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Women’s Infertility Causes: PCOS, Fibroids & More
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The information provided here serves as a general guide and does not constitute medical advice. We strongly advise consulting a certified fertility expert for professional assessment and personalized treatment recommendations.
Synopsis
Infertility in women is becoming a major medical concern, with an average of around 8% married women affected by this problem in India. Besides being a physical pain, it carries emotional and social baggage for women, leaving them feeling isolated and lonely in this struggle.
While infertility can feel overwhelming, advances in medical science have made it possible to identify and treat many of these conditions effectively. So, in this article, we will get to know about various causes of infertility in women, which can help you track down your cause of infertility and make a timely decision for the same. So let’s begin.
Understanding Infertility in Women
Infertility in women is basically defined as not being able to conceive even after regular and unprotected intercourse, that is, 12 months in women under 35 and 6 months for women over 35. Moreover, infertility in women can also be categorised into two major types, which are:
- Primary Infertility: Primary infertility is when a woman has never been able to conceive, even after regular unprotected sex.
- Secondary Infertility: It is when a woman has previously conceived and given birth, but has been struggling to conceive again for any reason.
While the cause of inability to conceive can be due to infertility in either partner, female infertility mainly occurs when there is a problem in the female reproductive system.
Common Causes of Female Infertility:
Causes of infertility in females can differ widely and are often interrelated. Here are some of the most common causes of infertility in women:
Polycystic Ovary Syndrome (PCOS):
PCOS is among the most prevalent causes of disrupted fertility in women. This disorder is a hormonal condition characterised by the accumulation of eggs and the development of cysts on the ovaries.
How PCOS Affects Fertility
- PCOS causes irregular ovulation or even the complete absence of ovulation and periods.
- When there is a higher level of androgens in the body, it interferes with egg development, initiating the accumulation.
- In some women, insulin resistance initiates the imbalance of hormones and weight gain.
Symptoms
- Irregular or missed periods
- Acne and oily skin
- Excessive hair growth (hirsutism)
- Weight gain, especially around the waist
- Multiple small cysts on the ovaries (seen in ultrasounds)
Uterine Fibroids:
Uterine fibroids, or simply fibroids, are the non-cancerous overgrowth of the uterus, which often occurs during pregnancy.
How Fibroids Affect Fertility
- Although non-cancerous, some large fibroids in the region of the fallopian tubes can block it.
- It can also change the morphology of the uterus, which makes implantation quite difficult.
- Even if the implantation is successful with fibroids, it increases the chances of complications or miscarriage during pregnancy.
Symptoms
- Heavy bleeding during menstruation
- Pelvic pain or pressure
- Frequent urination due to pressure on the bladder
- Constipation
Endometriosis:
Endometriosis is basically the growth of uterine lining-like tissues outside the uterus, that is, on the ovaries, fallopian tubes, or pelvic organs.
Impact on Fertility
- Overgrowth of uterine tissues causes inflammation, which in turn results in damage to reproductive tissues.
- Blocking of the fallopian tubes and damaging the tissues around the uterus.
- Distortion in the pelvic and uterine region also causes hindrance in the meeting of sperm with the ovum.
Symptoms
- Severe menstrual cramps
- Pain during intercourse
- Heavy periods
- Fatigue and digestive issues
Ovulation Disorders:
Regular ovulation is a must to get pregnant, as the ovulation will help couples to track down the exact timing for intercourse. Ovulation disorder can disrupt this cycle, which is commonly caused by:
- Hormonal Imbalances – Low FSH or LH levels can prevent the ovaries from releasing an egg.
- Hyperprolactinemia – High levels of prolactin will prevent ovulation.
- Premature Ovarian Insufficiency (POI) – Decline in ovarian function at a young age (before 40 years old).
- Too much exercise and eating disorders – A lack of energy can hinder ovulation.
These disorders often can be treated with medications, lifestyle adjustments, or hormone therapy.
Fallopian Tube Damage or Blockage:
The fallopian tube is the region of the uterus where the fertilisation of sperm and the ovum occurs. Therefore, blockage in this region can act as a barrier for sperm swimming towards the egg. The blockage, apart from the above-mentioned causes, can occur due to:
- Pelvic Inflammatory Disease (PID)
- Sexually transmitted infections (STIs) like chlamydia
- Past pelvic or abdominal surgeries
- Endometriosis-related scarring
Thyroid Disorders:
The thyroid gland releases some essential gonadotropic hormones, which are much needed to develop and support the female reproductive system. Therefore, any distress in this gland can, in turn, become a major cause for infertility. Thyroid disorders can be classified into two categories, which are:
- Hypothyroidism (underactive thyroid): This causes irregular periods, anovulatory cycles(skipping of periods), and an increased risk of miscarriage.
