Female infertility can be caused by a number of factors. These include ovulation dysfunction, anatomical problems and endometriosis.
In a woman’s monthly cycle, the ovaries produce tiny cysts or blisters called follicles. Usually, one of these follicles ripens and releases an egg.
1. Cirrhosis of the liver
Getting pregnant and carrying a pregnancy to term are complicated processes that require many things working well. When something goes wrong, it can lead to infertility.
Among the most common causes of female infertility is cirrhosis of the liver. This condition causes enlargement of the spleen (splenomegaly), and changes in blood vessels in your liver called portal hypertension.
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The pressure in the portal veins can cause enlarged veins in your esophagus and stomach (esophageal varices). If these esophageal varices burst, you may have bleeding that is life-threatening. This is a good reason to see a hepatologist if you have cirrhosis.
2. Polycystic ovary syndrome (PCOS)
Polycystic ovary syndrome (PCOS) is one of the most common causes of female infertility. It involves an imbalance of hormones that causes irregular ovulation and missed periods.
Ovulation occurs when the ovaries produce small cysts or blisters called follicles that ripen to release an egg. In PCOS, the follicles fail to ripen, causing the ovaries to produce excessive male sex hormones.
Another hormonal condition that affects fertility is endometriosis, which happens when tissue that lines the uterus grows elsewhere in the body. This may thicken and bleed during your menstrual cycle and cause pain, inflammation and infertility.
3. Endometriosis
Endometriosis is a condition where cells from the lining of the uterus (endometrial tissue) grow outside the uterus in abnormal places. It can cause pain, scarring and adhesions.
It can also damage the fallopian tubes and ovaries, and affect fertility. In severe cases, the tissue can interfere with egg pickup or fertilization, and can block sperm from reaching an egg.
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Your doctor can diagnose endometriosis with a pelvic exam and ultrasound of the uterus, fallopian tubes and ovaries. She may also take your menstrual blood to test for endometrial cells.
4. Pelvic inflammatory disease (PID)
Pelvic inflammatory disease (PID) occurs when bacteria that cause an STI, such as gonorrhea and chlamydia, move up from the vagina or cervix into the fallopian tubes and ovaries. These infections can cause pelvic pain and damage your reproductive organs, making it difficult to get pregnant.
PID can be prevented by using safe sex and keeping your sexual partners updated on any STI testing that you might need. Use condoms and limit the number of sexual partners you have at once. Ask your health care provider to help you set up a screening schedule for STIs if needed.
5. Uterine fibroids or polyps
Uterine fibroids or polyps are abnormal growths in your uterus that may interfere with pregnancy. They can be symptom-free or cause bleeding, pain and cramping.
They can also block the lining of your uterus from containing enough sperm to carry your pregnancy to term.
Fortunately, many women with uterine fibroids or polyps have no symptoms and are able to have children without treatment. However, if the growths are large and cause symptoms, you should consider seeing your Ob/Gyn to discuss treatment options.
6. Cervical stenosis
Cervical stenosis occurs when the spinal canal narrows to a degree where it can pinch the spinal cord and nerve roots. This may happen because of age, a herniated disc, degeneration of the spine’s facet joints or bone spurs called osteophytes.
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Pain, numbness and weakness in the arms and legs can develop from the pressure on the spinal nerves (radiculopathy). If the condition is severe, it may cause cervical myelopathy.
To determine the cause of the stenosis, your doctor will perform a physical exam and request x-rays or MRI. Your doctor may also order lab tests to check for cancer, such as a Pap test and a HPV test.
7. Hyperprolactinemia
Hyperprolactinemia occurs when a woman has high levels of prolactin in her blood. Prolactin is a hormone that’s produced in the pituitary gland (a small gland at the base of your brain).
High levels of prolactin can interfere with normal menstrual cycles and fertility. Other health conditions can cause it as well, including a benign growth called a prolactinoma on the pituitary gland, hypothyroidism or liver or kidney disease.
