Female infertility factor is the cause of about one third of all infertility cases. The reasons why a woman cannot get pregnant naturally are numerous, and the treatment varies depending on the case. In this article we will highlight the most common of them.
Ovulation disorders occur in nearly 40% of women with infertility. Among them, the most common are polycystic ovarian syndrome and premature ovarian insufficiency.
Hypothalamic dysfunctions (disorders of the secretion of luteinizing and follicle-stimulating hormone), as well as increased prolactin secretion (hyperprolactinemia) also lead to ovulatory problems.
Endometriosis occurs when the endometrium spreads to other anatomical structures: fallopian tubes, ovaries, intestines, bladder and others. This leads to the formation of scar tissue that can block the fallopian tubes and prevent sperm from reaching the egg, therefore preventing fertilization.
Obstruction of the fallopian tubes can be a consequence of endometriosis, genital infections (gonorrhea, chlamydia, etc.), abdominal surgery. It prevents fertilization as well as the movement of the embryo to the uterine cavity (implantation).
One of the mandatory tests in the diagnosis of infertility is hysterosalpingography — a procedure that assesses the level of obstruction of the fallopian tubes.
Fibroids are benign tumors (very rarely malignant) that originate in the muscular layer of the uterus. There are different types of fibroids: subserous — those that grow towards the abdominal cavity, intramural — inside the muscle itself, submucosal — growing inward to the uterine cavity. They can lead to infertility, as they:
-Change the position of the cervix, which reduces the number of sperm entering the uterus;
— Change the shape of the uterus, which can interfere with sperm movement or implantation of the fertilized egg;
— Block the fallopian tubes;
— Reduce blood flow to the uterus, which prevents the implantation of the embryo.
In this category fall various congenital anomalies in the shape of the uterus — unicornuate, bicornuate uterus, etc. Adhesions due to uterine infections, injuries and surgery can disrupt implantation, leading to infertility.
Autoimmune diseases cause the immune system to attack normal body tissues, which it usually ignores. Autoimmune diseases, such as lupus, Hashimoto’s thyroiditis or rheumatoid arthritis, can affect fertility. The mechanisms for this are not fully understood, but are thought to be related to inflammatory reactions.
WHEN TO VISIT A REPRODUCTIVE SPECIALIST?
When to seek help usually depends on your age:
By the age of 35, most doctors recommend one year of trying to conceive before testing.
If you are between 35 and 40 years old, discuss your concerns with your doctor after six months of trying.
If you are over 40, your doctor may suggest testing right away.
Your doctor may also recommend some tests without waiting if you have a disease that is known to affect fertility.