The term infertility is defined as the inability to conceive a child after 12 months of trying to get pregnant with frequent intercourse. It is quite common, affecting roughly 1 in 6 Australians, and the causes vary greatly.
Not being able to conceive a child can be very frustrating, especially when do you do not know why. Here are 7 possible reasons for infertility in women.
When the cause of infertility exists within the female partner, it is known as female infertility, and this is the case roughly 30% of the time.
The reason for female infertility can range from issues with the eggs, age, the anatomy of the reproductive system, disease, or hormonal conditions. And while it can be very stressing for those trying to get pregnant, there are many treatments available, which will depend on the underlying cause.
Let’s take a look at some of the reasons for female infertility.
Age is the one of the most significant factors influencing female fertility as the quality and quantity of a woman’s eggs begin to decline as women get older. This process starts around the age of 30, and by the mid-late 30s fertility can drop as much as 40%.
By the age of 40, this will have decreased even more, while the risk of complications and miscarriage will have increased. For women in their mid-40s and older, the chance of a live birth is roughly 5% or lower. As women get older, the prevalence of conditions such as endometriosis also increases, contributing to decreased fertility.
Endometriosis is a common gynaecological condition where the endometrium (the lining of the uterus) grows outside the uterus. It is quite common, affecting roughly one in 10 women of reproductive age.
It can cause irritation and inflammation in the abdomen, and damage the ovaries, which disrupts ovulation, thus affecting fertility. It can also cause blockages or disruptions in the fallopian tubes that may affect the journey of the sperm to the egg. Endometriosis can also affect the lining of the uterus, which impacts the fertilisation process of the egg.
Sexually Transmitted Infections (STIs) and Pelvic Inflammatory Disease
Pelvic inflammatory disease (PID) is an infection and inflammation of the organs and tissue in the pelvis. This includes the cervix (the opening of the uterus), the endometrium (the lining of the womb), the fallopian tubes, the ovaries and other abdominal organs.
It is usually caused by an untreated sexually transmitted infection, such as chlamydia or gonorrhoea, but it can also be caused by a bowel infection, a ruptured appendix, and surgery. If PID goes untreated, it can cause scarring or narrowing of the fallopian tubes, which affects fertility.
Damage to the Fallopian Tubes
When issues with the fallopian tubes cause infertility, it is known as tubal factor infertility. This may be due to damaged or blocked fallopian tubes, which disrupts the process of the sperm fertilising the egg in the uterus. This accounts for roughly 20-25% of female infertility cases.
The most common causes of tubal factor infertility include:
• Scarring or damage to the fallopian tubes resulting from pelvic or tubal surgery.
• Pelvic inflammatory disease
Issues with ovulation accounts for roughly 25% of infertility in women. Ovulation disorders can be caused by problems with the ovaries, and hormonal imbalances.
• Polycystic ovary syndrome – PCOS is characterised by high levels of androgens and insulin, and the occurrence of multiple partially formed follicles (cysts) in the ovaries. Both high levels of androgens and insulin can affect the menstrual cycle and ovulation, which can become irregular or cease completely. It is one of the most common causes of infertility.
• Hypothalamic dysfunction – Two hormones, produced by the pituitary gland, are responsible for triggering ovulation each month. Factors such as weight and stress can disrupt the production of these hormones, causing irregular periods, or a complete in ovulation.
• Excess prolactin – Excess production of prolactin (hyperprolactinemia) can reduce oestrogen production and may cause infertility.
Fibroids are benign tumours that grow within the uterine wall. Some fibroids are very small and do not cause any noticeable symptoms – many women don’t even notice they are present. However, in some cases they can block the fallopian tubes and affect fertilisation.
A polyp is a small lump that grows in some parts of the body. In women, they are often found in the cervix (the neck of the womb) or in the endometrium (the lining of uterus). They can also cause infertility.
If you have any questions regarding fertility, please don’t hesitate to get in touch. Dr Bevan Brown is one of the most trusted gynaecologist and obstetricians in Sydney. We will strive to give you guidance and compassionate care in every way possible.