In the modern world, there is a real and increasing concern around infertility and conception. This concern is well founded and has been highlighted often in the past 20 years. We have seen the European Union, the World Health Organisation and the United Nations all discuss this topic.

Introduction to Female Infertility

Infertility causes are split equally between women and men at about 30 per cent each (unexplained infertility and cases of infertility in both partners make up the remaining 40 per cent). Infertility primarily refers to the biological inability of a person to contribute to conception. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term.

Incredible numbers of people are having trouble conceiving and bearing a child today. In 2006, The International Committee for Monitoring Assisted Reproduction Technologies announced that three million children had been born through In vitro fertilisation (IVF) alone. In 2004 (the most recent research available), research showed that there had been a 128 per cent increase in the number of children born in the United States through IVF from 1996. An astonishing 4 per cent of children in Finland are born through IVF. Statistics like this abound. This is a growing trend and highlights the global concern over infertility.

Across the world, there are various causes of female infertility. They are generally split into two areas: acquired, and genetic.

Why the rise in infertility levels?

According to the American Society for Reproductive Medicine (ASRM), age, smoking, nutritional standings, sexually transmitted infections, and being overweight or underweight can all affect fertility.

In the broad sense, acquired factors practically include any factor that is not based on a genetic mutation. Genetic factors can be a little more complex and can begin with a fault in a particular gene. There are additional conditions involving female infertility which are believed to be genetic, but where no single gene has been found to be responsible. Finally, an unknown number of genetic mutations cause a state of sub-fertility, which in addition to other factors such as environmental ones may then manifest as actual infertility.

For either sex, it is a good idea to try identify the cause of infertility. When the root cause in the delay of conception is known, it is easier to determine a protocol to correct it.

Female Infertility: What Goes Wrong?

One of the leading causes of female infertility is ovulatory failure. Some estimates say this accounts for 30% of female infertility. The majority of these cases are treated with the drugs Clomiphene and Menogon (hCG). All of this basically means that the ovaries fail to ovulate. The main reason for this is a hormonal problem, which is an umbrella term. Some of the main causes are:

Polycystic Ovary Syndrome

A failure to produce mature eggs counts for around 50 per cent of the umbrella term. Put simply, the ovaries do not produce follicles that can produce mature eggs. Polycystic Ovary Syndrome (PCOS) is the most common disorder responsible. PCOS has a long list of potential symptoms, but it is believed that PCOS suppresses Follicle Stimulating Hormone (FSH) and increases Lutenising Hormone (LH), oestrogen and testosterone. A low FSH means the follicle does not develop, thus the egg does not develop. This makes fertilisation nearly impossible.

Hypothalmus malfunction

The Hypothalamus is a small gland at the base of the brain. It is sometimes considered as a ‘master gland’. This gland has a regulatory function in this instance and works closely with the pituitary gland. The hypothalamus sends signals to the pituitary gland to control FSH and LH secretion. A malfunction in this system can result in a gap in communication and an irregular hormonal pattern between these two crucial hormones. Malfunctions can be caused by damage resulting from malnutrition, including anorexia and bulimia eating disorders, genetic disorders, radiation, surgery, head trauma, lesion, tumour or other physical injury to the hypothalamus. Long term stress has also been identified as a causing factor.

Ovary Scarring

Ovary Scarring has also been noted to interrupt ovulation. This cause is probably the easiest to understand. A damaged ovary is unlikely to function as well as an undamaged or healthy ovary. Invasive surgery is generally the primary cause of scarred ovaries. This is often a result of PCOS surgery. There is very interesting research highlighting ‘infection(s)’ in the area having a similar result.

Premature Menopause

Another cause of anovulation is premature menopause. Premature menopause has become more of an occurrence over the past 25 years. Simply put, it is a case of a woman entering menopause before the average age, and generally well before. This can also be called ‘Primary Ovarian Insufficiency’. Chemotherapy, radiation treatment, pelvic surgery, autoimmunity, endometriosis, infection, and genetic disorders are all possible causes of premature menopause.

Follicular Problems

Follicular problems also tend to occur. This is generally classed as ‘unruptured follicle syndrome’. This means that a normal follicle is produced and behaves in a normal way. For some reason (generally unexplained) the follicle does not rupture and therefore, the egg is not released and remains inside the follicle.

Fallopian Tube Disease

According to Stanford University, tubal disease can affect around 25 per cent of infertile couples. Tubal disease is a result of your Fallopian tubes being blocked or damaged. The Fallopian tubes are very delicate structures that are responsible for picking up the egg and providing the site for fertilisation of the egg as well as early embryo development and transport to the uterine cavity. The cells lining the tube produce secretions that nourish the egg and embryo. A prior history of pelvic inflammatory disease (PID), tubal surgery, ectopic pregnancy, ruptured appendix, ovarian surgery, or septic abortion strongly suggests the possibility of tubal disease.

PID is clearly the major cause of tubal factor infertility and ectopic pregnancies. The risk of ectopic pregnancy is also greatly increased after pelvic infections. However, some women who are found to have pelvic adhesions and/or tubal disease have no known prior history of pelvic infection. These “silent” infections are most often caused by chlamydia. Tubal factor infertility is due to any anatomic abnormality that prevents the union of sperm and egg. Essentially, with tubal factor infertility, treatment options are reconstructive surgery or IVF. Over the last decade, for most conditions, IVF success rates have steadily increased to now exceed those that can be achieved with surgery. This being said, surgery can still get some very good results.

Endometriosis

The other major cause of female infertility is Endometriosis. It is estimated that somewhere between 6 per cent and 10 per cent of women in the United States has endometriosis. There is a follow up statistic that states around 40 per cent of these women are classed as infertile as a result. The Endometriosis Association of Ireland has a video explaining the disease, which you can watch below. We would like people to be aware of complementary therapies that can have a significant impact on the disease.

Endometrial tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus (endometrial implant). Endometriosis most commonly involves your ovaries, bowel or the tissue lining your pelvis. Rarely, endometrial tissue may spread beyond your pelvic region. Painful periods, pelvic pain, cramping, back pain, pain during intercourse, pain with bowel movements or even urination, heavy and irregular periods, fatigue, bowel discomfort and nausea have all been recorded as symptoms of endometriosis.

Other causes

At least 10 per cent of all cases of female infertility are caused by an abnormal uterus. Conditions such as fibroid, polyps and adenomyosis may lead to obstruction of the uterus and Fallopian tubes. Congenital abnormalities, such as septate uterus, may lead to recurrent miscarriages or the inability to conceive. Approximately 3 per cent of couples face infertility due to problems with the females cervical mucous. The mucous needs to be of a certain consistency and available in adequate amounts for sperm to swim easily within it. The most common reason for abnormal cervical mucous is a hormone imbalance, namely too little oestrogen or too much progesterone.