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Common causes of infertility in women

Common causes of infertility in women:

 

1) Polycystic Ovarian Syndrome (PCOS):

 

PCOS is a hormonal imbalance in woman causing delayed ovulation or no ovulation at all. Woman suffering from PCOS might find they have very irregular periods, some months lasting longer than 35 days. Others do not have their period for several months at a time. Other symptoms are abnormal facial hair growth and unexplained weight gain. If left untreated, it can cause diabetes or heart disease.

 

PCOS can be diagnosed by an ultra sound where they will find multiple ripening follicles or cysts on each ovary. This cause hormonal imbalance as each cyst/follicle produces a certain amount of hormones. (Normally, a healthy, fertile woman produces one or two ripening follicles on her ovaries with each cycle). Due to the increased level of hormones produced by the multiple cysts/follicles, the eggs in the follicles do not get released and ovulation does not take place. Alternatively it can cause ovulation to take place at irregular intervals, which makes it difficult to time intercourse.

 

Treatment will include hormonal therapy via tablets or hormonal injections given at certain times during your cycle. This will assist to balance your hormones and stimulate healthy ovulation.

 

 

2) Endometriosis:

Endometriosis is when your endometrial tissue, which normally lines the inside of your uterus, grows outside your uterus. This abnormal growth of tissue in your pelvis or abdominal cavity can cause scarring and the growth of adhesions. These adhesions can bind the fallopian tubes and ovaries together, interfering with the natural path the released egg needs to travel to be fertilized.

Endometriosis can be difficult to diagnose as a lot of woman have no symptoms at all. Some common symptoms are painful menstrual cramps, pain during intercourse and infertility.

Treatment will include hormonal therapy by taking tablets or injections. Some woman might need surgery to remove scar tissue or adhesions. A combination of medicine and surgery might be needed, it all depends on each woman’s specific progression of the illness.

 

3) Fallopian Tube Damage or blockage:

Fallopian tube damage or blockage can prevent the egg and sperm to meet in order for fertilization to take place. Causes include endometriosis, pelvic infections and pelvic surgeries as it can cause scarring or adhesions.

Blocked tubes can be diagnosed with a hysterosalpingogram (HSG). This is an x-ray test where sterile dye is injected into your uterus, via a small tube entering through the vagina, almost like a speculum exam when a pap smear is done. While the dye moves through your uterine cavity and fallopian tubes, the x-ray will show if the dye is maintained inside the tubes or if it exits into the abdominal cavity.

This test can actually dislodge any debris caught in the tubes causing woman to be quite fertile after the procedure. If the tubes are found to be blocked, a laparoscope might need to be done to examine the cause of the blockage.

 

4) Cervical factor infertility:

The journey of sperm starts in the vagina where it is deposited during intercourse. The consistency of the woman’s cervical mucous must provide nutritional support to the sperm and also needs to be the correct consistency to allow sperm to swim effectively through it. If a woman’s cervical mucous is too thick, sperm will not be able to swim through it to reach the cervix and enter the uterus. There are lubrication products on the market which can assist with getting the mucous to the correct consistency, like Pre~Seed (sold on our website).

Some women have antisperm antibodies in their cervical mucous. This causes the sperm to be killed once in contact with the cervical mucous.

A doctor can diagnose this condition with a post-coital test which is done by collecting a sample of a woman’s cervical fluid within 8 hours after intercourse. The sperm in the mucous is examined to detect any abnormalities in the number of sperm, their ability to swim, shape as well as the thickness of the mucous is examined.

If this condition is diagnosed, intrauterine insemination (IUI) is done to bypass the cervical mucous and vagina completely. During his procedure, specially prepared sperm is inserted directly into the uterus through a small tube via the vagina. This is not a painful procedure at all, similar to having a speculum exam. The sperm inserted is specially prepared in the lab, it is washed and only the most healthy and active sperm are isolated. The reason the sperm needs to be prepared in the lab is because only sperm can enter the uterus, not the semen.

TAKE NOTE: Men can also have antisperm antibodies in their semen. A semen sample might need to be tested for this as well.

 

5) Uterine abnormalities:

Abnormalities of the uterus occurs during development and can cause various symptoms of which the most common are infertility, abnormal periods, pain during menstruation (dysmenorrheal), early stage pregnancy loss, just tot name a few. 

Most women generally show no specific symptoms of an abnormal uterus. They are normally diagnosed when they suffer from infertility. Although the following uterine abnormalities can cause infertility, by no means does this mean women with these abnormalities can not fall pregnant and give birth. It may just mean that they will need close monitoring during pregnancy as these can cause preterm labour or miscarriages. The time woman try to fall pregnant might also be prolonged due to these abnormalities.

The following are examples of the most common uterine abnormalities:

 

  • Bicornuate uterus:

     

    A heart shaped uterus with a deep indentation at the top. In appearance it looks like the uterus has two horns instead of being pear shaped like a normal uterus.

     

  • Unicornuate uterus:

     

    A unicornuate uterus is half the size of a normal uterus and will only be connected to one ovary. This minimizes the chances of becoming pregnant as you only have one ovary and fallopian tube.

     

  • Uterus didelphys:

     

    This conditions is where the woman has two separate uteri each with its own cervix and vagina. Each uterus is connected to one fallopian tube and ovary.

     

  • Septate uterus:

     

    This is where the inside of the uterus is divided in two halves by a septum consisting of a muscular of fibrous wall. The septum might only divide the uterus half way down, called a partial septate uterus. The septum might also divide the uterus all the way down to the cervix, called a complete septate uterus.

     

    Abnormalities to the uterus can be corrected surgically, but might cause scarring of the uterus. A septum for example can be removed vaginally via a hysteroscope rather than open surgery which decreases the chances of uterine damage and scarring. 

 

6) Unexplained infertility: Approximately 15% of couples struggling to conceive have unexplained infertility, whereby none of the normal tests will identify the cause of not conceiving.

 

 

 

 

 

 

 

 

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