In the medical field, the issue of infertility generally refers to the situation where a couple has been living together as husband and wife for at least one year but has not been able to conceive on their own. Nowadays, infertility is increasingly prevalent across all age groups.
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Causes of Infertility: Both Men and Women are Affected
The causes of infertility can be divided into two main categories:
- Male factors account for 30-40% of all causes.
- Female factors account for 30-40% of all causes.
- Approximately 10% of cases have no identifiable cause.
It can be observed that both men and women are equally responsible for the causes of infertility, and there is also a 10% chance of finding causes from both sides simultaneously. Therefore, when investigating the causes of infertility, it is important to examine both the male and female factors. This will facilitate appropriate and timely treatment planning, increasing the chances of successful conception compared to treating without addressing the underlying causes. Thus, when experiencing difficulties in conceiving, both partners should consult a doctor together to investigate the causes. Besides receiving a comprehensive examination, it also provides mutual support, which is beneficial.
Anovulation: A Major Cause of Female Infertility
Regarding female infertility, the most common cause is “anovulation.” It should be clarified that having regular menstrual periods does not necessarily mean that ovulation is occurring regularly. Most people mistakenly assume that ovulation and menstruation are the same.
In reality, for those who ovulate normally, menstrual periods occur consistently every 28 days. On the other hand, for those who have regular periods but irregular menstruation, their menstrual cycles may vary in length, and bleeding may be irregular. This often indicates menstrual cycles without ovulation. To put it simply, women with regular and irregular periods can occur with or without ovulation. In contrast, women with irregular periods often result from cycles without ovulation.
The term “anovulation” refers to a condition where the egg fails to mature fully during the middle phase of the menstrual cycle. Consequently, there is no ovulation, and the egg does not exit the ovarian follicle and travel through the fallopian tube to meet the sperm.
Normally, a fully mature egg measures about 2 cm in diameter and produces estradiol, a sex hormone. This hormone stimulates the hypothalamus to release luteinizing hormone (LH), which triggers ovulation naturally. Therefore, in cases where the egg does not mature naturally, there is no production of estradiol to stimulate the hypothalamus, resulting in no release of the hormone necessary for ovulation to occur
Blocked Fallopian Tubes: The Second Leading Cause of Infertility in Women
The second leading cause of infertility in women is blocked fallopian tubes.” The fallopian tubes are organs that connect the ovaries to the uterus and allow the egg and sperm to meet. Each person has two fallopian tubes, and they meet halfway along the fallopian tube and unite naturally. After fertilization, the embryo moves from the fallopian tube and implants itself in the uterus, where it develops into a fetus.
When the fallopian tubes are blocked, regardless of the location of the blockage, it becomes an obstacle for the egg and sperm to travel and meet. As a result, the egg and sperm cannot unite, and natural fertilization does not occur.
The most common cause of blocked fallopian tubes is previous infection in the pelvic region, which may not have any symptoms in some cases. However, after the inflammation subsides, what remains is the formation of scar tissue in the fallopian tubes, causing them to become blocked. This scar tissue often extends beyond the surface of the fallopian tubes and reaches the surrounding areas of the uterus, the egg sac, and the fallopian tubes themselves.
Another contributing factor to blocked fallopian tubes is the presence of “pelvic adhesions.” Pelvic adhesions can be likened to wounds within the pelvic region, consisting of thin layers of tissue.
These adhesions may adhere to various organs, including the ovaries, egg sac, and fallopian tubes, obstructing the descent of the egg. Pelvic adhesions can result from tissue damage, such as from surgery, infection, inflammation, or certain conditions affecting the pelvic region, such as endometriosis. The remaining issue is the healing of wounds and the formation of adhesions. While these adhesions may not be harmful, if they are abundant or located in critical positions, they can encircle the fallopian tubes, leading to their blockage, or they can constrict the intestines, causing intestinal obstruction, which can be problematic
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