Couples that have trouble conceiving often have underlying fertility problems. In around half of the cases, this is caused by female infertility.
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Menstrual disorders or severe bleeding are often obvious and provide a clear indication of fertility issues. However, in other cases, the cycle seems perfectly normal, so the diagnosis of “infertility” comes out of the blue.
Sometimes even a change in diet helps to increase the fertility. In other cases, natural remedies can be used to regulate hormones. At times, more complex treatments are needed in order to conceive.
Below, we present 19 of the most common causes of female infertility.
Hormones are important messengers in our body. They are produced by specialised cells and transported around the bloodstream to regulate various processes.
The hormonal system associated with reproduction is highly complex. Hormones are responsible for ensuring egg maturation and ovulation, for the development of the uterus, and for the maintenance of pregnancy.
Fertility can be greatly decreased when the hormones involved become disrupted.
If you are having difficulties falling pregnant, you may want to try running a cycle calendar and regularly measure your basal body temperature. Understanding your body rhythms will help you to identify potential problems, even without medical assistance.
You can also consult a gynaecologist to track your blood hormone levels. This makes it possible to determine whether the concentrations of the chemical messengers are coherent.
DISORDERS OF THE PITUITARY GLAND
The pituitary gland plays a major role in fertility. During a normal menstrual cycle, the pituitary gland realises a follicle stimulating hormone (FSH). FSH promotes the development of the eggs within the follicles on the surface of the ovary.
The pituitary gland also produces another hormone, luteinizing hormone (LH), which triggers ovulation by simulating the follicle to release the egg. When the pituitary gland is dysfunctional, these critical hormones can be absent or reduced in concentration. Consequently, menstruation is absent and it’s not possible to conceive.
In many cases, the infertility associated with pituitary gland dysfunction is temporary. The hormonal imbalances may be a response to stress, rapid weight loss, bulimia, anorexia, or excessive exercising. In rare cases, the cause can be linked to a circulatory disorder of the pituitary gland.
Blood tests can be taken to determine if a patient has an abnormal concentration of LH, FSH and oestrogen. If a problem is identified, medical steps can be taken to try and resolve the issue.
LUTEAL PHASE DEFECT
A very common diagnosis for female infertility is luteal phase defect. The time period between ovulation and menstruation in a women’s cycle is referred to as the luteal phase. A normal luteal phase is 14 days, although it can range between 10 to 17 days. Women that have short luteal phases, less than 12 days, are more likely to miscarry.
The reason for this is because the uterus is not optimally prepared for implantation because the second half of the cycle is shortened. The uterine lining starts to break down and menstrual bleeding occurs, resulting in miscarriage.
There are a range of factors that can contribute to luteal phase defect. Excess prolactin or androgens, low progesterone levels, and thyroid disorders, can all lead to a luteal phase defect. Once diagnosed, this condition can often be treated with simple remedies.
For example, natural remedies containing Chaste tree (Vitex agnus-castus) are renowned for helping to restore hormonal balance.
Prolactin is a hormone produced by the pituitary gland, which is released mainly during breastfeeding. Excess prolactin can lead to ovulation suppression. In some cases, elevated prolactin levels of can be attributed to problems with the pituitary gland or the thyroid. However, stress can also increase prolactin levels, as well as a range of medications. Even high beer consumption can lead to an increase in this hormone.
Thyroid hormones are critical for a wide range of bodily functions, including the cardiovascular system, sugar metabolism and intestinal motility. These hormones are also important for a woman’s fertility. A slightly pronounced underactive thyroid will negatively affect fertility. This is because a reduction in thyroid hormones can interfere with ovulation by elevating prolactin.
Hypothyroidism is thought to impact up to 10 percent of the female population. For most people it is easy to treat with appropriate medication.
EXCESS MALE HORMONES
The female body manufactures both female and male sex hormones in order to run smoothly. The male sex hormones, androgens, are present in small quantities within the body. However, if the concentration of androgens increases, oocyte maturation and ovulation can be hindered. The result can be long, irregular menstrual cycles and infertility.
Androgens are produced by the female body in the ovaries, in the adrenal cortex and adipose tissue. An overactive adrenal gland or obesity is the main cause of excess androgens. In some rare cases, hormone-producing tumours on the ovary can account for the excess of male sex hormones. In other instances, the exact causes are unclear.
