Female Fertility problems

Infertility in a woman may stem from many causes, such as hormonal deficiencies, problems in the reproductive organs, and some illnesses. Complications from surgery and certain medications may also impair fertility.

The most likely causes for female infertility are:

Pelvic Inflammatory Disease (PID) - PID is the most common cause of infertility worldwide. It's an infection of the pelvis or one or more of the reproductive organs, including, the cervix or the uterus. PID usually stems from the same bacteria that cause sexually transmitted diseases, such as gonorrhea or Chlamydia. PID may also develop from bacteria that reach the reproductive organs through abortion, hysterectomy, childbirth, sexual intercourse, use of an intrauterine (IUD) contraceptive device or a ruptured appendix.
Polycystic ovary syndrome (PCOS) is a syndrome which 1 in 10 woman are said to be suffering from where tiny cysts develop in your ovaries. You may not ovulate each month, some women with PCOS do not ovulate at all. If you do not ovulate then you do not have a period. The balance of hormones that you make in the ovaries is altered. In particular, your ovaries make more testosterone (male hormone) than normal.

Causes

The exact cause of PCOS is unknown, but several factors are thought to play a part. These include:
- Insulin
  A raised level of insulin in the bloodstream is thought to be the main underlying reason why PCOS develops. Insulin is a hormone that you make in your pancreas, the main role of insulin is to control your blood sugar level. Insulin acts mainly on fat and muscle cells which take in sugar (glucose) when your blood sugar level rises.
- Women with PCOS have what is called 'insulin resistance'. This means that cells in the body are resistant to the effect of a normal level of insulin. Therefore, the level of insulin in the blood needs to be higher than normal to control the blood sugar level. So, to keep the level of sugar in the blood normal, you make more insulin. A 'side effect' of a high blood level of insulin is to cause the ovaries to make too much testosterone (male hormone). A high level of insulin and testosterone interfere with the normal development of follicles in the ovaries. As a result, many follicles tend to develop but often do not develop fully.
- Luteinising hormone (LH)
  This hormone is also probably involved in causing PCOS. You make this hormone in your pituitary gland. LH stimulates the ovaries to ovulate, and to make certain hormones. A high level of LH may affect the ovaries in some abnormal way. A raised level of LH is found in about 4 in 10 women with PCOS. It may be that a high level of insulin and a high level of LH work together to cause more testosterone than normal to be made in the ovaries.
- Hereditary factors
  Your genetic makeup is probably important. One or more genes may make you more prone to develop PCOS. PCOS is not strictly inherited from parents to children, but it may run in some families.
- Weight
  Being overweight or obese is not the underlying cause of PCOS. However, if you are overweight or obese it may make things worse. Excess fat can make insulin resistance worse, which may then cause the level of insulin to rise even further.However, PCOS may also be a contributing cause of overweight and obesity. This is because high levels of insulin can contribute to weight gain. For more info go to www.pcos-uk.org.uk
Read Mum's real life experiences of PCOS
Endometriosis - This disease is another common cause of female infertility. Endometriosis refers to a condition in which sections of the uterine lining implant in the vagina, ovaries, fallopian tubes or pelvis. These implants eventually form cysts that grow with each menstrual cycle, and may eventually turn into blisters and scars. The scars can then block the passage of the egg.
Sexually transmitted diseases such as genital herpes can decrease fertility.
Ovary Problems - Decreased production of any one of the five hormones that regulate a woman's reproductive cycle may result in infertility. Problems within the ovaries may inhibit reproduction as well. Instead of releasing an egg, the ovarian follicle remains empty, fails to rupture or traps the egg.
Hormonal Problems - Adrenal or thyroid deficiencies may cause hormonal and ovarian problems. Some women produce excess amounts of prolactin, a hormone that normally stimulates the production of breast milk. Prolactin can also prevent ovulation. High levels of prolactin in a woman who is not nursing may indicate a pituitary tumor.
Immune System Problems - Women may develop antibodies or immune cells that attack the man's sperm, mistaking it for a virus. Certain autoimmune diseases, in which the woman's immune cells attack normal cells in her own body, may also contribute to ovarian problems.
Fibroids - Fibroids, or benign growths, may form in the uterus near the fallopian tubes or cervix. As a result, the sperm or fertilized egg cannot reach the uterus or implant there. Fibroids in the uterus are very common in women over age 30.
Surgical Complications - Scar tissue left after abdominal surgery can cause problems in the movement of the ovaries, fallopian tubes, and uterus, resulting in infertility. Frequent abortions may also produce infertility by weakening the cervix or by leaving scar tissue that obstructs the uterus.
Uterine muscle problems - Some women may produce weak, infrequent or abnormal contractions in the uterus. During ovulation, these contractions usually push the sperm up to the fallopian tubes.
Illness - Certain diseases, such as diabetes, kidney disease or high blood pressure may cause infertility. Ectopic pregnancy and some urinary tract infections may also elevate the risk of infertility.
Medications - Many medicines, such as hormones, antibiotics, antidepressants, and pain killers may bring on temporary infertility. Commonly used medications such as aspirin and ibuprofen can also impair fertility if taken mid-cycle.
Premature Menopause - Some women may experience premature menopause, when their ovaries stop producing eggs. Often the cause is excessive exercise or anorexia.
Other causes: some other contributors to infertility include excessive exercise, stress or anorexia.

Read Mum's real life experiences of infertility or for more information on fertility try www.fertilityexpert.co.uk/home.htm