Causes of Female Infertility

By Larry Wurn

Infertility is the inability to naturally conceive after 12 months of trying to get pregnant. Overall, infertility affects some 10% to 15% of couples in their reproductive years. It's estimated that female problems are involved in one third of cases; male problems, in another third; and a combination of female and male problems, in the other third.

There are many causes of female infertility. Some are difficult to diagnose. They can be grouped into 3 broad categories: congenital (inherited), acquired and psychological. Following are some of the more common sources of female infertility.

Genetics. Researchers have identified about 350 genes that control female fertility. Just one missing or defective gene can cause infertility. One particular flawed gene, for example, prevents the ovaries from developing, so no eggs can be produced. Many women with inherited defective genes have benefited from in vitro fertilization, a procedure in which the sperm and egg are joined in a laboratory. The fertilized egg is then planted into the uterus (womb).

Hormonal imbalance. An imbalance of female sex hormones can interfere with menstruation, ovulation and egg growth. For example, high levels of the male hormone in the female body cause the eggs to form small cysts and stay within the ovaries instead of maturing and traveling to the fallopian tube or uterus. Various fertility drugs and hormone injections have helped in such cases of female infertility.

Damage to the reproductive organs. Abnormalities in the organs of the female reproductive system-ovaries, fallopian tubes, cervix, vagina and uterus-can be congenital or acquired. The malfunction of any one of the reproductive organs can prevent natural conception.

Congenital abnormalities include a missing reproductive organ, an abnormally shaped organ or even an extra organ.

Damage to the reproductive system can also come from disease, injury, surgery, and unknown causes. Here are some causes and types of damage:

Pelvic inflammatory disease is an infection of the uterus, fallopian tubes and tissue around and in the ovaries. It's a serious complication of certain sexually transmitted diseases that can permanently damage the reproductive organs.

Fused fallopian tubes occur as a result of inflammation, a previous tubal pregnancy or surgery. With this condition, the fallopian tubes stick together, blocking the transport of the fertilized egg to the womb.

Endometriosis is a condition in which the inner lining of the uterus (the tissue shed during the menstrual period) grows outside its normal place. The misplaced tissue can settle on the ovaries, uterus or fallopian tubes where it forms into clumps, which eventually turn into scars. The resulting scars disrupt the normal function of the affected organ. Although one of the main causes of female infertility, the cause of endometriosis is unknown.

Uterine fibroids are noncancerous polyps or tumors in the uterus. Though not a major cause of female infertility, they are common and painful and can block the fallopian tubes. They can also form scars that prevent the fertilized egg from attaching to the wall of the uterus.

Treatments for damaged reproductive organs include drugs and surgery. When the buildup of scare tissue is the main problem, some physical therapists use the Wurn technique, a hands-on procedure that destroys scars without drugs or surgery.

Psychological causes. Emotional stress, anxiety, fear and mental diseases, such as depression and bipolar disorder, sometimes lead to psychosomatic female infertility. Repeated failure to conceive usually causes more emotional stress, which makes the problem worse. Psychological causes are usually temporary and are treated with drugs and talk therapy.

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