Female Infertility: Know the 8 Major Culprits


In women, ovulation happens when the egg is released from the ovaries. The egg travels to the fallopian tube where it meets the sperm for fertilization; then it becomes an embryo that attaches to the uterus. This process may seem pretty simple, but a lot of other factors, both internal and external can contribute to its downfall.

Here are eight conditions that lead to a woman’s inability to conceive and bear a child:

1. Polycystic Ovary Syndrome (PCOS)

cysts in the ovariesPolycystic ovary syndrome is a condition caused by hormonal imbalances due to elevated levels of androgen (male sex hormone) in the body.

Growth of small cysts or fluid-filled sacs are common in women with PCOS, but not all women with cysts in the ovaries have PCOS, because cysts could develop for a number of other reasons.

Other symptoms include weight gain, high levels of insulin and insulin resistance, which poses a risk for diabetes, acne, excessive hair growth or hair loss, irregular menstrual periods with either a light or heavy flow, and infertility.

Women with PCOS may not experience the other symptoms, but all of them have irregular or no menstrual periods. Ovulation does not happen regularly or monthly causing abnormal menstrual cycles and the difficulty of conceiving.

You are more likely to develop PCOS if you have a sister or mother with PCOS because health experts say it could run in the genes.

2. Hypothalamic Amenorrhea

hypothalamus is part of the brainHypothalamic Amenorrhea is the irregularity of menstrual periods due to a problem involving the hypothalamus. The hypothalamus is part of the brain responsible for various bodily functions that include reproduction.

During the first part of your menstrual cycle, one matured egg is waiting to be released from the ovary. As the release of an egg (ovulation) is nearing, your body releases increased levels of estrogen to create a healthy environment in your uterus for the sperm.

The sudden increase of estrogen also triggers the release of another hormone LH (luteinizing hormone) which send signals the ovary to release the mature egg.

The production of estrogen and LH is dependent on another hormone called gonadotropin releasing hormone (GnRH) produced by the hypothalamus. If the hypothalamus ceases to produce GnRH, then the levels of estrogen and LH decreases as well, thus, the absence of ovulation and menstruation, which could lead to infertility.

The main cause of hypothalamic amenorrhea involves a woman’s lifestyle. Too much stress, intense physical activities, together with poor nutrition resulting from a low or no calorie diet can alter the signals sent to and from the brain. Changes in your lifestyle and seeking treatment from a health professional can bring ovulation and menstruation back to normal. If left untreated, it increases the risk of heart disease and osteoporosis.

3. Damage To Fallopian Tubes

fallopian tube hinders the meeting of the egg and sperm
Photo by Takatakatakumi / CC BY-SA

Fertilization happens when a sperm unites with a mature egg released from the ovary. This process takes place in the fallopian tube so the fertilized egg can travel directly to the uterus.

An obstruction in the fallopian tube hinders the meeting of the egg and sperm; as a result, fertilization can’t take place.

Scarring between and in one or both ends of the tubes is the main cause of tubal infertility. Infections like gonorrhea or chlamydia and other non-STD infections can leave permanent scars in the tubes and the uterus, as well. The scars can either cause complete or partial blockage of the fallopian tubes. Scars from abdominal surgeries can also become an obstruction.

Apart from possibly causing infertility, blockage in the fallopian tubes increases a woman’s risk for ectopic pregnancy, where the fertilized egg attaches outside the uterus. Women with tubal infertility are diagnosed only after undergoing testing, because the condition has no symptoms. However, women with extreme cases of tubal damage can experience chronic pelvic pain.

4. Endometriosis

Infertility is one of the symptoms of endometriosis
Photo by BruceBlaus / CC BY

Endometriosis is a condition where the tissue, or endometrium,that normally lines the inner part of your uterus develops outside your uterus.

The tissues form into a clump called the implant that could grow in your fallopian tubes, ovaries, outside the intestines and in the surface lining of your pelvic cavity.

The implant will still function as it normally does each menstrual cycle. It grows, breaks down and bleeds just like how it would inside the uterus. This is why you will experience mild to severe pain and discomfort during your menstruation period.Some patients don’t complain of any pain-related symptoms while, in some cases, others experience pain during sex and bowel movements.

