KNOWN CAUSES OF Infertility
Premature Ovarian Failure (POF)
Sometimes referred to as
"premature menopause", is a loss of ovarian function in
women under 40 years of age. Periods stop, estrogen is
low, and the follicle-stimulating hormone (FSH) level is
elevated. Some women may experience premature ovarian
failure because of adrenal, pituitary, or thyroid
deficiencies. Radiation therapy and anti-cancer agents
may achieve a cancer cure at the cost of Fertility by
causing premature ovarian failure. Women with Turner's
Syndrome, a rare genetic disorder, do not develop
functional ovaries at all.
Endometriosis
Endometriosis, is
believed to be quite common. It is estimated that
between 25% and 50% of women with Infertility have
endometriosis. This disorder develops when fragments of
the endometrial lining are implanted in other areas of
the pelvis. These endometrial, or misplaced tissue
implants will still respond to a woman's monthly
hormonal cycle, causing pain and discomfort, slowly
increasing in number and size with each menstrual cycle
and eventually causing scarring and inflammation.
Endometrial implants in the ovaries or fallopian tubes
are particularly likely to cause Infertility, even if
the endometriosis is mild.
Endometriosis-related causes of conception difficulty
may include organ damage, low levels of a molecule
specific to enhancing implantation, increased presence
of peritoneal white blood cells, and dysfunctional
immune system. Unfortunately, there exists no simple
blood or urine test to detect this common affliction of
the reproductive organs; the only true diagnosis is via
Laparoscopy, a fortunately simple, yet still surgical,
procedure.
Polycystic Ovarian Syndrome (PCO,
PCOS, PCOD)
Polycystic ovarian
syndrome (also called Stein-Leventhal Syndrome) is a
hormonal disorder that affects approximately six to ten
percent of pre-menstrual women and is the major cause of
Infertility in American women. Polycystic Ovarian
Syndrome is the result of the overproduction of hormones
in a woman's body. During ovulation, the ovaries receive
hormones from the pituitary gland. These hormones,
follicle-stimulating hormone (FSH) and luteinizing
hormone (LH), help the egg reach maturity in preparation
to be fertilized. In women with PCOS, there is an
abnormal level of FSH and LH being secreted. The
overproduction of LH causes the ovaries to overproduce
androgens. Increased androgen production produces high
LH levels and low FSH levels, so the follicles are
prevented from producing a mature egg. Thus the
ovulatory process is not allowed to complete itself. The
partially-developed egg (inside its follicle shell)
dies. Without egg production, the follicles swell with
fluid and form into cysts, and it is these cysts that
create polycystic ovaries. Every time an egg is trapped
within the follicle, another cyst forms, so the ovary
swells, sometimes reaching the size of a grapefruit.
Without ovulation, progesterone is no longer produced,
whereas estrogen levels remain normal.
Although Polycystic Ovarian Syndrome presents itself
during adolescence or the early adult years, women often
do not know they have the disorder until after they
attempt to conceive. No two women affected by PCOS have
the same symptoms. Common characteristics associated
with PCOS are:
• Insulin Resistance
• Hyperandrogenison (Increased male hormones)
• Polycystic ovaries
• Irregular menstrual cycles (oligomenorrhea) or no
menstrual cycles
(amenorrhea)
• Excessive facial and body hair growth (hirsutism)
• Male pattern hair loss (androgenic alopecia)
• Acne
• Obesity/weight gain
• Infertility
Pelvic Inflammatory Disease and
Sexually Transmitted Diseases
Pelvic Inflammatory
Disease (PID) is the major cause of Infertility
worldwide. PID includes a variety of infections caused
by different bacteria that can affect the uterus,
fallopian tubes, ovaries, appendix, parts of the
intestine that lie in the pelvic area, or, in the worst
case, the entire pelvic area (peritonitis). The sites of
infection most often implicated in Infertility are in
the fallopian tubes, a condition known as Salpingitis.
Although PID can be a result of nonsterile abortions,
use of an IUD, or a ruptured appendix, most infections
are caused by sexually transmitted diseases. Chlamydia
Trachomatis is an infectious organism that causes 75% of
Salpingitis cases. A small US study suggests that
Chlamydial infection of the upper genital tract, even
without severe inflammation, may cause a higher
proportion of fallopian ectopic pregnancies than
previously thought. Gonorrhea is responsible for most of
the remaining cases. Severe or frequent attacks of PID
can eventually cause scarring, abscess formation, and
tubal damage that result in Infertility. The severity of
the infection, not the number of the infections, appears
to pose the greater risk for Infertility. About 20% of
women who develop symptomatic PID become infertile. PID
also significantly increases the risk of ectopic
pregnancy.
Ovulation and Hormonal Disorders
Given the intricate
interaction of the hormones necessary for ovulation, it
is not surprising that about 33% of Infertility cases
can be traced back to ovulation and hormonal problems.
They may result in the failure of the ovarian follicle
to rupture, an empty follicle, or entrapment of the egg
so that it isn't released. Various medical conditions,
as well as lifestyle factors such as excessive exercise,
eating disorders, smoking, or stress can change normal
hormonal rhythm. Even slight irregularities in the
hormonal system can result in ovulation disorder.
Fibroid Tumors
Benign fibroid tumors in
the uterus are extremely common in women over 30. In
rare cases, they can cause Infertility by interfering
with the uterine cavity, blocking the fallopian tubes,
or altering the position of the cervix and preventing
sperm from reaching the uterus. High levels of estrogen
seem to stimulate the growth of fibroid tumors; heredity
may also play a role in their development.
