Global Health Asia-Pacific Special Issue | Page 19

Causes of Infertility in Women

Fertility is an emerging problem , especially in developing and developed countries . It is postulated that as many as 1 in 6 couples suffer from sone degree of infertility . Human reproduction is a complex process and for pregnancy to happen , all the processes must happen at the right time . Any alternation or disruption can lead to a decline in the ability to conceive .
Dr . Aldrin Lie Tze Min BSc . ( UKM ), MD ( UKM ), MMED O & G ( Malaya )
Medical Director , Consultant Obstetrician & Gynaecologist , Fertility Specialist
TMC Fertility @ Thomson Hospital Kota Damansara
Please contact us at + 6018 211 1088 + 6016 211 1357
or visit our website at tmcfertility . com
In women , several factors can disrupt this process . Women suffering from infertility may have one , or a combination of these factors .
Ovarian Causes
Ovulatory factors are the most common cause , accounting for 20 to 30 % of female infertility . In almost half the cases of anovulation , the ovaries do not produce normal mature eggs . Ovulation usually does not happen if the eggs are immature , thus rendering the chances of fertilization remote . This can occur when there is a condition that leads to an imbalance of the hormones responsible for ovulation , one of the most common being Polycystic Ovarian Syndrome ( PCOS ).
PCOS is a condition that is classically characterized by irregular scanty periods , persistent weight gain and infertility . In more severe cases , women with PCOS may have excessive body hair growth . Besides causing infertility , untreated PCOS may lead to higher risk of womb cancer , heart diseases , and hypertension .
Other less common hormonal causes of ovulatory disturbances include malfunction of the hypothalamus ( the part of the brain that regulates the hormones responsible for stimulating the ovaries to produce and release the mature eggs ) and malfunction of the pituitary gland ( the organ that produces these hormones ). These can be attributed to physical injury or presence of a tumor .
Hyperprolactinaemia is a condition that is characterized by elevated levels of prolactin , the hormone that is responsible for the production of breast milk , which can inhibit ovulation .
Premature ovarian failure is a rare and unexplainable condition in which the women cease to menstruate and ovulate at a much younger age . Some studies have suggested a genetic link . Other even rarer conditions include congenital absence of the ovaries .
Dysfunction / Obstruction to the fallopian tubes
The fallopian tube is the place in which fertilization occurs during natural conception . A poorly functioning or obstructed tube will hamper the possibility of the sperm being able to reach the egg thus reducing the chances of fertilization .
Infections ( which are usually transmitted sexually ) can lead to inflammation of the tubes resulting in scarring . In severe cases , the tubes may be swollen because of fluid collection within the obstructed ends of the tubes . Damage to the tubes can also occur following inflammation and scarring because of previous surgeries , such as ectopic pregnancies . Adhesions of the tube to the surrounding organs following previous pelvic or abdominal surgery may further reduce its mobility .
Abnormal Womb
These include the presence of fibroids especially those which affects the inner lining of the womb , as well as polyps . Congenital conditions which lead to abnormality of the shape of the womb are rare .
Endometriosis is a common cause of infertility throughout the world . It is characterized by the presence of the cells from the inner lining of the womb in other parts of the body , mainly in the ovaries , fallopian tubes and the pelvic cavity . This leads to inflammation which may cause infertility as a result of excessive damage and scarring to the ovaries , as well as tubal obstructions .
Other Contributing Factors
Other contributing factors to female infertility includes lifestyle factors such as diet , lack of exercise , smoking , excessive alcohol intake , and substance abuse which has a direct as well as indirect , influence on ovulation .