Female Infertility

Polycystic Ovary Syndrome (PCOS)

PCOS is the most common ovulation disorder; PCOS is marked by experience irregular or absent periods, anovulation, and have ovarian cysts – the production of multiple cysts that blocks ovarian follicles from producing mature eggs. Ovulation occurs when a mature egg is released from an ovary. This happens so it can be fertilized by a male sperm. If the egg is not fertilized, it is sent out of the body during the periods. PCOS is marked by irregular or absent periods, anovulation, and have ovarian cysts – the production of multiple cysts that blocks ovarian follicles from producing mature eggs.

In some cases, a woman doesn’t make enough of the hormones needed to ovulate. When ovulation doesn’t happen, the ovaries can develop many small cysts which adversely impacting the follicles.

Hypothalamic amenorrhea

Women with hypothalamic amenorrhea have irregular or absent ovulation because their bodies don’t have the nutrients or fat content which helps send hormone impulses to the ovaries. Excess stress, high or low weight, and excessive weight gain or weight loss can all be contributing factors. Hypothalamic amenorrhea is common in professional athletes, dancers, and ladies with anorexia nervosa.

Hypothyroidism/Hyperthyroidism

Both hypothyroidism and hyperthyroidism can cause infertility by affecting ovulation. With hypothyroidism, the thyroid gland doesn't produce enough of certain important hormones. Low levels of thyroid hormone can interfere with the release of an egg from the ovary (ovulation), which impairs fertility. While, Hyperthyroidism can lead to elevated levels of the protein Sex Hormone Binding Globulin (SHBG) and the hormone prolactin, which can prevent the ovaries from releasing eggs.

Premature ovarian failure, early menopause & Ovarian insufficiency

Menopause is a stage in life when you no longer can get pregnant. Premature menopause happens to women assigned female at birth (AFAB) before age 40 and early menopause happens before age 45 while the average woman goes through menopause at 50 years of age.

Premature menopause isn’t the same as premature ovarian failure (POI). POI is a condition where the periods stop suddenly and spontaneously, either early or prematurely. People with POI may still ovulate, menstruate or become pregnant while premature menopause, don’t ovulate or menstruate, and lose the ability to get pregnant.

Uterine fibroids, polyps

Uterine fibroids also called leiomyomas are a common type of noncancerous tumor that can grow in and on the uterus. Uterine tumors that develop in the cavity, called submucosal fibroids, have the worst effect on fertility. They can act almost like an IUD, either by preventing a pregnancy from implanting on the uterine wall or by making it less likely that the pregnancy will remain attached to the wall.

Polyps are small growths that can occur inside of the uterus. Polyps are attached to your endometrial lining and extend inward into the uterine cavity. They range in size and can grow to a few centimetres in diameter. Polyps impact fertility by making it more difficult for a fertilized egg to attach to the uterine walls or block sperm from joining with an egg or block sperm from entering the uterus

Previous pelvic surgery, adhesions

Pelvic adhesions, sometimes referred to as scar tissue, are a common cause of both infertility and pelvic pain. Pelvic adhesions develop over 90% of the time following a major abdominal surgery. Many complications can occur as a result of pelvic adhesions. It is estimated that adhesions may be a significant factor in as much as 40% of cases of infertility

Endometriosis

The inner lining of Uterus is called the endometrium. At times, a tissue similar to endometrium grows in places where it doesn't belong. Endometriosis is an often-painful condition in which tissue that is similar to the inner lining of the uterus grows outside the uterus. It often affects the ovaries, fallopian tubes and the tissue lining the pelvis. Rarely, endometriosis growths may be found beyond the area where pelvic organs are located.

Endometriosis can influence fertility in several ways: distorted anatomy of the pelvis, adhesions, scarred fallopian tubes, inflammation of the pelvic structures, altered immune system functioning, changes in the hormonal environment of the eggs, impaired implantation of a pregnancy, and altered egg quality. Up to 30% to 50% of women with endometriosis may experience infertility.

Pelvic inflammatory disease (PID)

PID is an infection of the female reproductive organs transmitted through sexual contact, which if left untreated can cause problems such as scarring, lifelong pain and infertility.

Pelvic inflammatory disease affects 1 in 10 women with infertility.

Follicle-stimulating hormone (FSH)

Very important for the regulation of the menstrual cycle and the production of healthy eggs. It regulates puberty, development, growth, and the reproductive system. In a male, any abnormality in the level of this hormone can cause either low sperm production or absence of sperm production.

Luteinizing hormone (LH)

Similar to FSH, a correct level of LH is also important and prompts the release of the egg, desired sperm production.

Estrogen:

Estrogen is a crucial hormone for both males and females. It is synthesized by the ovaries, adrenal glands, and fat cells in the body. In females, it ensures the development of reproductive structures and female characteristics, such as breasts and pubic hair. It stimulates egg follicle maturation, enhances vaginal lubrication, fortifies the vaginal lining and halts milk production post-breastfeeding. An imbalance in estrogen can lead to issues like anovulation or irregular periods, directly affecting a woman's fertility.

Progesterone

This hormone plays a vital role in preparing the endometrium for potential pregnancy. Progesterone enhances endometrium’s thickness to nurture a fertilized egg. It helps to keep uterine muscles relaxed to prevent rejection of the egg.

When fertilization doesn’t take place, less progesterone levels trigger menstruation. Similarly, if conception occurs, progesterone supports foetal development and maintains high levels to suppress ovulation during pregnancy once the placenta develops. low levels can prevent the uterus from properly preparing for embryo implantation, leading to infertility or miscarriage.

Prolactin

Prolactin originates from the pituitary gland. It plays a crucial role in breast development and the production of breast milk. It also contributes to the regulation of the menstrual cycle, an essential element in fertility planning. Elevated levels of prolactin can disrupt the menstrual cycle and ovulation, causing infertility in women and affecting sperm production in men.

TSH, T3, T4

TSH, secreted by the pituitary gland, prompts the thyroid to release T3 and T4 hormones. Disruptions in these hormones can lead to thyroid conditions that might negatively impact fertility, such as increased miscarriage risk, ovulation issues, and irregular menstrual cycles.

The intricate interplay among the thyroid, adrenal glands, and the reproductive system is crucial for successful conception. Abnormalities in these hormones can disrupt menstrual regularity and ovulation in women, as well as sperm production and quality in men, which contributes to infertility.