There are many factors causing female infertility. To determine your diagnosis and why you may not be able to conceive, Dr. Blotner will focus on the functioning of your ovaries, fallopian tubes and uterus.
25% of infertility problems are due to problems with ovulation, which is the regular release of eggs from a woman’s ovaries. Women can have irregular/infrequent ovulation and menstruation or, even, a complete absence of ovulation and a menstrual period, called amenorrhea. Some reasons for this disorder can include exercise-induced stress, extreme weight loss, low thyroid levels, or an excess of prolactin, the breast-feeding hormone. Women with PCOS often have ovulation disorders.
If you are diagnosed with an ovulation problem, typically we first prescribe oral fertility medications, such as Clomid or Serophene, to stimulate follicle growth, egg development and ovulation. Though Clomid is very effective, if it does not jumpstart ovulation, we may recommend injectable gonadotropins as the next step.
Low ovarian reserve
A woman is born with all the eggs or oocytes she will ever potentially ovulate or release each month until she reaches menopause. Some women, however, are born with a lower amount or reserve of eggs and prematurely are at risk for not being able to become pregnant with their own eggs.
This is a common cause of female infertility when women attempt pregnancy in their late 30’s and early 40’s, but occasionally happens to women who are much younger.
Polycystic Ovary Syndrome (PCOS) is the most common cause for ovulatory dysfunction in reproductive age women, affecting about 8% of that population. Signs and symptoms include absence of or irregular menses, with accompanying infertility due to lack of ovulation; obesity; and hirsutism, characterized by dark, coarse hair located on the face, chest, abdomen and inner thighs.
Infertility caused by PCOS can be treated by diet and lifestyle changes, as well as medications and in vitro fertilization.
Endometriosis is a complex, though common, disease process that frequently results in pelvic pain and infertility. It most likely starts with normal menstrual flow that spills back through the tubes and into the pelvis. It can spread to the ovaries and fallopian tubes, as well as other parts of the body, and leads to a cycle of growth and inflammation. It is estimated that 10% of women suffer from endometriosis, with 50% of infertility patients having it.
Fibroids, polyps and structural abnormalities in the uterus can interfere with implantation.
One or both fallopian tubes can be blocked due to infection, endometriosis or scar tissue that forms after surgery. In addition, a previous ectopic pregnancy can cause damage to one of the tubes.