To be informed about the causes of infertility in women is the first step in preparing for the initial stages of fertility treatment and the real possibility of overcoming infertility. Infertility in women is a much more common problem than many people realize. It is generally defined as the inability of a woman to become pregnant after at least one year of unprotected intercourse. Determining the causes of infertility in women is sometimes a time-consuming and emotionally challenging process. Don't be discouraged if a definitive diagnosis is not quickly reached. Be informed about the options available to you as you make decisions about whether to pursue fertility treatment.

⇒ Polycystic Ovarian Syndrome (PCOS) PCOS affects about 61% of women. This condition develops when the ovaries produce large amounts of androgens, which reduce levels of follicle-stimulating hormone (FSH). Ovulation is prevented, causing the follicles to turn into cysts. Without ovulation, progesterone production stops, while estrogen production continues. Symptoms of PCOS can include irregular cycles, excessive weight gain, hair growth, and acne.

Treatment: Although PCOS cannot be cured, specially designed supplements to increase egg quality and ovarian function have been shown to be particularly helpful. Clomiphene citrate, which acts on the pituitary gland, is sometimes used. Metformin (Glucophage) may be prescribed to reduce the production of male hormones in some women with PCOS.

⇒ Endometriosis About 301% of female infertility cases are due to endometriosis, a condition in which endometrial cells grow on the ovaries, the pouch of Douglas, the peritoneum, and other areas. Endometrial cysts on the ovaries can prevent ovulation. When they form in the fallopian tubes, the cysts can block the passage of an egg. In severe cases, scar tissue spreads to the uterus, fallopian tubes, and ovaries, preventing the transfer of an egg. There may be no symptoms of endometriosis other than the inability to conceive. Symptoms can include painful and irregular periods, chronic pelvic pain, severe pain during intercourse, bowel pain, and painful urination during menstruation.

Treatment: Laparoscopic surgery can be used to remove endometrial tissue that is blocking the passage of eggs. Surgery to remove and destroy endometrial tissue has been shown to double a patient's chances of becoming pregnant. Surgery can also remove uterine fibroids, polyps, or adhesions, which may be affecting fertility.

⇒ Fallopian Tube Blockages . Damaged fallopian tubes can block eggs from passing into the uterus and prevent sperm from reaching the egg. There are usually no symptoms other than infertility associated with this condition. Worldwide, recurrent or severe pelvic inflammatory disease (PID) is one of the most common causes of blocked fallopian tubes that result in female infertility. PID can cause abscess formation, adhesions, or damage to the fallopian tubes, resulting in infertility or ectopic pregnancy (fetus development in the fallopian tube instead of the uterus). The most common causes of PID are: sexually transmitted diseases (STDs), with the chlamydia to cause the 75% of infertility in the fallopian tubes and gonorrhea to cause most other cases.

Treatment: Surgery to remove and repair the fallopian tubes may be recommended. However, the success rates after these types of surgeries are low. In addition, tubal surgery is associated with an increased risk of ectopic pregnancy. However, surgery may be the most promising option for removing polyps, adhesions, or uterine fibroids that appear to be affecting fertility. IVF and surrogacy are sometimes the best options in such cases.

⇒ Egg quality Eggs that are damaged or develop chromosomal abnormalities cannot lead to a successful pregnancy. This problem is usually related to age, as egg quality declines significantly in the late 30s and early 40s. Fertility begins to decline when women reach their mid-30s and declines sharply after the late 30s. At this stage of life, fewer eggs remain, egg quality declines, and the ovaries' ability to release eggs decreases. The risk of chromosomal abnormalities increases, increasing the risk of miscarriage or birth defects.

Treatment: The use of a donor egg or embryo or surrogacy may be necessary. About 331% of women who use egg donation in IVF treatments have a successful pregnancy. In some cases, prescription medications or medical treatment are needed. However, many women benefit from a nutritional regimen that includes vitamins. Dietary supplements, including vitamins, minerals, and antioxidants, can help balance hormone levels, which can promote regular menstrual cycles.

⇒ Ovulation problems. Various diseases (most often hormonal) such as hyperprolactinemia can prevent the release of a mature egg from the ovary. This happens when the hormone prolactin, which is produced by the pituitary gland to stimulate breast milk production, is produced in excessive amounts. The excessive amount of prolactin reduces the gonadotropin hormones and therefore inhibits ovulation. Symptoms can include amenorrhea or infrequent periods with light or extremely heavy bleeding. About 11% of women are affected by another ovulation problem, known as Premature Ovarian Insufficiency (POF)), which is caused by depletion of ovarian follicles before the age of 40. Causes of POF include deficiencies in the function of the pituitary gland, adrenal glands, or thyroid, among others. This usually leads to premature menopause.

Treatment: Medications such as clomiphene citrate, gonadotropins, and human chorionic gonadotropin (hCG) are hormones used to stimulate egg development and ovulation. Note that there is a 101% chance of twin pregnancy when using clomiphene and a 301% chance of multiples for women who conceive using hCG. Other treatments include bromocriptine and cabergoline, which are oral medications used to reduce excessive prolactin levels. For overweight women, changes in diet and/or lifestyle can improve overall reproductive health and may increase the chances of successful ovulation. For some women, the use of technology assisted reproduction can be recommended.

If you would like more information about the causes of infertility in women, contact our modern clinic at (+30) 2310 220267 to schedule an appointment and learn about your treatment options