Female infertility: conditions and diseases that can cause it
Infertility is steadily rising in our society. According to recent data published by the Spanish Fertility Society, infertility currently affects one in every five couples, and it is estimated that by 2020 it will affect one in every four.
When we talk about the causes of female infertility there are very specific conditions and/or diseases that may be causing problems when it comes to conceiving. This is normally the case in approximately 80% of patients who come to our fertility clinic in Spain.
Today we would like to talk to you about this topic in order to shed some light on an issue that is becoming increasingly common. Here are some of the factors which are causing female infertility today.
Advanced age in the female
Age is the number one factor when it comes to trying to conceive. Delaying the age at which the female starts trying to get pregnant is the main issue we face in assisted reproduction clinics.
At present, the average age at which women start trying to conceive their first child is around 31 years old. According to recent data, 30% of births in 2018 were in women who were already over the age of 35, and almost 7% in women over the age of 40.
We know that a woman is most fertile around the age of 20 and that fertility gradually declines thereon after. Starting at the age of 30 this decline starts to speed up, becoming more drastic when the woman reaches 35 years of age and then decreasing sharply after the age of 40. At this age, the likelihood of pregnancy is less than 10%.
Once a woman turns 44 her likelihood of becoming pregnant is less than 1%, even when using assisted reproduction techniques such as in vitro fertilisation; for this reason, the best alternative is to use egg donation.
Polycystic ovarian syndrome (PCOS)
Polycystic ovarian syndrome is an endocrine disorder which affects between 6 and 15% of women of reproductive age.
PCOS is a complex disorder primarily caused by increased levels of androgens which lead to physical and metabolic issues such as hirsutism (excessive hair growth), obesity, acne, irregular periods caused by irregular ovulation and, thus, infertility. Another problem present in approximately 40% of women with polycystic ovarian syndrome is insulin resistance, a condition responsible for several metabolic disorders.
PCOS is a chronic condition which is normally diagnosed during adolescence due to the presence of irregular menstrual cycles, acne and hirsutism. Its consequence in the medium‑term is generally the dreaded infertility, while in the long‑term it can put women at higher risk for diabetes mellitus, hypertension, elevated cholesterol… as well as an increased risk for endometrial cancer due to less frequent menstrual cycles.
Endometriosis is a condition which affects approximately 10% of females during their reproductive years.
It is a condition whose origin is unknown, characterised by the presence of endometrial tissue outside of the uterine cavity. This endometrial tissue can most often be found in the ovaries and peritoneum (inner lining of the abdominal cavity), though it may affect many other organs such as the fallopian tubes, bladder, intestines, etc.
Between 30 and 50% of women who suffer from endometriosis may have fertility issues due to an abnormality in the internal anatomy of the female reproductive system and/or lower quality oocytes or eggs.
When we talk about a tubal factor we are referring to the fallopian tubes, the site where the egg is fertilised and the embryo develops until it arrives to the uterus.
Sometimes the fallopian tubes do not work properly due to obstructions, malformations, lack of permeability or flexibility… situations which may lead to infertility in the female.
Pelvic infections and endometriosis are the primary causes of problems in the fallopian tubes. These are problems which are common and may not present any symptoms, and their prognosis is good thanks to in vitro fertilisation treatment.
The uterus is an important organ in the female reproductive system, especially at the moment of embryo implantation in the endometrial cavity. Correct embryo implantation may be negatively affected by the presence of submucosal myomas, endometrial polyps, uterine adhesions, adenomyosis, malformations, etc., all of which are factors that can also lead to infertility.
Other conditions that affect female fertility
Although we have discussed some of the most frequent conditions, there are other risk factors that may affect your fertility.
Being overweight or obese are the most common risk factors, while extreme thinness can also have a negative impact on conceiving.
In addition to the above, infertility can also be caused by certain sexually transmitted diseases or chronic illnesses such as diabetes, thyroid conditions, autoimmune disorders, blood clotting disorders, etc.
If you fall into one of these categories or have been trying to conceive naturally for six to twelve months but haven’t been successful yet, consult with a professional fertility specialist!
At our fertility clinic in Spain the first consultation is cost‑free and we can evaluate your case: contact us.