Female-factor infertility

One in four cases of female infertility are caused by problems with ovulation. Without ovulation, there are no eggs to be fertilized. Failure or difficulty ovulating may result from the following causes:

• Polycystic ovarian syndrome (PCOS) – a hormonal imbalance, where hormones that trigger the reproductive tract are released abnormally or not at all – can interfere with the release and maturation of eggs. Common signs are irregular menstrual cycles or absence of menstruation. PCOS is one of the most common causes of female infertility.
• Diminished ovarian reserve, meaning a reduction with age in a woman’s reproductive potential determined by the number and quality of her eggs.
• Endocrine disorders – such as having an overactive/underactive thyroid or problems with the hypothalamus – may disrupt the release of hormones responsible for stimulating ovulation, leading to irregular or absent menstrual cycles.

Fallopian tubes carry eggs from the ovaries to the uterus, and are also where fertilization takes place. Blockage of the fallopian tubes may prevent sperm from travelling towards eggs in the tube and also block the path for fertilized eggs to travel to the uterus for implantation. If the tubes are partially blocked, a woman can still get pregnant via the unblocked tube. If both tubes are fully blocked, laparoscopic surgery may be performed to remove the blockage.

Uterine fibroids are non-cancerous growths on the inner uterine lining. These abnormal growths may cause little or no symptom in some women to excruciating pain in others. Fibroids can cause infertility if they interfere with blood flow to the uterus and prevent eggs from implanting or if they block the fallopian tubes. Many women with uterine fibroids go on to become pregnant, although this depends on size and location of the growths.

The endometrium – the inner lining of the uterus – will shed and exit from the body through menstruation if conception doesn’t occur. In some cases, these endometrial tissues will fail to exit the body and attach themselves to other organs and tissues, causing inflammation and irritation. These endometrial tissues may cause a blockage in the fallopian tubes and prevents pregnancy.

PID is an infection of the female upper reproductive tract, including the uterus, fallopian tubes and ovaries. PID diagnosed at an early stage can be easily and effectively treated with antibiotics and is unlikely to affect a woman’s fertility. It is one of the leading causes of preventable infertility worldwide.