Female Factor Subfertility
Age is recognized as the most important factor for reduced ovarian reserve, reduced oocyte quality and subsequent reduced ability to conceive. As age advances, the decline of fertility begins around 30 years old, and it becomes more pronounced after the age of 35. The lack of the ability to produce new eggs after the ovaries are formed during the in-utero life, results to the depletion of oocytes and the reduction of their quality, both of which are important to conceiving and establishing a pregnancy that reaches full term.
Endometriosis and Adenomyosis
In endometriosis and adenomyosis cells from the uterine lining are located outside the uterus in the abdominal cavity, or inside the muscle of the womb respectively. These two conditions are associated with reduction of fertility with a variety of mechanisms, affecting the normal function of the ovaries, the tubes and the uterine cavity.
Blockage, adhesions and anatomical malformations of the Fallopian tubes are other major factors of subfertility. Adhesions and scarring of the tubes or loss of their normal function can be the result of endometriosis, previous surgery in the pelvis or infections from Chlamydia.
Uterine fibroids, endometrial scarring, endometrial polyps and anatomical malformation of the uterus are other factors contributing to subfertility. Fibroids and endometrial polyps are benign tumors which can distort the cavity of the uterus and reduce the ability of an embryo to implant in the cavity.
Polycystic Ovaries & Ovulation Disorders
Polycystic Ovarian Syndrome (PCOS) and Hypogonadotrophic Hypogonadism (HH) are two of the commonest examples of ovulation disorders. They result in irregular ovulation, minimizing the chances of spontaneous conception.
The consistency of the cervical secretions might sometimes be hostile for the sperm. This results to difficulty of the sperms in passing through the cervical canal, the uterine cavity and the tubes as well as reduced interaction with the egg reducing the chances of conception.
Disruption of ovulation can be caused by hormones secreted by other organs. Common examples of this include dysfunction of the Thyroid gland and the presence of high levels of Prolactin that can lead to irregular menstruation.