Causes Of Infertility
List Of Common Causes Of Fertility Problems In Women

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Causes Of Female Infertility

Contents

What Causes Infertility In Women?
Ovulation Problems
Fallopian Tube Damage
Endometriosis
Abnormalities In The Reproductive Organs
Lifestyle Factors
What About Unexplained Infertility?


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Infertility Guide

What Causes Infertility In Women?

There are four main causes of female infertility, all of which we will discuss below. These are: (1) failure to ovulate, (2) damage to the fallopian tubes, (3) the presence of endometriosis or (4) abnormalities in the reproductive organs such as fibroids or polyps. In nearly 90 percent of these cases conventional therapies like fertility drugs or corrective surgery to repair reproductive disorders will result in pregnancy. Only a small minority will need the aid of higher tech options like in vitro fertilization (IVF) or egg donation. It is important to note that lifestyle factors also play a role in fertility, for example being overweight or highly stressed can cause you stop ovulating. Opting to improve your diet, practicing stress reduction techniques and losing weight may all be that stands between you and your baby.

Ovulation Problems

About 30 percent of female infertility cases are caused by ovulatory disorders - in other words, failure to ovulate. No egg, nothing for the sperm to fertilize! Failure to ovulate may be due to a hormone imbalance, physical damage to the ovaries, premature menopause or failure of the follicles in the ovaries to rupture and release their egg. About 70 percent of patients are treated, usually successfully, with fertility drugs.

The main cause of hormone imbalances are:
- PCOS: Polycystic ovary syndrome, which can interfere with the balance of FSH, LH, estrogen and testosterone hormone levels.
- If the hypothalamus (in the brain) or the pituitary gland fail to work properly, reproductive hormone production is less efficient.
- Uncontrolled diabetes or thyroid disease may be a factor.

The main cause of ovary damage is:
- Presence of persistent ovarian cysts which damage or scar the ovaries.
- Infections.

Fallopian Tube Damage

Blockages in or damage to the fallopian tubes account for another 25 percent of infertility cases. Damage can range from mild endometrial adhesions to a complete blockage. Treatment usually involves surgery and about 30 percent of women become pregnant within one year (although some procedures have a 65 percent pregnancy success rate). The main cause of fallopian tube damage is:
- Infections: Scarring and damage caused by bacteria and viruses related to sexually transmitted diseases (STDs).
- Ectopic pregnancy: This is where pregnancy occurs in the fallopian tubes instead of moving to the womb. A life threatening condition, even if it is captured in time it can still cause damage.
- Previous surgeries to the tummy or pelvic region might have accidentally caused damage.
- Diseases like colitis and appendicitis can cause inflammation, scarring and blockages in the fallopian tubes.

Endometriosis

Endometriosis, affects as many as 6 million American women and 30 to 40 percent of these women are infertile. At any one time, only a certain amount of these women will be trying for a baby, so about 10 percent of infertile couples seeking help will be affected by endometriosis. Endometriosis is the presence of endometrial tissue (the tissue that lines the womb) in places where it should not be. It can spread and grow on the fallopian tubes and ovaries but it has also been found on the lungs and brain! (check signs of endometriosis). Research shows that removing mild endometriosis as an infertility treatment does NOT increase fertility in a woman (see treatment for endometriosis). However surgery in the case of moderate or severe cases DOES seem to improve chances of becoming pregnant. In some severe or urgent infertility cases doctors may even recommend skipping the surgical removal of endometrial implants and going straight to IVF treatment. See also, can endometriosis cause miscarriages?

Abnormalities In The Reproductive Organs

About 10 percent of female infertility is caused by abnormalities/growths in the reproductive organs which interfere with fertility. These growths may block the fallopian tubes (stopping conception) or prevent implantation of the embryo in the womb (resulting in miscarriage). Conditions like uterine fibroids, polyps and adenomyosis can cause these problems. A further 3 percent of women will have complications due to the mucus in their cervix. This is the thick cloudy or transparent discharge you might find on your underwear at certain times of your menstrual cycle. If the mucus is not 'sperm friendly' it can prevent your partner's sperm from passing through the cervix towards the fallopian tubes. Fertility tests, in particular the cervical mucus test can diagnose this problem. Very rarely a woman may be born with abnormalities in the physical structure of her womb or cervix which can make pregnancy difficult. For support and resources on this topic, see our list of infertility resources.