- Hyperthyroidism (overactive thyroid): Hyperthyroidism results in menstrual irregularities and hormonal imbalance.
Most women can restore their fertility with early diagnosis and a prescription.
Age-Related Infertility:
Fertility in women generally declines with age naturally due to a decrease in the quantity as well as the quality of eggs produced in women. That is, women remain most fertile:
- Under the age of 35, it starts declining significantly.
- After the age of 40, the chances of getting pregnant naturally become even slimmer.
Besides, pregnancy after this fertile window also has a higher risk of miscarriage and chromosomal abnormalities.
Lifestyle-Related Causes:
Your standard of life and style of living can also directly or indirectly influence your fertility, and here is how:
Negative Influences
- Smoking: Smoking can significantly damage the mature eggs, eventually affecting the ovarian reserve.
- Excessive Alcohol: Alcohol abuse can disrupt the ovulation and hormonal balance.
- Obesity: When linked with PCOS or insulin resistance, obesity can become a reason for infertility.
- Stress: Stress can indirectly alter your hormonal balances and menstrual cycles, eventually affecting fertility.
Positive Influences
- Maintain a balanced diet that includes folic acid, iron and antioxidants.
- Maintaining a healthy body weight.
- Moderate physical activity.
- Stress management with yoga, meditation, or counselling can also help fight infertility.
Apart from these disorders mentioned above, some other linked issues, like autoimmune and genetic factors and unexplained causes, can also influence infertility in females.
Who is at a More Risk of Infertility?
While infertility is an unexpected problem which can affect anyone, there are some factors that increase these chances in some women, which include:
- Age greater than 35 years old – Age naturally decreases fertility and increases the likelihood of having a miscarriage.
- Family history of reproductive disorders – Risk increases if a close relative has PCOS, endometriosis, or premature ovarian failure.
- Early onset of irregular menstrual cycles – Irregular menstrual cycles lasting for many months may signal hormonal issues.
- Previous surgeries to the pelvis or abdomen – Scar tissue and adhesions created because of the procedure can impact fertility.
- Radiation or chemotherapy exposure – Cancer treatment may harm eggs or diminish the egg reserve.
- Autoimmune disease – Autoimmune diseases such as lupus or rheumatoid arthritis may hinder reproductive health.
- Chronic illness – Conditions like diabetes, kidney disease, or high blood pressure may also pose a risk to fertility.
- Hazardous Job exposure – Exposure to chemicals, toxins or radiation at work might result in fertility issues.
- Medications for long periods of time – The use of antidepressants, steroids and or chemotherapy long-term may pose challenges to fertility.
Treatment Options
Infertility is concerning, but fortunately, with the advancement in technology and medical procedures, such as IVF in Nepal, treatment is possible. With early diagnosis and the following treatment options, fighting infertility is now within reach:
- Medicines are the first option of care used against infertility.
- Surgery for endometriosis and blocked fallopian tubes.
- Techniques like intracytoplasmic sperm injection are useful when sperm motility or quality is a concern.
- Assisted reproductive technologies, such as IVF and IUI, can also be used to assist women who are aspiring to get pregnant.
- Changes in lifestyle, while also avoiding things that are negative to the lifestyle.
- Counselling and support to deal with the emotional scars of infertility.
Couples often discuss IVF vs ICSI cost comparison with their fertility specialists to decide the most suitable treatment path.
Conclusion
In summary, female infertility is a multifactorial issue impacted by medical diagnoses, age and lifestyle factors. Medical diagnoses such as PCOS, fibroids, endometriosis, and hormonal irregularities are often the foremost causes, and other risk factors of age, family history or exposure to toxins increase risk factors. The bright side is that with early diagnosis and timely treatment, IVF success rates continue to improve, offering hope to couples facing infertility. Infertility or fertility struggles are not the end of the road, but a new journey of possibilities leading to motherhood.
Frequently Asked Questions
Is it true that infertility is forever?
No, with prompt diagnosis and treatment, many women will become pregnant. Early access to medical care, if necessary, will increase the chances of success.
Does PCOS and fibroids mean I will have infertility?
Not necessarily; they can also affect ovulation or the implantation of an egg. Managing these conditions will allow many women to successfully become pregnant.
Can making lifestyle changes improve my fertility?
Yes, a healthy diet, being active, and avoiding tobacco and alcohol can contribute to better reproductive health.
What is unexplained infertility?
It is the type of infertility where there is no clear cause even after the completion of the appropriate diagnostic tests. Unexplained infertility is reported to affect approximately 30% of couples around the world.
When should a woman seek medical intervention?
If the patient is under 35 and has not become pregnant after one year, or is above 35 and has not been successful after six months, they should seek medical intervention.
