lead to heavy and/or irregular periods.

If your androgen levels are high for a long time, you may develop acne and/or hair on your face, and you may experience hair loss.

Experiencing a miscarriage can be very difficult and emotionally devastating. Sometimes the mind takes longer to recover than the body. The doctors, nurses, and counselors at RMA are here to support you.

Recurrent miscarriage is defined as three or more consecutive, spontaneous pregnancy losses. Approximately 20% of pregnancies end in miscarriage (loss before 20 weeks). Most miscarriages occur within the first 12 weeks of gestation.

With miscarriages, there may be an underlying cause such as a genetic defect, an infection, or a condition in which the cervix is too weak to support a pregnancy. Other causes include an abnormally shaped uterus, uterine fibroids that hinder implantation or growth of the fetus, and hormonal imbalances (prolactin, thyroid, and progesterone). Having an illness such as diabetes mellitus or an immune-system abnormality may also cause miscarriage.

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