Frequently Asked Questions
What are the Factors which may contribute to infertility?
Pelvic Inflammatory Disease (PID)
Pelvic inflammatory disease may result from sexually transmitted diseases, non-sterile abortions, intrauterine devices (IUDs), ruptured appendix and pelvic tuberculosis.
Symptoms include fever, chills and pelvic pain. Occasionally there are no symptoms.
Endometriosis
Endometriosis occurs when endometrial tissue (the menstrual tissue inside the uterus which is shed during menstruation) grows outside of the uterus. This can occur on the ovaries, fallopian tubes, the ligaments that support the uterus and other organs in the pelvic cavity. Other possible sites of endometriosis are the bladder. bowel and vagina.
Medical researchers are continually investigating the cause of this disease and its relation to infertility, although currently the exact cause remains unclear. The most common theory is that the menstrual flow secretes from the fallopian tubes as well as the cervix, thus disrupting the natural course of conception. Problems associated with endometriosis can include chronic pelvic pain, pain during sexual intercourse, painful menstrual periods, lower back pain and bowel and bladder changes.
Hypothalamic-Pituitary Disorders (Hypogonadotropic Hypogodism)
Hypothalamic-pituitary disorder is an irregularity in hormones or gonadotropins (LH and FSH), which can disrupt normal ovulation.
Some of the known causes are: direct injuries to the hypothalamus or pituitary gland; medical conditions that disturb hormone regulation (like kidney failure, cirrhosis, pituitary tumors); excessive exercise and anorexia nervosa.
Polycystic Ovarian Syndrome (PCOS)
PCOS is a result of high ovarian production of androgens - hormones normally found in high levels in men but in low levels in most women, particularly testosterone. It is commonly associated with amenorrhea (the absence of menses for greater than six months) or oligomenorrhea (infrequent menses). Symptoms are due to the increased androgren production and can include facial hair, acne and obesity. However, not all women with PCOS experience these symptoms. PCOS may be related to diabetes. Insulin resistance occurs when insulin levels are normal or high but the body cannot use the hormone efficiently. It is associated with Type II Diabetes, or adult onset diabetes. Women with PCOS are at a higher risk for insulin levels and, as a result, may need medication.
Ovarian Cysts
Ovarian cysts are small fluid-filled sacs that grow within the ovary and are actually not uncommon. Many times cysts disappear on their own and are benign, but cysts that do not go away in two to three menstrual periods may interfere with fertility, depending on their size and characteristics.
Premature Ovarian Failure
Premature ovarian failure, also known as early menopause, occurs when menstruation ceases before the age of 40. It is related to the early depletion of follicles - the sacs which contain a women's eggs produced by the ovaries.
Elevated Prolactin Levels
Chronic Diseases
Diseases such as lupus, diabetes and hypertension can affect fertility.
Multiple Miscarriages
Excessive or Very Low Body Fat
Obesity can affect fertility as well as extreme underweight.
Environmental Factors
Environmental factors such as smoking, alcohol consumption, stress, exposure to workplace hazards or toxins can all affect the chances of a woman to conceive.
Age
Age plays a significant role in fertility. Women in their late 30's are about 30% less fertile than women in their early 20's. And women in their 40's are 70% less likely to become pregnant. Recent studies have suggested that the fertility curve begins to drop as early as the late 20's.
Luteal Phase Defect
Luteal phase defect refers to the failure of the embryo to implant in the uterus.
Benign Uterine Fibroids
Uterine fibroids are benign (harmless) tumors consisting of smooth uterine muscle. They are common among women in their 30's and beyond. In rare cases they may interfere with the uterine cavity, blocking the fallopian tubes and preventing the eggs from reaching the uterus, or they may interfere with the sperm's ability to reach to uterus and thus fertilize the egg.
Surgical Problems
Adhesions or scarring which may result from previous abdominal or pelvic surgeries can limit the movement of ovaries and fallopian tubes and can affect fertility.
Please contact an experienced health care provider at The Endometriosis Center for more details related to infertility. Or visit our Resources section for related links and suggested readings.
