Female Factor Infertility: Top 5 Causes
Approximately 30% of infertility cases stem from female factors. This article explores the primary causes behind female factor infertility, shedding light on critical issues that can affect fertility and conception.
1. Ovulatory Disorders: Ovulation (the expulsion of a mature egg from the ovary) is critical for fertilization and pregnancy to occur. However, some women experience irregular (oligoovulation) or absent (anovulation) ovulation. This can be the result of:
Hormone imbalances. The body may not be producing the right amount of reproductive hormones required for ovulation to occur. For example, women with polycystic ovarian syndrome (PCOS) often produce high levels of testosterone. Additionally, women with primary ovarian insufficiency (POI) have underactive reproductive hormone function. Other endocrine disorders such as hypothyroidism and hyperprolactinemia (high prolactin levels) can also affect ovulation.
Diminished ovarian reserve (DOR). As women age, the number of eggs remaining in their ovaries (their ovarian reserve) declines. A low number of eggs maturing may not increase ovarian E2 production high enough to trigger ovulation to occur.
Menopause. No eggs remain in the ovaries to be ovulated.
2. Tubal Infertility: The fallopian tubes are responsible for transporting an egg to the uterus and is also the site of fertilization. Damage to one or both of the fallopian tubes can interfere with fertilization and implantation. A common cause of tubal infertility is hydrosalpinx, in which one or both of the fallopian tubes are blocked with fluid. This is normally the result of endometriosis, an untreated STI (such as chlamydia), or pelvic inflammatory disease.
3. Endometriosis: Tissue that resembles endometrial (uterine lining) tissue is found outside of the uterus (typically in the pelvis) with endometriosis. This scar tissue can cause inflammation and may force organs to adhere together. This can interfere with ovulation or can cause the fallopian tubes to swell. Endometriosis may also cause toxic environments for ovulation and affect embryo implantation and fetal development in the uterus.
4. Uterine Abnormalities:
Endometrial obstructions: the presence of uterine polyps, fibroids, or scar tissue (adhesions) can interfere with embryo implantation and development.
Congenital abnormalities: sometimes the uterus does not develop properly prior to birth. This can cause conditions such as a septate, bicornuate, or unicornuate uterus.
Cervical conditions: sometimes the cervix is unable to support a pregnancy. For example, cervical insufficiency occurs when the cervical neck is weakened and opens up before birth.
5. Unexplained Infertility: there are some situations in which it is not possible to determine the cause of infertility regardless of how many diagnostic tests are performed.
