Causes of Female Infertility – howMed

According to WHO, it is the inability of a couple to conceive after two years of unprotected intercourse. Factors that may become a cause of infertility in a female include:

A.    Ovarian or Hormonal Factors:

1.    Hypogonadotrophic Hypogonadism:

Hypogonadism is an important cause of infertility in both males and females.Causes of hypogonadotrophic hypogonadism are: •    Hyperprolactinemia usually occurs due to: a)    Drugs b)    prolactin-secreting tumours •    Hypothalamic Insufficiency as occurs in Kallman syndrome which is  associated with low levels of sex hormones resulting in late commence or non-completion of puberty. •    Pituitary Insufficiency  usually due to: a)    Tumours b)    Necrosis c)    Thrombosis d)    Stress

e)    Exercise

2.    Hypergonadotrophic Hypogonadism:

It can occur in following conditions: •    Menopause •    Luteal Phase Deficiency(shorter duration of luteal phase & low progesterone level during it) •    Gonadal Dysgenesis(developmental disorder of reproductive system) •    Premature Ovarian Failure (autoimmune,cytotoxic chemotherapy,tumour)

•    Resistant Ovary Syndrome(insensitivity to hormones)

3.    Metabolic Diseases:

•    Thyroid Disorders like hypo or hyperthyroidism. •    Liver Diseases(decreased levels of SHBG) •    Obesity •    Androgen Excess

•    Polycystic Ovarian Syndrome(androgen excess and anovulation)

B.    Tubal Factors (involving fallopian tubes): 

These can be any of the following: •    Occlusion Or Scarring Of The Fallopian Tube •    Salpingitis Isthmica Nodosa (nodular thickening of narrow part of fallopian tube due to inflammation)

•    Infectious Salpingitis

C.    Uterine Factors:

These are: •    Leiomyomata (Fibroids) •    Congenital Malformations (Bifid Uterus) •    Adhesions (Asherman’s Sydrome)

•    Endometritis or Abnormal Endometrium

D.    Cervical Factors:

•    Stenosis •    Inflammation Or Infection

•    Abnormal Mucus Viscosity

E.    Immunological Factors (Anti-Sperm Antibodies in serum and Cervical Mucus)

F.    Psychosocial Factors (Decreased Libido)

G.    Iatrogenic : •    Prolonged use of oral contraceptives •    Cancer chemotherapy

•    Radiotherapy

H.    Idiopathic(unexplained etiology)