In women, the following causes are considered:
- Ovarian Factor
– Absence of ovulation (which does not necessarily imply absence of menstruation) or dysovulation;
– Insufficiency of the yellow body – can be manifested by the presence of short cycles (at the expense of the luteal phase, after ovulation) and/or by early spontaneous abortions. It is a rare and exclusionary diagnosis.
They can be resolved through ovulation inducing drugs.
- Tubal Factor
The absence of fallopian tubes after surgery or tubal obstruction due to ligature, infections or endometriosis, does not allow the encounter between ovules and spermatozoa, and consequently, the occurrence of fertilization.
The presence of pelvic adhesions caused by surgeries or local infections can lead to loss of mobility of the fallopian tubes, which are unable to catch the ovum at the time of ovulation.
The tubal pathology is the main indication for conducting in Vitro Fertilization.
- Uterine factor
The presence of intrauterine pathology (polyps, fibroids, synechia, etc.) may make it difficult to attach the embryo to the uterus.
- Cervical factor
Cervical infections, cysts or uterine surgeries are situations that can alter the quality and quantity of the mucus produced, and thus make it difficult for the sperm to rise to the uterine cavity.
- Endometriosis
Endometriosis is a disease characterized by the presence of endometrial cells (identical to the inner lining of the uterus) in other locations: fallopian tubes, ovaries, peritoneum, etc. These cells become more active during menstruation, which can cause pain and formation of cysts in the ovaries.
They may cause infertility by obstructing or impairing the function of the fallopian tubes, or by altering the quality of the oocytes.
- Chronic diseases
- Endocrinological diseases
Diabetes, thyroid dysfunction and hyperprolactinemia, among others, may be responsible for disturbances in ovulation or prejudice egg and endometrial quality.
- Oncological diseases
Malignant tumors of pelvic excavation may require surgery, with removal of organs vital to fertility.
Chemotherapy and radiotherapy of the pelvic region can cause atrophy of the ovaries, with destruction of the oocytes.
Nowadays there are procedures that can and should be considered before these therapies, in order to preserve the fertility of women, such as the cryopreservation of oocytes.
- Autoimmune diseases
Autoimmune diseases are diseases in which the immune system can attack the body itself. The woman can create antibodies that make it difficult to fertilize and implant the embryo.
- Age
Fertility naturally declines as the age advances.
This happens because the quantity and quality of the ovules present (follicular reserve) in the ovary decreases, being exhausted at the menopause.
- Genetic anomalies
In women, a change in the number or structure of chromosomes may be associated with changes in ovulation, production of immature or abnormal oocytes, or premature ovarian failure.
Anomalies of the female or male karyotype may also lead to embryo implantation failures, repetitive miscarriages or abnormalities of the embryo and fetus.
- Unknown cause
In about 10% of cases of infertility there is no causal fact, being apparently everything well with both members of the couple.
There may, however, exist some anomalies for which there are no detection tests.
The indication for treatment by in vitro fertilization is a possibility and, at that time, some anomalies can be detected, since it is possible to observe the oocytes, the spermatozoa, the fertilization and the embryonic development.
Poor quality oocytes, absence of fertilization or abnormalities in embryonic development may be found.
[statistic data]
How to prevent?
The best way to prevent infertility is to adopt a healthy lifestyle: not to smoke or use drugs, consume alcohol moderately and choose to practice physical exercise and healthy eating, avoiding obesity and associated diseases such as hypertension and Diabetes. In women, age is an important factor in infertility that should not be overlooked. If it is not possible to plan a pregnancy at a young reproductive age (i.e. before the age of 35), there are techniques that allow cryopreservation of oocytes – vitrification, to be used in the future if necessary.
How to treat
There are several treatments for female infertility, which depend naturally on their cause. In cases where there is no specific cause for infertility, intrauterine insemination or in vitro fertilization may be used for its treatment
Alternative solutions
In cases where the probable cause of infertility is associated with poor egg reserve or with its poor quality, the most effective solution for the treatment of infertility is the use of eggs from a donor.