MEDICAL CAUSES OF FEMALE INFERTILITY

• Anovulation (lack of ovulation)

• Late ovulation

• Short luteal phases (the second phases of the cycle)

• Infertile cervical fluid

• Hormonal imbalances (such as polycystic ovary syndrome [PCOS])

• Insufficient progesterone levels

• Occurrence of miscarriages

• Irregular or abnormal bleeding

• Vaginal infections

• Urinary tract infections

• Cervical anomalies

• Breast lumps

• Premenstrual syndrome

• Miscalculated date of conception

• Endometrioses

• Sexually transmitted diseases

 Genetic          

• A Robertsonian translocation in either partner may cause recurrent spontaneous abortions or complete infertility;

• General factors

• Diabetes mellitus, thyroid disorders, adrenal disease

• Hypothalamic-pituitary factors

1. Kallmann syndrome

2. Hyperprolactinemia

3. Hypopituitarism

Inadequate hypothalamus function

• Inadequate functioning of the hypothalamus, resulting from poor feedback mechanisms or stress.  The hypothalamus is extremely sensitive to emotions as well as to xenobiotics (chemicals that mimic hormones), which are derived from plastic waste and hormone fed animals, and which may reduce stimulation of the pituitary gland.

• Genetic factors or tumours can also affect hypothalamic-pituitary access.

• Prolactin (from stress or breastfeeding) also inhibits pituitary release of the Follicle Stimulating Hormone (FSH) and prevents ovulation.

Slow oestrogen production through

• Weak response of the follicle, or lack of oestrogen precursors or poor quality follicles or FSH resistance.

Over production of cortisol

• Stress causes adrenal over-stimulation, and the result is the increased production of cortisol, the long-term stress hormone, which uses up much-needed progesterone.  The long-term effect is low oestrogen, progesterone and testosterone.

Too high/low progesterone level

• Too low or too high a progesterone level can result in cyst formation and endometrioses, PMS, breast tenderness and painful periods.  Too high a level may cause early ovulation with ovum maturity, and too low a level may cause delayed ovulation and poor ovum maturation as well as delayed periods.

Cervical cancer

• Cervical cancer is the 2^nd most common cancer worldwide in women under 45 and the third leading cause of cancer deaths among women worldwide after breast and lung cancer. 

• Cervical cancer develops in the cervix – the low, narrow neck of the uterus that opens into the vagina.  The cervix protects your uterus. 

• The main cause of cervical cancer is a virus called Human Papiloma Virus (HPV).  The virus can be transmitted during sex or even sometimes during intimate genital skin to skin contact.  Every woman risks catching the virus.  Up to 80% of women will be infected with some type of virus at some time in their lives.  This is why it is so important to have regular pap smear tests to detect abnormalities.  A pap smear test involves taking a swab of your cervix.  This involves a doctor, gynaecologist or nurse using a special brush device to gently take a few cells from the surface of your cervix.  These are then examined under a microscope for possible early abnormalities.  Should abnormalities be found, you will quickly be contacted and advised on further tests and possible treatment.

Low oestrogen levels

• Low oestrogen levels will cause LH not to trigger ovulation, without which no ovarian progesterone is produced.  When progesterone levels are too low, or there is poor tissue response to progesterone, the endometrium remains immature and the result delayed heavy and painful periods.

• Blocked fallopian tubes due to endometrioses, pelvic inflammatory disease or surgery

• Physical problems with the uterine wall

• Uterine fibroids