The dynamics that grounds infertility in women are equivalent to those causing infertility in men which includes anovulation (faulty or inadequate production of ova transport through the fallopian tubes to the uterus, uterine factors such as tumors or poor endometrial development, and cervical and vaginal factors that immobilize spermatozoa. In rough terms, about 30 percent of infertility causes are due to factors that affect man, another 30 percent are due to women. In the remaining 40 percent of infertility cases is due to both partners.
The question now is what causes infertility? Anovulation is the most common cause of female infertility. Failure to ovulate often occurs for no obvious reason. It can be caused by hormonal imbalance, stress, or a disorder in the ovary, such as tumor or cyst. Blocked fallopian tubes, which frequently occur after pelvic inflammatory disease, may prevent the sperm from reaching the egg. The woman may have one tube or no tubes because of a congenital defect or because they were removed surgically. Some women ovulate only a few times a year because of polycystic ovary syndrome. This can usually be detected by examining the menstrual history, but even if a woman experiences regular monthly menstruation, it does not necessarily indicate that she is also ovulating on a regular basis.
What causes infertility may also include disorders of the uterus such as fibroids may cause infertility, as can endometriosis. Infertility can also occur if the woman’s cervical mucus provides a hostile environment to her partner’s sperm by producing antibodies that kill or immobilize them. Rarely, a chromosomal abnormality such as Turner’s syndrome is the cause of a woman’s infertility. Tumors such as fibromas may be a rare case of infertility if they block the entrance of the fallopian tubes into the uterus or limit the space available on the uterine wall for effective implantation. Pelvic inflammatory disease may occur in women who use intrauterine devices. If PID is left untreated this will enter into a chronic phase, which will cause a scarring which leads to stricture in the fallopian tubes and resulting in infertility problems.
At the time of ovulation, the cervical mucus is thin and watery and can easily be penetrated by spermatozoa for a period of 12 to 72 hours. If coitus is not synchronized with this time period, the cervical mucus may be too thick to allow spermatozoa to penetrate the cervix. Infection or inflammation of the cervix may cause so much thickening in cervical mucus that spermatozoa cannot penetrate it easily or survive in it. However, this is rarely enough of a problem to be the sole cause of infertility.
Infection of the vagina can cause the pH of the vaginal secretions to become acidotic, limiting or destroying the motility of the spermatozoa. Some women appear to have sperm- immobilizing antibodies in their blood plasma that act to destroy sperm cells in the vagina or cervix. Either of these problems limits the ability of the sperm to enter the uterus.
In a small proportion of couples, no known cause for infertility can be determined. Possibly the problems of either partner alone are not significant, but when combined they become sufficient to create infertility. It is obviously discouraging to couples to complete a fertility evaluation and be told their inability to conceive cannot be explained. These couples need support from health care providers to find alternative ways, such as continuing to try to conceive, using an assistive reproductive technique or agreeing to adopt a child.
When no specific cause can be found, improving the general state of health may help. The doctor may suggest changes in diet like reducing alcohol intake, and may suggest relaxation techniques and stress elimination. About half of the couples professionally treated for infertility can achieve pregnancy. Each couple’s chances depend on what causes infertility.
