Causes of Infertility in Women

Ovarian Causes

One of the most common causes of infertility in women is problems related to ovulation (25%). Some women may not ovulate at all, or may ovulate irregularly. Menstrual irregularities are an indicator in this regard, but ovulation disorders can also occur in women whose periods are regular. The most common cause of ovulation disorders is Polycystic Ovary Syndrome (PCOS). These patients are generally overweight, have male-pattern hair growth, irregular periods and are infertile. Excessive secretion of the milk hormone prolactin from the brain stem, and failure to secrete the hormones that stimulate ovarian function, can also lead to ovulation problems. Ovarian cysts, infection, chocolate cysts (endometrioma), cancers and previous surgeries can also impair ovarian function and cause infertility. Radiation and drug treatments used for cancer therapy can cause damage to egg cells.

Tubal Causes

The tubes (fallopian tubes) are thin canals located between the uterus and the ovaries. Sperm travel through the uterus to the tubes, where they fertilize the egg released from the ovary. Partial or complete blockage of the tubes, or impaired tubal function, prevents sperm and egg from meeting and causes infertility (35%). Past sexually transmitted infections, tuberculosis (TB), endometriosis or adhesions following abdominal surgery can damage the tubes. Congenital underdevelopment of the tubes is also among the rare causes of infertility.

Uterine Causes

A few days after the egg is fertilized by sperm in the tube, it implants in the uterus and continues its development inside the uterus until birth. Congenital septum within the uterus, fibroids/polyps or similar formations, previous curettage and surgeries, or infections and the adhesions resulting from them can prevent the embryo (fertilized egg) from implanting in the uterus and developing, leading to infertility.

Cervical Causes

Mucus secreted from the cervix, which increases during ovulation periods, facilitates the passage of sperm into the uterus. Disorders of cervical mucus, structural abnormalities, polyps or similar tumors, and previous cervical procedures can cause infertility. Antibodies that impair or kill sperm movement may be secreted from the cervix. However, it is currently accepted that research and treatments related to antibodies have no benefit. This problem has been overcome with methods such as intrauterine insemination and micromanipulation (intracytoplasmic sperm injection).