Important fertility information

Cause of female infertility

Saturday, April 25, 2015
Tubal occlusion

This is the most common cause of infertility in women, and is the result of an obstructed fallopian tube. This makes it difficult for the fertilized egg to make the move through the fallopian tubes to implant into the uterus. Tubal occlusion is very often brought on by pelvic inflammatory disease (PID). Most women with PID don't know they have it.

Endometriosis

Endometriosis accounts for between 5-30% of female infertility cases. Endometriosis is a medical condition in which the tissue of the uterine lining is implanted and growing outside of the uterus, most often on the ovaries or the lining of the abdomen near the uterus, fallopian tubes and ovaries. This can cause scarring and inflammation of the tissues of the pelvis.

Hypothalamic-pituitary disorders

Approximately 30% of female infertility is caused by ovulation 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.

Polycystic ovary syndrome (PCOS)

Polycystic ovary syndrome accounts for under 10% of female infertility. This syndrome 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).

Early menopause

Early menopause is premature ovarian failure, and results in the absence of menstruation and the early depletion of ovarian follicles prior to 40 years of age. A number of conditions are associated with early menopause including:

  • Low levels of some growth factors produced by the ovaries
  • Radiation therapy and chemotherapy
  • 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, and elevated 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.

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, resulting from an insufficient production of the hormone progesterone.

Benign uterine fibroids

These benign tumors exist in the wall of the uterus and can interfere with the contour of the uterine cavity, causing some blockage of the fallopian tubes or changes in the position of the cervix. This prevents the sperm from reaching the uterus, where it can fertilize an egg. Benign uterine fibroids are common in women in their 30s.

Pelvic adhesions

Abdominal or pelvic surgery or infection can cause bands of scar tissue to develop which can restrict the movement of the ovaries and fallopian tubes, leading to infertility.

Other conditions may include:

  • Amenorrhea or an absence of or onset of menstruation for over 3 months.
  • Hypomenorrhea refers to scanty periods, and spotting at periods is menstrual blood flow that is extremely light
  • Anovular menstruation: uterine bleeding without recent ovulation.
  • Metropathia Hemorrhaigca: Abnormal, excessive, often continuous, uterine bleeding due to persistence of the follicular phase of the menstrual cycle.
  • Cervicitis, or an inflammation of the cervix that results in an abnormality of cervical secretion such as leucorrhea or turbid discharge.
  • Carcinoma or cancer associated with any of the reproductive organs and tissues associated with conception and fertility.
  • Tuberculosis, a lung disease that can impact can irreparably damage the fallopian tubes and endometrium.
  • Tuberculosis of the endometrium; A complication of TB that can be reactivated in the system and spread to the genital tract even after the initial lung condition has resolved. It has the potential to damage the fallopian tubes and endometrium. It has in many cases been cured but can result in infertility.
  • Stenosis of cervix or scarring of the cervix that causes it to seal shut.
  • Inflammatory tubal lesion or a relativlely rare condition known as Xanthogranulomatous salpingitis
  • Dyspareunia or vaginal pain after intercourse associated with one or many of medical conditions listed on this page.
  • Vaginismus or a spasming of the muscles at the vaginal entrance that prevents penetration.
  • Frölich's syndrome: A rare syndrome where damage to the hypothalamus impairs the activity of the pituitary gland resulting in obesity, sluggishness and delayed puberty.
  • Myxoedema: Skin and tissue disorder usually due to hypothyroidism.
  • Simmonds' disease or Hypopituitarism: A disorder caused by reduced pituitary hormone levels. Hormones produce by the pituitary gland produces growth hormones, prolactin, thyroid stimulating hormone, antidiuretic hormone and others.
  • Metropathia Hemorrhaigca: Abnormal, excessive, often continuous, uterine bleeding due to persistence of the follicular phase of the menstrual cycle.
  • Ovarian failure: describes a stop in the normal functioning of the ovaries in a woman younger than age 40. Some people also use the term primary ovarian insufficiency to describe this condition. It is also known as hypergonadotropic hypogonadism.
  • Turner's syndrome: A rare chromosomal genetic syndrome with one X chromosome and no second sex chromosome (X or Y). People are female as there is no male Y chromosome. The effects are often relatively minor, although sterility is possible.
  • Super-female chromosomal anomaly: a condition that affects 1 in 1000 female births, that can be asymptomatic, but will typically result in neuromotor developmental delay, a lack of co-ordination, poor academic performance and immature behaviour. There is an increased incidence of infertility in females affected by this condition.
  • Anxiety: Some level of anxiety is very common, and people worry about all sorts of things. Different types of people worry about different things and to different extents. Having some anxiety doesn't necessarily mean you have an anxiety disorder. However, severe anxiety or exaggerated worry, fear, phobias, or other major concerns might indicate some type of anxiety disorder or other psychological disorder.
  • Over 43 years of age: women who wish to complete a program at Australian Natural Fertility and are over 43 years of age are exempt from refund if conception has not occurred with the specified time frame.
  • Obesity: referring to being more than 20% over your desirable weight according to the Body Mass Index. If you are 1.5m and over 65kg, 1.6m tall and over 77kg, 1.7m tall and 87 kg, 1.8m tall and 97kg, 1.9m tall and 108 kg or 2m tall and 120kg, then you are officially classed as obese. It is understandable that some peoples structures and body shapes can dramatically vary these results and that these will be taken into consideration and potentially have the condition struck from the clause.

