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Female Infertility |
Women with no ovarian function. Occasionally, a woman's ovaries are not normal, such as when they present chromosomal anomalies. Other women have normal ovaries but they stop functioning well before menopause usually occurs (i.e., after the age of 45). A woman who stops getting her period when she is between 40 and 45 is said to have premature menopause. If her period stops before she is 40, the condition is known as premature ovarian failure. Ovarian function can also be affected by medical and surgical treatments. For example, it may be necessary to remove the ovaries in certain cancer cases when a bilateral adnexectomy is performed, or radiotherapy castration may lead to the loss of ovarian function following radiation treatment..
Women with abnormal ovarian function. Women who menstruate may sometimes have a very low reserve of good-quality eggs in their ovaries. This is known as occult ovarian failure and women who suffer from this condition do not usually respond well to the stimulation procedure used in fertility treatments. Another ovarian disorder is polycystic ovarian syndrome, in which correct ovulation does not occur and the woman may go a number of months without getting her period (amenorrhea). Long periods without menstruation also occur in other hormonal disorders, such as hyperprolactinemia, in which excessive secretion of the hormone prolactin, produced in the hypophysis gland, can cause infertility.
Some inflammatory diseases that affect the ovaries, such as endometriosis, can lead to a deterioration in the quality of the eggs. Endometriosis occurs when there is endometrial tissue (such as the uterine mucous membrane that produces menstruation) outside the uterine cavity. This tissue usually grows in the ovaries but can be found in other areas. It can produce bleeding and inflammation.
The fallopian tubes should allow the passage of sperm in order to fertilize the egg and then carry the fertilized egg to the uterus. Any tubular obstruction that prevents these processes from taking place can cause infertility. A lack of tubal mobility due to faulty adhering processes or inflammation can also cause problems.
The blocked tube can sometimes be dilated and contain liquid. This condition is known as hydrosalpinx. The presence of the often inflammatory liquid can further hinder attempts to become pregnant.
Sperm reaches the uterus through the cervix. A hostile cervical environment, with the presence of thick, acidic mucus or inflammatory substances, can impede the normal access of the sperm and prevent fertilization.
The embryo should attach to the mucous membrane lining of the uterus, known as the endometrium. If the endometrium is not fully developed or matured, implantation will not occur. The presence of tumors in the endometrium, such as polyps or submucous myomas, can also make it harder to become pregnant. Another possible cause of infertility is the existence of uterine malformations, which in many cases are not picked up during routine gynecological explorations.
