There are two different types of female infertility: primary and secondary. If a woman has never fallen pregnant, she falls into the category of primary infertility. If a woman has fallen pregnant at any point in her life, regardless of how that pregnancy ended (the birth of a child, an abortion, a miscarriage, an ectopic pregnancy), she falls into the category of secondary infertility. The greatest difficulty comes in diagnosing cases of so-called “unexplained” infertility. In some cases it’s just not possible to establish a cause using modern medical methods of diagnosis.
What Are the Leading Reasons for Infertility in Women?
As with men, inflammatory diseases and infections affecting the reproductive organs can be the cause of infertility. The presence and intensity of inflammatory diseases can be found with the help of cervical, vaginal and urethral smear samples. If necessary, more tests may be required in order to determine the harming infection and to prescribe treatment.
Another reason for a woman’s inability to fall pregnant may be a hormonal imbalance: the absence of ovulation or lowered levels of the progesterone hormone in the second phase of the menstrual cycle. Infertility can be caused by disorders affecting other glands of the endocrine system. As a rule, endocrine infertility usually manifests itself in a visible symptom form. An example of this can be excess hair growth in “masculine” places (the face, back, chest areas), which is caused by ovary and adrenal dysfunction. In cases where the thyroid gland fails to function properly we can observe the following symptoms: weight gain, fatigue, dry skin and breakable nails. In the case of diabetes we can observe increased levels of thirst and appetite, weight loss, fatigue.
In most cases of endocrine infertility the menstrual cycle is disturbed. Intervals between menstruation are increased, and a woman’s period may be late by 14-30 (or more) days. Sometimes, a woman may stop menstruating altogether.
The immune system plays a large role in protecting the body over the course of a human lifespan. It protects the body from infections, bacteria and viruses. However, this protection process can also lead to infertility. In this case either the male sperm cells or the developing embryo are perceived as a foreign body and are attacked by immune system cells. This leads to the disruption of the fertilization process and the development of the embryo.
The obstruction of the fallopian tubes is another known cause of infertility. It makes it impossible to conceive a child, because the sperm and ovum are incapable of meeting in the uterus. This is known as tubal factor infertility. The obstruction can be present in both the fallopian themselves as well as the space between the ovaries and the tubes (where a commissure is formed). This phenomenon is known as peritoneal infertility. Often times the adhesive process also affects the oviduct and ovaries, causing an obstruction to form there.
The ovum migrates through the fallopian tube to the ovary with the help of motile cilia (microscopic hair-like structures). If the cilia are affected by inflammatory processes, they can become immotile. In this case, the fallopian tubes may not be obstructed, but they cannot function properly either. This type of phenomenon is also known as tubal factor infertility.
Anatomic defects of the uterus, whether acquired later in life or inborn, can cause uterine infertility. Malformations (underdevelopment or the absence of a uterus, a double uterus, a saddle-shaped uterus, different obstructions found in the uterus) are types of defects that are present from birth. Defects that are acquired later in life are usually the result of intrauterine interference (uterine scarring, intrauterine adhesions etc.). Sometimes, the so-called “tilted” uterus condition can also be considered a cause of infertility, although currently there is not enough evidence to support this theory.
Presently, the leading cause of infertility is considered to be endometriosis. Endometriosis is a condition resulting from the appearance of endometrial tissue outside the womb. These tissue cells have the ability to adapt to completely foreign organs (on the peritoneum, the peritoneal cavity, the fallopian tubes). The problem is that these clusters of tissue behave themselves as if though they were still inside the uterus: they alter their state based on the menstrual cycle and bleed during menstruation. The spread out growth of the endometrium and the presence of blood in the pelvic floor can negatively affect the insemination process and prevent conception. These are the symptoms of endometriosis: pain in the lower abdominal area, that also spreads to the spine and sacrum (this pain is increased during menstruation and sexual intercourse); smeared brown discharge before and after menstruation.
In the case of mixed factor infertility a woman can show symptoms of several different types of infertility (fallopian tube obstruction, hormonal imbalance, endometriosis etc.).