Infertility refers to the inability to get pregnant after having regular unprotected sex for at least twelve months (or six months if the female partner is over 35 years old). Infertility can also signify the inability of an individual to biologically contribute to conception or the inability of a female to carry a pregnancy to full term…
BABY STEPS
In order for pregnancy to occur, there are a number complex steps in the reproduction process that must take place. The basic steps include the following:
- One ovary must release a mature egg
- The fallopian tube must “pick up” the egg
- Sperm must swim through the cervix and uterus, making its way into the fallopian tube to find the egg for fertilization
- Once the egg is fertilized, it must travel through the fallopian tube to the uterus
- The fertilized egg must implant itself into the uterus to grow
For women, there are a number of things that can interrupt the reproduction process. Female fertility can be disrupted by any one of the following factors:
UTERINE OR CERVICAL CAUSES
More than 10 percent of all female infertility cases are the result of uterine or cervical issues. These types of issues can cause infertility by inhibiting implantation or increasing the chance of one or more miscarriages:
- Polyps or benign tumors are not uncommon in the uterus; sometimes these can lead to an obstruction in the fallopian tubes or the uterus.
- Congenital uterine abnormalities, including an abnormally shaped uterus may be present. Such abnormalities can cause an inability to conceive or lead to recurring miscarriages.
- Sometimes the cervix does not produce the right kind of mucus due to hormonal imbalances; therefore, the sperm cannot swim through the cervix into the uterus.
OVULATION DISORDERS
Anovulation accounts for infertility in about 25 percent of all infertile couples. There are a number of hormones that are needed in the reproductive process. If the balance of hormones is disrupted, the process of ovulation is greatly hindered. There are several different ways that hormonal problems may occur:
Hypothalamus Malfunction
The hypothalamus is responsible for forwarding the appropriate signals to the pituitary gland to send the stimulating hormones to the ovaries. Those hormones (LH and FSH) initiate the process that helps the eggs mature. When the hypothalamus does not send the signals, the eggs cannot mature.
Pituitary Gland Malfunction
There are two hormones, FSH and LH, needed to stimulate ovulation each month. The pituitary gland is responsible to produce and secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in a specific pattern during the menstrual cycle. The ovaries are unable to properly ovulate when too little or too much of these hormones is produced.
Polycystic Ovary Syndrome (PCOS)
The most common cause of female infertility is PCOS. With PCOS, complicated changes occur in the hypothalamus, pituitary gland, and ovaries; these changes bring about a hormone imbalance, which impacts ovulation.
Premature Ovarian Insufficiency
This disorder is usually caused by an autoimmune response where the body mistakenly attacks ovarian tissues or by premature loss of eggs from your ovary due to genetic problems or environmental issues such as chemotherapy. It results in the loss of the ability to produce mature eggs by the ovary, as well as a decreased production of estrogen for women under the age of 40.
DAMAGE TO FALLOPIAN TUBES (TUBAL INFERTILITY)
Tubal issues impact approximately 25 percent of couples who are infertile. When fallopian tubes become damaged or blocked, they keep sperm from getting to the egg or block the passage of the fertilized egg into the uterus. Causes of fallopian tube damage or blockage can include:
- Pelvic inflammatory disease (PID), an infection of the uterus and fallopian tubes due to chlamydia, gonorrhea, or other sexually transmitted infections, often results in scarring and tubal damage.
- Previous surgery in the abdomen or pelvis is a significant cause of tubal damage. Adhesions may result and change one or both tubes in a way that does not give the egg an opportunity to travel to meet the sperm.
- Abdominal diseases, including colitis and appendicitis, can cause inflammation in the abdomen. The inflammation may also impact the fallopian tubes, leading to tubal blockage and possible scarring.
- When pregnancy occurs in a fallopian tube (ectopic pregnancy), it often causes damage and scarring to the tube itself.
ENDOMETRIOSIS
Endometriosis impacts approximately 10 percent of infertile couples. It occurs when the lining of the uterus (endometrium) experiences abnormal tissue growth. This extra growth occurs in the uterus, and also in other areas of the abdomen, including the ovaries and fallopian tubes. Diagnosis of endometriosis is made through a laparoscopic procedure; if necessary, surgery is done to remove the excess tissue. Sometimes, however, this surgery may cause scarring that leads to complete tubal obstruction.
The Center of Reproductive Medicine, with offices in Webster, Houston, Beaumont, and Pearland, is committed to investigating the specific reason behind every patient’s fertility concerns. The compassionate reproductive specialists will help you through the process, step-by-step, ensuring that you have all the information needed to make informed choices throughout your infertility treatment process. In addition, the professional staff will answer any questions you may have and recommend the best treatment options for your particular situation.