The most important causes of infertility in women are ovulation disorders, endometriosis and damaged or blocked tubes. The reasons for infertility in men include inadequate sperm count, motility and in some cases abnormal sperm cells.
Causes of infertility in women
1. Ovulation disorders:
The most common cause of infertility in women is ovulation disorders. Fertilization and pregnancy cannot occur without ovulation (ovulation). The term ovulation disorder means that ovulation is absent or irregular and sparse. Overexposure of menstruation is often seen as an ovulation disorder, but ovulation disorders can also be encountered in cases where menstruation is completely regular. Ovulation disorders can be divided into three main groups.
Inability to secrete from the brain stem due to the congenital deficiency of hormones that stimulate egg production in the ovaries: In this case, no menstrual bleeding is seen in the woman since puberty.
Excessive secretion of milk hormone prolactin from the brain stem: This is usually due to the presence of a benign tumor in this region, but sometimes there is no cause. In cases where benign tumors cannot be removed surgically or if there is no cause, ovulation can be normalized by lowering prolactin levels with various drug treatments.
Polycystic ovary syndrome: In the typical form of this disease, menstruation is generally irregular and rare (3-4 per year). In some patients, menstruation is absent, while in others it may be completely normal. Patients are generally prone to obesity. Fat and hair problems such as acne and skin are common. There are more than normal eggs in the ovaries and they secrete male hormones that prevent normal egg development.
2. Damaged and clogged tubes:
Partially or completely obstructed tubes prevent sperm and egg from meeting, making fertilization and pregnancy impossible. This damage to the tubes may be due to a number of causes, including previous infection, endometriosis, or intra-abdominal adhesions remaining after a previous surgery. Tubes can also be damaged by an ectopic pregnancy. In developed countries, sexually transmitted infections are the most important cause of tube damage. Tuberculosis taken in childhood in our country also causes irreversible damage in tubes.
Endometriosis is the development of endometrium outside the uterus. Endometriosis is most commonly located in the ligaments that hold the uterus in place. Other common areas are the uterine surface, tubes and ovaries. Endometriosis is sensitive to hormones, just like the tissue lining the uterus, and bleeding during menstruation. These micro-hemorrhages in the abdomen create inflammation-like inflammatory conditions and cause adhesions. When endometriosis settles in the ovaries, it causes cyst formation. These cysts are called endometriomas.
The most important symptoms of endometriosis are pain before and during menstruation, pain during or after intercourse, irregular severe menstruation and infertility. Other less common symptoms include fatigue, intensification of bowel movements during menstruation, or other digestive system symptoms such as diarrhea and constipation. In addition, endometriosis may show no symptoms in some women.
Approximately 50 percent of women with endometriosis require treatment to have children. Endometriosis is found in about 25 percent of women presenting with infertility.
4. Problems of the cervix:
Structural, infectious or secretory (mucus) disorders in the cervix may be the cause of infertility. Mucus secreted from the cervix facilitates the genital transport of sperm. Under the influence of estrogen and progesterone hormones, the amount and quality of the mucus during the cycle changes. Benign tumors such as polyps or surgical procedures performed in this region may be the cause of infertility.
5. Allergic reasons:
Allergic causes can be the cause of infertility but diagnosis and treatment are difficult. The allergic agent may be present in the sperm or mucus. The therapeutic efficacy of these allergic conditions, called antisperm antibodies, is unclear and pregnancy rates in treated or untreated are not very different. Therefore, the necessity of routine measurement is controversial.