In order for a female to conceive, she needs to have a capable vagina, a capable cervix, a capable uterus, a capable fallopian tube, and a capable ovary.
Even when all of these are functioning, another element that plays a big part in a women’s ability to conceive is maternal age.
Causes of Female Infertility
Women are born with all of their eggs and from puberty, normally an egg is released once a month. After the age of 35, there is a marked decrease as the body starts to realise the egg supply is diminishing and starts to hold back on the releasing of an egg and ovulation may only occur every two to three months instead of monthly.
Once women reach their 40’s, the quality and quantity of eggs produced declines and it becomes very difficult to conceive and the risk of miscarriage and abnormalities increases.
Also women have further complications for achieving pregnancy with the presence of fibroids, endometriosis and cysts as they age. Some women may suffer from more that one factor that affects their ability to conceive. The cervix is the opening to the uterus or womb, the mucus in this canal changes when you are ovulating to allow the sperm to pass through, sometimes this isn’t happening and therefore the sperm cannot pass to meet the egg.
Also the cervix can have a blockages that stop the sperm from traveling any further, this can be due to narrowing of the passage or from previous surgery. If sperm is allowed to travel to the uterus or womb, then this needs to be functioning for implantation of a fertilised egg. If there are fibroids present these growths attach to the wall of the uterus and can change the space of this cavity. Endometriosis is a very painful condition, each month the lining of the womb thickens in anticipation of a fertilised egg. When a patient has Endometriosis these endometrial cells attach themselves to other parts of the body outside of the womb.
It can attach itself to the ovary affecting egg health, and create a blockage between the fallopian tube and the ovary. Medication is usually prescribed to prevent menstruation and then IVF to help conception.The role of the fallopian tube is to carry the egg from the ovary, it is here that the sperm usually finds the egg for fertilization to take place and the fallopian tube carries the egg to the womb for implantation. If the tube is blocked then the sperm cannot meet the egg and the egg cannot travel any further. Previous infection such as pelvic inflammatory disease or an ectopic pregnancy will damage these delicate tubes, after tubal damage IVF is the only course of treatment.
The ovaries are responsible for maturing eggs and releasing them once a month for fertilization, if the ovaries do not release an egg this is called anovulation.
The most common cause for this is Polycystic Ovarian Syndrome (PCOS).
PCOS is caused by a hormone imbalance in the ovaries. The ovaries are covered in a large number of small follicles and are the ovaries are bigger than normal. Other symptoms include acne, excessive hair growth, obesity, irregular periods and due to the immature follicles patients rarely ovulate with a mature egg.
It is very important that PCOS is managed with medication, only 5% of PCOS patients actually need an IVF cycle, usually with the right medication, ovulation can occur and pregnancy achieved.
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