What causes infertility in women?

Most cases of fertility in women are caused by problems with ovulation. Here is a list of factors that may be responsible for female infertility.

 

1. Ovulation disorders

Issues with the reproductive hormones by the pituitary gland, hypothalamus or the ovaries may result in ovulation disorders. This deregulation may result in infrequent ovulation or no ovulation at all.

• Polycystic ovary syndrome (PCOS) – It is a hormonal disorder which disturbs ovulation. It is related to obesity and insulin resistance, excess male hormones and excess hair growth on the face and the body. The ovaries develop small cysts and fail to release eggs.

• Premature Ovarian Failure – This occurs by the premature loss of eggs from the ovary (due to chemotherapy or genetics) or an autoimmune response and is also known as primary ovarian insufficiency. The ovary doesn’t produce eggs and reduces the creation of estrogen in women less than 40 years of age.

• Hypothalamic Dysfunction- Two hormones produced by the pituitary gland are responsible for ovulation – LH (Luteinizing hormone) and FSH (Follicle stimulating hormone). Excessive stress or weight gain or loss may result in deregulation of these hormones which, in turn, affects ovulation.

• Excess of Prolactin- The pituitary gland may lead to overproduction of prolactin which has an effect on the estrogen production that may lead to infertility.

 

2. Damage to the Fallopian Tubes

Blocked or damaged fallopian tubes may cause a hindrance for the sperms to get to the egg or obstruct the fertilized egg from reaching the uterus. There may be many reasons for the damage to the fallopian tubes –

• Pelvic Tuberculosis – a leading cause of tubal infertility

• Pelvic surgery in the abdomen or pelvis

• Pelvic inflammatory disease, an infection of the uterus and fallopian tubes due to sexually transmitted diseases such as gonorrhoea, chlamydia etc.

 

3. Uterine or cervical causes

Some uterine or cervical abnormalities may result in improper implantation and may lead to miscarriages.

• Benign tumours and polyps are not uncommon in the uterus which affects the implantation.

• Uterine abnormalities such as an abnormally shaped uterus.

• Inflammation of the uterus or endometriosis scarring.

• Cervical stenosis which is the narrowing of the cervix that may have occurred due to some damage or is inherited.

• Sometimes cervical mucus doesn’t allow the sperms to move via the cervix to the uterus.

 

4. Endometriosis

It is the condition when tissue which is supposed to grow in the uterus, grows at other locations. This extra tissue or its surgical removal may cause scarring in that area.

Risk factors associated with female infertility

Besides these medical conditions, there are certain risk factors which may result in female infertility, such as –

• Age: With increasing age, the quality and number of the eggs decrease due to which the chance of conception decreases and the risk of miscarriages increases.

• Smoking and drinking: These habits can increase the chances of miscarriages and an ectopic pregnancy.

• Weight: Being obese or underweight directly influences your ovulation pattern. Maintaining a healthy BMI is crucial in improving your chances of conceiving.

• Sexual History: STDs may damage the fallopian tubes. Thus, you should practice safe sex and avoid sexual intercourse with multiple partners.