After the implants bleed out, scars are likely to form at the site where it developed. These scars can alter the function of your tubes or ovaries, which can affect your fertility. Infertility is one of the symptoms of endometriosis, but not all women with the condition are infertile.

5. Cervical-Caused Infertility

cervical fluid is naturally rich in nutrients
Photo by Acaparadora / CC BY-SA

The sperm travels through the cervix, then to the fallopian tubes to fertilize the egg.

In order for the sperm to get through the process, the cervical glands will release cervical fluid with just the right consistency to make it easier for the sperm to transport.

If the fluid is too rich or sticky, it delays or obstructs the sperm transport, which results in infertility.

The cervical fluid is naturally rich in nutrients to keep the sperm healthy, but it can also contain antibodies that will attack the sperm. Antibodies are naturally released by the body to help fight off viruses and bacteria. However, in this particular case, the antibodies are released after mistakenly identifying the sperm as a harmful pathogen.

If infertility involves cervical cases, you can choose to undergo intrauterine insemination (IUI). The sperm cells are washed and concentrated then injected directly into the uterus with a small catheter to eliminate contact with the cervical mucus.

6. Uterine-Caused Infertility

uterusAfter fertilization, the egg becomes an embryo that attaches itself to the uterus. The uterus should provide a healthy and friendly environment for the embryo so it can develop.

However, uterus problems sometimes occur that can affect or hinder embryonic growth.

The embryo plants itself in the endometrium, the tissues lining the uterus cavity.

When there are no sufficient levels of progesterone, the endometrium can’t properly develop, and so it can’t provide the nutrients necessary to support embryonic growth, called a luteal phase defect.

This can lead to infertility or early miscarriage. Progesterone supplementation is an effective treatment for luteal phase defect that should be done with proper timing to avoid tubal pregnancy.

Hormone-induced overgrowth of muscle tissue, called fibroids, and endometrial tissue, called polyps, in the uterus can also impede the growth and development of the embryo. These tissue growths work similarly with an intrauterine contraception device and should be removed from you under any fertility treatment using hysteroscopy or laparoscopy.

If the damage in your uterus is too severe, your only option to have a child is through a surrogate mother.The egg and sperm are collected from you and your partner, fertilized in a laboratory, then transferred into the uterus of your chosen and willing surrogate mother. She will then carry the baby until delivery.

7. Premature Ovarian Failure

irritabilityIn this condition, you will experience irregular menstrual periods and menopause-like symptoms, such as hot flashes, irritability, sleeplessness, vaginal dryness and low sex drive.

Premature ovarian failure or primary ovarian insufficiency occurs before the age of 40 and as early as in your teens. This happens when the ovaries store few or no eggs at all. As a result, you may not produce eggs monthly.

Your genes may play a role, or it could be an immune system disorder where the body attacks your tissues including your ovaries. Surgery and radiation from chemotherapy can also cause primary ovarian insufficiency. Although it will be difficult for you to conceive, it is not impossible. In some cases, the condition is only temporary, and the ovaries will resume its function a few years later.

8. Excessive Levels Of Prolactin

prolactinProlactin is a hormone that boosts milk production for breastfeeding moms who have just given birth. Several months after giving birth, breastfeeding moms still have no menstrual periods. This is because high levels of prolactin inhibit ovulation. Hence, elevated levels of prolactin, called hyperprolactinemia in women who are not pregnant and did not just gave birth can cause infertility.

Irregularity or the absence of menstrual periods is the main symptom if you have too much prolactin in your body. In some cases, a milky discharge from the nipples called galactorrhea can occur.

A blood test is done first thing in the morning is the only way to measure prolactin levels accurately.

Human reproduction is a complex process that involves different organs to function in coordination. A single failure throughout the whole process can make it difficult for you to conceive. Your doctor can diagnose the exact cause and set up a treatment plan for you.

They can work with you and help you conceive or make other alternative plans for starting a family, too. Modern medicine can work miracles, so if you are having trouble conceiving don’t hesitate to see your doctor to discover the cause and address it.


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