POLYCYSTIC OVARY SYNDROME
One particular disorder linked to excess male hormones is polycystic ovary syndrome (POS). Patients with POS don’t have the right hormone balance to enable an egg to mature fully. Ovulation is absent and often follicles remain as cysts on the ovaries. The menstrual cycle can be absent or irregular because progesterone isn’t produced.
The exact cause of POS is uncertain, although there is strong evidence to suggest it’s linked to genetics. Unfortunately, there is no cure for POS. However, it can be effectively managed through diet and certain medications.
Women naturally stop being fertile once they reach a certain age. This is often between 45 to 55 years of age, although it does vary depending on lifestyle factors and ethnicity. Premature menopause, also referred to as precocious menopause and menopause praecox, can occur in women before their forties.
Symptoms are the same as “normal” menopause. Women often experience hot flashes, insomnia and depression. The reasons for a precocious menopause are varied and poorly understood. Some medical authorities suggest that genetics play a role, while others postulate that it is an autoimmune disease.
Smokers, diabetics and vegetarians are more frequently affected than other women. Some women experience precocious menopause following radiation and chemotherapy treatments. Operations in the vicinity of the ovaries can also cause them to stop functioning.
This can be a temporary or permanent dysfunction. Unfortunately, for women planning a pregnancy there are no medications that can help with premature menopause. However, some women still ovulate occasionally.
ORGAN ADHESIONS AND SCARRING
Damaged or blocked fallopian tubes are a very common cause of infertility. When there are problems with the fallopian tubes it’s difficult for the egg to reach the uterus for implantation. Other problems that can lead to infertility may include a fusion of the uterus, fallopian tubes or ovaries with the surrounding tissue.
In all these situations it’s difficult to conceive because there is an interference with the direct transportation of the egg or sperm.
Diagnosing adhesions can be difficult as both the cycle and the hormonal balance are generally normal. A laparoscopy is usually necessary for a physician to clearly identify the condition of the reproductive organs.
While restrictions to the fallopian tube certainly reduce fertility, it is still possible to become pregnant naturally, although it may take longer to conceive.
The most common cause for inflamed or damaged fallopian tubes are bacterial infections. Particularly common are Chlamydia infections. Most women with Chlamydia will have no obvious symptoms as a result of the infection. However, left untreated it can lead to inflammation and later to adhesions and scarring.
Chlamydia is easily transmitted through unprotected sexual intercourse. It is one of the most common sexually transmitted disease worldwide. If diagnosed early, it’s possible to treat and cure Chlamydia with antibiotics. Unfortunately, the disease is not always discovered in time.
Other bacteria, such as the normally harmless intestinal inhabitant E. coli, can also cause inflammation. Unprotected anal intercourse combined with vaginal intercourse, and poor hygiene practices, can introduce E. coli into the vagina and the cervix, causing the infection. There are a range of medications available to treat E. coli infections.
Re-occurring yeast infections (Candida) can also impact fertility. An unnatural balance of Candida within the vagina can make it very difficult for sperm to pass through and reduce fertility. Candida is usually easy to treat and maintaining a healthy diet can help to prevent future infections.
Endometriosis is a common cause of infertility in women. This disease is characterised by cells associated with the uterus lining (endometrium) developing and thriving outside the uterine cavity, typically within the abdominal cavity. Most women with endometriosis experience pelvic pain and infertility problems. The condition can lead to adhesions and anatomical distortions which make conception difficult.
NARROW OR BLOCKED CERVIX
Fibroids are benign growths that develop under the uterine lining. They can impact fertility in a number of ways. In some instances the fibroids can compress the fallopian tubes. This creates a blockage, making it difficult for eggs or sperm to be transported.
Severe fibroids within the uterine cavity can also create an implantation barrier. There is also evidence to suggest that fibroids can increase the risk of miscarriage. The good news is that fibroids can be treated. They can be surgically removed, or in some cases they can be reduced by the administration of hormones.
In most cases ovarian cysts do not interfere with fertility. However, in some cases they can disrupt the hormonal balance and interfere with oocyte maturation, such as those associated with endometriosis. Surgical removal can help to improve fertility.
MALFORMATION OR ORGAN REMOVAL
Congenital malformations of the sexual organs are rare. However, in some instances they can occur during embryonic development, leading to frequent miscarriages. In situations where the uterus must be removed because of serious illness or due to complications from a previous birth, the result is lifelong infertility.