Lifestyle Factors

Weight
Even a slight increase or decrease of weight (about 15 percent) can cause irregular periods which means you do not ovulate regularly. Staying within the healthy weight range for your height is the best way to ensure fertility. To do this, eat a balanced diet (something like the Low GI Diet) and get plenty of regular exercise. It is also worth taking time to discover your most fertile days.

Excessive Exercise
Rarely a problem for most of us, but exercising to point where your body fat percentage drops to less than 22 percent causes your periods to stop. This is more of an issue for female athletes.

Smoking
If you smoke, you are 50 percent more likely to suffer a miscarriage. You are 4 times more likely to experience an ectopic pregnancy, and even if the baby survives all this, it has a higher chance of being born with a birth defect.

Stress
For years doctors have wondered if stress could be the cause of infertility in some of their female patients. Recent research published in the journal Fertility and Sterility has provided some clue. Researchers reported that women who stopped using contraceptives took longer to become pregnant IF they had higher levels of the enzyme alpha-amylase in their saliva. This particular enzyme is usually only present in large quantities in stressed people. Women with the highest concentration of alpha-amylase were 12 percent less likely to fall pregnant every month than those with low levels. If you are stressed (the stress may even be due to your worries about infertility), consider alternative therapies like biofeedback or cognitive behavioral therapy (talking to a therapist).
Useful Q&A’s
Is there an online test for stress?
How long does it take to get pregnant after stopping the Pill?
When is it safe to get pregnant after stopping the Pill?

Advancing Age
By the age of 32 the quality of your eggs start to decline; and from 35 onwards the statistics start to seriously stack against you (read about pregnancy after 35). Even though women today are looking after themselves much better than before, improved health later in life still doesn't offset the natural rate of age-related declining fertility. See, what age does fertility go down in women?

Heavy Drinking
Drinking more than 3 alcoholic drinks a day can affect your ability to conceive. Recreational drugs can also cause problems. Check out our list of books on infertility to learn more improving your conception chances.

Caffeine
Drinking more than 6 cups of coffee a day can decrease your fertility.

Sexual History
If you have had STDs or pelvic inflammatory disease, your risk of infertility is higher. All women ideally should undergo STD testing before falling pregnant, in particular they should screen for hepatitis B, syphilis, chlamydia and gonorrhea infections.

Medicines and Drugs
The following medications can effect fertility by either interfering with ovulation or cervical mucus:
Antihistamines
Inhalers
Sleeping pills
Depression medications like Prozac
Antiviral drugs
Diuretics
Antimalarial meds
Painkillers such as ibuprofen
Decongestants

What About Unexplained Infertility?

Unexplained infertility accounts for about 20 percent of all infertile couples. It means, despite all their fertility tests coming back normal, they still have not conceived after a year of trying. It may be that there is a cause, but the science to discover it is still beyond us. Eventually most of these couples go on to spontaneously become pregnant, but it might take up to 6 or 7 years. For younger couples this may not be a huge issue, but for older mothers who do not have the luxury of time, fertility treatment may still be considered - even if the cause has not been identified. They may start with infertility drugs and progress to more costly therapies like IVF with a fertility clinic if all else fails.

Related Questions
Average time taken to conceive: How long does it take to get pregnant?
Considering advanced therapies: What is an egg donation clinic?

  Related Articles on Causes Of Infertility In Women

For more about conceiving, see the following:
Can you get pregnant naturally with PCOS?

From the man's perspective
Male Infertility - an overview of symptoms, therapies and prognosis.
Causes of infertility in men - closer look at causes on the man's side.

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