In the recent years the number of couples seeking treatment for infertility has dramatically increased. This is due to both, the trend towards delayed childbearing as well as due to recent advances, newer techniques and increased awareness of available services. However, this is not the case in all scenarios. For instance, in certain communities childbearing inability is almost always attributed only to the woman. Whereas the fact is that only 30% cases of infertility are due to purely female factor, 30% are due to male factor, 30% due to combined causes and the cause for remaining 10% remains unknown.
Infertility is associated with several social, cultural and psychological issues. The stress of non- fulfillment of a wish for a child has been associated with issues such as anger, anxiety, depression and marital problems in couples. Due to these diverse ramifications of this condition, it becomes important to be aware of different aspects of infertility. This article will deal with the important causes of infertility in females.
These factors affect the cervix (mouth of the uterus). The cervical factors account for nearly 5% of the cases of female infertility. The diseases included in these are as follows:
Chronic cervicitis (infection of cervix)
Immunological factors (presence of anti sperm antibody)
These cervical factors cause ineffective sperm penetration through the mouth of the uterus or damage the sperm during their journey through the mouth of the uterus.
Causes of female infertility
Ovarian factors for infertility:
Ovarian factors for infertility include the following:
Anovulation (no egg production)
Oligo ovulation (infrequent or less egg production)
LPD (defective egg function)
LUF (trapped egg, ovulation not occuring)
These factors amount for 30-40% of female infertility cases. In these cases, the egg production and maturation is incomplete or is not normal. Without the egg (representative of female), there cannot be a baby (which is formed by the combination of egg and sperm- the male representative). This sub set includes diseases like PCOS.
How does normal Female reproduction work?
In order to achieve a complete understanding of the causes of infertility, it is essential to have a brief understanding of how a pregnancy occurs.
In females of reproductive age group, one of the two ovaries releases a mature egg every cycle. This is picked up by the fallopian tube.
After sexual intercourse sperms swim up the cervix through the uterus into the fallopian tubes to reach the egg for fertilization.
This fertilized egg travels down to the fallopian tube to the uterus where the pregnancy implants and grows.
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Female reproductive organs
Ovary- female reproductive organ that contains eggs and produces reproductive hormones
Fallopian tubes- a pair of tubes along which eggs travel from the ovaries to the uterus
Uterus- a pear shaped organ that contains a growing pregnancy
Follicles- fluid filled spaces in the ovary that contain a growing egg. Any disruption in one or more of the above factors can lead to infertility.
Tubal factors for infertility:
These factors include the factors that affect the fallopian tubes. These factors account for 30-40% of the female infertility cases. The egg that is produced in the ovaries (outside the uterus) enters the uterus via transport through the fallopian tubes. These tubes are very delicate structures and withstand damage poorly. Any block or impaired transport through these tubes may lead to female infertility. The causes include:
Polyps and debris inside tubes
Peri-tubal adhesions may also cause defective transport of the egg through the tubes causing infertility.
Infertility is the inability of a couple to conceive after one year of unprotected intercourse. According to World Health Organization (WHO), about 10 to 15% couples in the reproductive age group suffer from infertility.