* Anaemia: refers to a low red blood cell count. Hallmark symptoms include fatigue and pallor (pale skin). * Vitamin A deficiency
* Vitamin B deficiency

Other medical conditions listed in the Disease Database as possible causes of Female infertility as a symptom include:

  • Adrenal cortex tumours: A benign or malignant (primary or metastatic) neoplasm of the adrenal cortex.
  • Anorexia nervosa or being underweight by 20% of BMI.
  • Anovulatory cycles
  • Antipsychotic agents
  • Asherman's syndrome
  • Autoimmune adrenalitis
  • Bicornuate uterus
  • Breast feeding
  • C21-hydroxylase deficiency
  • Combined oral contraceptive pill
  • Cone biopsy of uterine cervix
  • Conn's syndrome
  • Cushing's disease
  • Cystic fibrosis
  • Cytotoxic therapeutic agents
  • Diabetes mellitus type 2
  • Dyspareunia
  • Ectopic pregnancy
  • Ethanol
  • FSH receptor deficiency
  • Galactorrhoea-Hyperprolactinaemia
  • Galactosemia type 1
  • Gonadal dysgenesis (female)
  • Haematocolpos
  • Haematometra
  • Haemosiderosis
  • Hematosalpinx
  • Hydatidiform mole
  • Hyperthyroidism
  • Hypokalaemic distal renal tubular acidosis
  • Hypopituitarism
  • Hysterectomy
  • Idiopathic premature ovarian failure
  • Imperforate hymen
  • Kallmann syndrome
  • Malabsorption syndrome
  • Medroxyprogesterone acetate
  • Menopause
  • Metoclopramide
  • Miscarriage
  • Mullerian dysgenesis
  • Mycobacterium tuberculosis
  • Myotonic dystrophy
  • Obesity
  • Ovarian cancer
  • Ovarian tubal ligation
  • Pelvic inflammatory disease
  • Peritoneal adhesions
  • Pituitary tumour
  • Primary affective disorder
  • Progestagens
  • Prolactin secreting pituitary tumour
  • Radiotherapy
  • Sheehan's syndrome
  • Systemic lupus erythematosus
  • Testicular feminization syndrome
  • Testosterone
  • Trisomy X
  • Turner's syndrome
  • Uterine anomaly
  • Vaginal agenesis