Female Infertility

Causes

Most women have no obvious signs of infertility until they try to become pregnant and are not successful after one year. Infertility may sometimes be signaled by heavy, irregular or absent menstrual periods or associated with conditions that cause pain during menstruation or intercourse. Other signs that may point to fertility problems include obesity, facial hair and fluid that leaks from the breasts. 

Infertility problem may occur by various reasons. The most common cause of female infertility include ovulation disorders, polycystic ovarian syndrome, fallopian tube damage or blockage, endometriosis, ovarian cysts, fibroids, pelvic infection and early menopause. It may also be caused by sexually transmitted diseases, poor nutrition, hormone imbalance, tumor, uterine factors and egg quality.

Ovulation disorders
Ovulation problems result when one part of the system that controls reproductive function malfunctions. The failure to ovulate is the most common cause of female infertility. Without ovulation, eggs are not available to be fertilized. Ovulation problems can be caused by various things such as excessive weight loss, stress, thyroid problems or slight irregularities in hormone imbalances. Disruption in the part of the brain that regulates ovulation (hypothalamic-pituitary axis) can cause deficiencies in luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Signs of problems with ovulation include irregular menstrual periods or no periods.

Polycystic Ovarian Syndrome (PCOS)
Polycystic ovarian syndrome is a condition characterised by the presence of many minute cysts in the ovaries which is caused by excess production of hormone called androgen. This will prevent the follicles of the ovaries from producing a mature egg. Without egg production, the follicles swell with fluid and form into cysts. Every time an egg is trapped within the follicle, another cyst forms, so the ovary swells, sometimes reaching the size of a grapefruit. PCOS can be diagnosed through a series of blood tests and some symptoms of this condition include weight gain, acne, irregular or absent periods. 

Fallopian tube damage or blockage
This condition usually results from inflammation of the fallopian tube (salpingitis). If they are blocked, the egg cannot move from the ovary to the uterus. This condition can happen as a result of pelvic inflammatory disease, endometriosis, pelvis surgery, ruptured appendix or mislocated (ectopic) pregnancy. Structural disorders, like birth defects of the uterus and fallopian tubes, fibroids in the uterus, and bands of scar tissue can also block the fallopian tubes.  

Endometriosis
This is a condition when the tissue that makes up the lining of the uterus (endometrium) grows into growths or lesions outside of the uterus usually on the ovaries or the lining of the abdomen near the uterus and fallopian tubes. In sync with the menstrual cycle, this tissue builds up, breaks down and sheds each month; but it has no way of leaving the body. As a result it causes internal bleeding, breakdown of blood which can lead to scarring and inflammation.
Pelvic pain and infertility are common in women with endometriosis. It can be detected during laparoscopy. If you experience pain while having sex, have very painful menstrual cramps, or experience heavy bleeding during your period or unusual spotting, you may have endometriosis. 

Ovarian Cysts (Endometriomas)
Ovarian cysts may indicate advanced endometriosis and often is associated with reduced fertility. An ovarian cyst is a small fluid-filled sac that grows in the ovary. Endometriomas can be treated with surgery.

Uterine Fibroids
Uterine fibroids or leiomymomas are benign tumors usually located on the outside surface or within the muscular wall of the uterus. They are not associated with the reproductive system but may cause infertility by interfering with the contour of the uterine cavity, blocking the fallopian tubes. It can also interfere with embryo implantation or fetal growth. Though the causes of these tumors are unknown, evidence suggest that estrogen and progesterone contribute to the growth of fibroids. It is most often diagnosed in women between the ages of 30 and 40. Common symptoms of fibroids is pelvic pressure, along with irregular bleeding and the effective treatment option is hysterectomy. 

Premature Ovarian Failure (POF) or Early Menopause
Early menopause is the absence of menstruation and the early depletion of ovarian follicles before age 40. Though the cause is often unknown, the condition is associated with autoimmune disease, pelvic surgery, tobacco smoking, genetic factors, radiation or chemotherapy. Treatment option for POF is In Vitro Fertilization (IVF). 

Pelvic Inflammatory Disease (PID)
PID is an infection of the pelvis or organs of the reproductive tract, including the ovaries, the fallopian tubes, the cervix or the uterus. It can lead to blocked or damaged fallopian tubes and is usually caused by sexually transmitted diseases, miscarriages, abortions, childbirth, or an intrauterine device.

Pelvic Adhesions
Pelvic adhesions are bands of scar tissue formed between two or more internal organs after pelvic infection, appendicitis or abdominal or pelvic surgery. This condition is usually caused by surgery or infection and can affect the functioning of the ovaries and fallopian tubes resulting in infertility. 

Age is also a risk factor of infertility. A woman's peak fertility occurs in her early 20s. The ability for ovaries to produce eggs declines with age, especially after age 35. As a woman ages beyond 35 (and particularly after age 40), the likelihood of conceiving diminishes to less than 10% per month. The risk of miscarriage also increases with a woman's age. Tobacco smoking, alcohol consumption, extremes in body mass either too high or too low are all risk factors of infertility.