The removal of a fallopian tube (such as after a tubal pregnancy) restricts a woman’s fertility by approximately 50 percent. With one functioning fallopian tube it is possible to conceive, although if both fallopian tubes are removed, a natural pregnancy is impossible.
Similarly, if one ovary is removed there is little impact on the menstrual cycle because the remaining ovary is still functional and conception is possible. The removal of both ovaries, however, leads to infertility and hormonal imbalance.
IMMUNE SYSTEM DYSFUNCTION
The cervix produces mucus that is a very effective barrier to invading germs. Among other things, the immune system makes antibodies against the bacteria to fight them. In the fertile period around ovulation the cervical mucus is such that the male sperm can freely pass through the barrier, while any pathogens are excluded.
However, in some cases a woman’s immune system not only produces antibodies against bacteria and toxins, but also against the sperm. The sperm cells are attacked on the cervix before they can invade the uterus. Likewise, in some cases the body makes antibodies against its own egg, so this is combated by the immune system.
Dysfunctional immune systems can also attack implanted embryos. An embryo has half of its genetic material from the father and is considered a foreign body within the womb, which would normally be attacked by the immune system.
However, the mother’s body protects it using a complex process before the defence mechanisms impede the embryo. If the protection does not function optimally, early miscarriages are the result.
UNHEALTHY BODY WEIGHT
Obese women are more likely to have fertility problems compared with women of average weight. The reason for this is because fat cells produce oestrogen and this can disrupt the hormone balance. Also, other body functions become out of balance, such as blood sugar control hormone metabolism. This places a further strain on the body and contributes to infertility.
Additionally, very underweight women often suffer from infertility. They can experience irregular menstruation, or in some cases ovulation stops completely. Even in situations where a severely underweight woman falls pregnant, miscarriages are common. This is because the body lacks the essential nutrients and hormonal balance to support healthy embryonic development.
There can be defects associated with chromosomes that impede fertility. For example, some women may have three X chromosomes in their nuclei instead of two. While this doesn’t cause any health problems, fertility can be somewhat limited. Premature menopause is also common in women with this particular genetic condition.
Women who have experienced miscarriages are considered fertile. This is because the process of oocyte maturation, fertilisation and embryo implantation are properly functioning. Nevertheless, miscarriages are very distressing and difficult to come to terms with.
There are many different factors that can contribute to a miscarriage and it’s estimated that approximately 10 to 15 percent of all confirmed pregnancies end in miscarriage.
The causes can relate to genetic defects, fibroids and adhesions, as well as infections or hormonal imbalances. Bleeding disorders and immunological diseases can also cause miscarriage. Smoking and alcohol consumption during pregnancy increase the risk of miscarriage, as well as heavy lifting and an unbalanced diet.
Generally, after three consecutive miscarriages, doctors will investigate to clarify the cause. However, it isn’t always possible to ascertain the reasons for miscarriage.[/learn_more]
We have presented some of the most common causes of infertility in women. While many of these factors can be serious, there are also a large range of treatment options available for the bulk of these conditions. In some situations, through a combination of healthy living, natural remedies or medical intervention, fertility can be improved and conception is possible.
Further research and breakthroughs in medical developments will continue to help women fall pregnant. In situations where conception is impossible, other options can be investigated to start a family. There are also a wide range of support groups available to help couples with infertility problems.
It is important to note, however, that many statistically subfertile couples get pregnant. Even if the woman is subfertile, the man can still impregnate her. The chance of this happening is of course higher if he has high quality sperm.
Improving male fertility with micronutrients
Several vitamins, vitaminoids, amino acids and trace elements have been proven effective in increasing sperm count, mobility and shape. This translates directly into better overall sperm quality and therefore a higher chance of pregnancy.
Fertility supplements for men are:
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There are no contraindications or side effects to this form of natural ‘sperm boosting’ with amino acids, vitamins and micronutrients.
An excellent and detailed overview of several related studies can be found in Steven Sinclair’s Male Infertility: Nutritional and Environmental Considerations.
A considerable range of male fertility supplement products available on the UK market differing widely in price and composition. Menfertility.org has compared 10 of them in terms of value for money and the nutrients they provide.
- “Imhof, Martin et al., “Improvement of sperm quality after micronutritient supplementation”, e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism, Epub published ahead of print.” ↩