Premature Ovarian Failure (POF)
Sometimes referred to as "premature menopause", is a loss of ovarian function
in women under 40 years of age. Periods stop, estrogen is low, and the follicle-stimulating
hormone (FSH) level is elevated. Some women may experience premature ovarian
failure because of adrenal, pituitary,
or thyroid deficiencies. Radiation therapy
and anti-cancer agents may achieve a cancer cure at the cost of Fertility by
causing premature ovarian failure. Women with Turner's
Syndrome, a rare genetic disorder, do not develop functional ovaries
at all.
Endometriosis
Endometriosis, is believed to be quite common. It is estimated that between
25% and 50% of women with Infertility have endometriosis. This disorder develops
when fragments of the endometrial lining are implanted in other areas of the
pelvis. These endometrial, or misplaced tissue implants will still respond to
a woman's monthly hormonal cycle, causing pain and discomfort, slowly increasing
in number and size with each menstrual cycle and eventually causing scarring
and inflammation. Endometrial implants in the ovaries
or fallopian
tubes are particularly likely
to cause infertility, even if the endometriosis
is mild.
Endometriosis-related causes of conception
difficulty may include organ damage, low levels of a molecule specific to enhancing
implantation, increased presence of peritoneal
white blood cells, and dysfunctional immune system. Unfortunately, there exists
no simple blood or urine test to detect this common affliction of the reproductive
organs; the only true diagnosis is via Laparoscopy,
a fortunately simple, yet still surgical, procedure.
Polycystic Ovarian Syndrome (PCO, PCOS,
PCOD)
Polycystic ovarian syndrome (also called Stein-Leventhal Syndrome) is a hormonal
disorder that affects approximately six to ten percent of pre-menstrual women
and is the major cause of infertility
in American women. Polycystic Ovarian Syndrome is the result of the overproduction
of hormones in a woman's body. During ovulation,
the ovaries receive hormones from the
pituitary gland. These hormones,
follicle-stimulating hormone (FSH)
and luteinizing hormone (LH), help
the egg reach maturity in preparation to be fertilized. In women with PCOS,
there is an abnormal level of FSH and
LH being secreted. The overproduction
of LH causes the ovaries to overproduce androgens.
Increased androgen production produces high LH levels and low FSH levels, so
the follicles are prevented from producing
a mature egg. Thus the ovulatory process is not allowed to complete itself.
The partially-developed egg (inside its follicle shell) dies. Without egg production,
the follicles swell with fluid and form into cysts, and it is these cysts that
create polycystic ovaries. Every time an egg is trapped within the follicle,
another cyst forms, so the ovary swells, sometimes reaching the size of a grapefruit.
Without ovulation, progesterone
is no longer produced, whereas estrogen levels remain normal.
Although Polycystic Ovarian Syndrome presents itself during adolescence
or the early adult years, women often do not know they have the disorder until
after they attempt to conceive. No two women affected by PCOS have the same
symptoms. Common characteristics associated with PCOS are:
· Insulin Resistance · Hyperandrogenison (Increased male hormones) · Polycystic ovaries · Irregular menstrual cycles (oligomenorrhea) or no menstrual cycles
(amenorrhea) · Excessive facial and body hair growth (hirsutism) · Male pattern hair loss (androgenic alopecia) · Acne · Obesity/weight gain · Infertility
Pelvic Inflammatory Disease and Sexually
Transmitted Diseases
Pelvic Inflammatory Disease (PID) is the major cause of infertility
worldwide. PID includes a variety of infections caused by different bacteria
that can affect the uterus, fallopian
tubes, ovaries, appendix, parts of the
intestine that lie in the pelvic area, or, in the worst case, the entire pelvic
area (peritonitis). The sites of infection most often implicated in Infertility
are in the fallopian tubes, a condition known as Salpingitis.
Although PID can be a result of nonsterile abortions, use of an IUD, or a ruptured
appendix, most infections are caused by sexually transmitted diseases. Chlamydia
Trachomatis is an infectious organism that causes 75% of Salpingitis cases.
A small US study suggests that Chlamydial infection of the upper genital tract,
even without severe inflammation, may cause a higher proportion of fallopian
ectopic pregnancies than previously thought. Gonorrhea
is responsible for most of the remaining cases. Severe or frequent attacks of
PID can eventually cause scarring, abscess formation, and tubal damage that
result in Infertility. The severity of the infection, not the number of the
infections, appears to pose the greater risk for Infertility. About 20% of women
who develop symptomatic PID become infertile. PID also significantly increases
the risk of ectopic pregnancy.
Ovulation and Hormonal Disorders
Given the intricate interaction of the hormones necessary for ovulation,
it is not surprising that about 33% of Infertility cases can be traced back
to ovulation and hormonal problems. They may result in the failure of the ovarian
follicle to rupture, an empty follicle, or entrapment of the egg so that it
isn't released. Various medical conditions, as well as lifestyle factors such
as excessive exercise, eating disorders, smoking, or stress can change normal
hormonal rhythm. Even slight irregularities in the hormonal system can result
in ovulation disorder.
Fibroid Tumors
Benign fibroid tumors in the uterus are extremely common in women over 30. In
rare cases, they can cause Infertility by interfering with the uterine cavity,
blocking the fallopian tubes, or altering the position of the cervix
and preventing sperm from reaching the uterus.
High levels of estrogen seem to stimulate the growth of fibroid tumors; heredity
may also play a role in their development.