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Reasons for Female Fertility Problems

Reasons for Female Fertility Problems

When it comes to fertility, the hormonal control of the menstrual cycle can be extremely complex. Below is a short list of conditions that can cause fertility problems. If you're concerned that one of them may affect you, speak

to your healthcare provider. The good news is that treatments may be available for many of these conditions.

Ovulatory problems: a common cause of infertility.
Approximately 33% to 50% of all infertile women have problems with ovulation[1]. The normal ovarian cycle is so complex that even small changes may disrupt the cycle and prevent ovulation.

In the majority of cases, the problem is caused by hormonal imbalances (e.g. not having enough of a certain hormone or not releasing a hormone at the right time). Often this may be caused by improper communication between the hypothalamus in the brain and the pituitary gland. Sometimes, abnormal ovulation may also be associated with extremely low body weight or with being overweight, as well as any significant change in weight (loss or gain).

If you have an ovulation problem, your healthcare provider may choose to treat you with clomiphene citrate. If that doesn't work, you and your healthcare provider may explore more advanced treatments.

Age impacts fertility
A woman's fertility naturally declines as she gets older. If you're over 35, and you've been unable to conceive after six months of unprotected, regular intercourse, you should talk to a healthcare provider.

Anatomical problems can impact fertility
Blocked Fallopian Tubes
Sometimes a woman's fallopian tubes get blocked due to past infections such as pelvic inflammatory disease (PID), or by abdominal surgery. Sexually transmitted diseases (STDs) can also cause scarring and damage to the fallopian tubes, causing blockages. Blockage can interfere with the sperm and egg uniting, or if they do unite, prevent the embryo from implanting itself in the uterus. Often women with blocked fallopian tubes don't experience any symptoms. Treatment of tubal problems or pelvic scarring may require specialized surgery, depending upon a woman's situation.

Cervical disorders
When a woman isn't ovulating, cervical mucus helps prevent infections entering the uterus. During ovulation, the thickness and quality of the mucus alters to let the sperm pass through. Sometimes cervical problems can prevent the sperm from entering.

Endometriosis
Endometriosis is a disease in which cells that normally line the uterine cavity also implant outside the uterus on the ovaries or other pelvic organs. This condition is found in about 35% of women who have no other diagnosable infertility problem. There is no direct correlation between the severity of the symptoms and the extent of the disease. In fact, some women with a large amount of endometriosis may feel no discomfort. Surgery may alleviate the problem

Polycystic Ovarian Syndrome (PCOS)
Polycystic ovarian syndrome (PCOS) is one of the leading causes of infertility, affecting an estimated 5 - 10% of women of childbearing age. PCOS is a condition in which cysts develop in the ovaries due to abnormal hormone levels. The ovaries can then enlarge. Symptoms may include irregular or absent periods, high blood pressure, acne, elevated insulin levels, excess hair on the face and body, and weight problems.

Cancer treatments
Depending upon the location of treatment and the drug and dosage used, chemotherapy and radiation can contribute to difficulty conceiving. Fertile Hope is a non-profit organization that provides fertility information and support for cancer patients.

The possibility of lifestyle factors
Weight
A low or high body mass may affect a woman's fertility.

Alcohol & Smoking
Alcohol consumption has been shown to affect a woman's fertility. Smoking has been shown to increase the risk of tubal pregnancies, cervical cancer, and pelvic infections.

When you should see a healthcare provider
You should see a healthcare provider anytime you have concerns about your fertility. Don't wait! By definition you are considered infertile if you're younger than 35 and you've been unable to conceive after a year of regular, unprotected intercourse (after six months if older than 35). However, you should consider seeing a healthcare provider if any of the following apply to you:

  1. Over age 35
  2. Irregular, too long, too short, or absent periods
  3. Two or more miscarriages in a row 
  4. Prior use of an intrauterine device (IUD)
  5. Endometriosis/painful menstruation
  6. Breast discharge
  7. Excessive acne or hirsutism (body hair)
  8. Prior use of contraceptive and no subsequent menstruation
  9. History of sexually transmitted disease
  10. History or pelvic/genital infection
  11. Previous abdominal surgery
  12. Reversal of surgical sterilization
  13. Chronic medical condition (e.g. diabetes, high blood pressure)
  14. History of chemotherapy or radiation therapy

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