Female infertility like in the male partner is a worldwide epidemic today with a wide margin affecting 20% – 30% married females.

From statistics, 1 out of every 4 couples in developing countries is directly affected by infertility as reported by World Health Organization (WHO).

And there are certain underlying factors, in both male and female found to be responsible for preventing couples from becoming pregnant.


What is Infertility?

Infertility (primary infertility) is a disease of the reproductive system resulting to failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.


Whereas, secondary infertility is as a result of a couple’s inability to conceive and carry a pregnancy to full term, after already having one or two babies in the past.


Previously, infertility was generally viewed as solely the female partner’s problem; hence she bears the shame and agony of being labeled a “barren woman.” This is a big misconception and completely wrong.

The Underlying causes of Infertility among Couples
It has been estimated that the female contributes 40% causes of infertility (female factor) and the male (male factor) also contributes 40% causes of infertility and the remaining underlying causes were traced directly from both the male and female.


The common causes of female infertility:
1. Hormonal Imbalance
Hormones are chemical messengers in the body that travels in the bloodstream to the target organs and tissues where they are needed, and these hormones are responsible for the maturation of the ovarian follicles and the release of a ripened female egg (ovulation).

Many things could go wrong if the female sex hormones go out of balance, particularly the Follicular Stimulating Hormone (FSH), Luteinizing Hormone (LH) and the Progesterone hormone.

And the deficiency of the above sex hormones will wreak havoc on the female reproductive health leading to infertility.


Signs of hormonal imbalances:
• Dysfunctional uterine bleeding (“heavy flow” or excessive menstruation)
• Amenorrhea (lack of menstruation)
• Hyperprolactinemia (milkish secretion from the breasts)
• Luteal phase defect (low progesterone production)
• Miscarriages
• Endometriosis
• Poly cystic ovarian syndrome Etc.


2. Blocked Fallopian Tubes
Blocked tube (or tubal blockage) occurs when the fallopian tube that receives the mature egg after ovulation becomes blocked, either due to scar tissue formation resulting from ascending genital infection through the vagina up the pelvic organs.

Or due to a scar tissue formation (adhesion) from past surgery thereby impeding the movement of the mature egg down the tract of the fallopian tube and frustrating the forward movement of the male sperm from the meeting the mature female egg, along the mid-part of the fallopian tube (ampulla), thus hindering fertilization.

It will interest you to know that this is one of commonest causes of infertility in Sub-saharan Africa.


Other conditions that could cause tubal blockage:
• Hydrosalpinx (collection of fluid within the wall of the fallopian tube)
• Uterine fibroids
• Bilateral tubal ligation (surgical tying of the fallopian tubes)
• Inflammation, after a tubal surgery (adhesions)


3. Uterine Fibroids
Fibroids are benign tumours (non-cancerous) of the uterus that are commonly seen in black women in their reproductive years.

Fibroids depend on the female estrogen hormone for their growth and survival, and have been known to distort the architecture of the uterus thereby preventing a fertilized egg from implanting into the wall of the womb, leading to infertility.


4. Abortion complication (Asherman’s syndrome):
Asherman’s syndrome is characterized by scar tissue formation of the lining of the uterus (womb) due to over-zealous scrapping of the interior of the womb (D&C) using a hard instrument, and as a result traumatizing the inner wall of the womb, in the process leading to scar tissue formation and in most cases infertility ensues.

Some women with this kind of problem find it difficult to conceive because the endometrial layer (womb) where normally the embryo should attach and grow is found disoriented due to the scar formation.


5. Stress & Tension:
Stress is often the most ignored factor when it comes to infertility. It counts as a major underlying cause of infertility in women up to 40 percent.

In our world today, we have become accustomed to living a stressful life especially in this part of the world where many have become used to multi-tasking or doing multiple jobs, and then finding little time for relaxation; giving less attention to their emotional and physical health.

In the human body, there are certain hormones known stressors. These hormones are protective in their way of inducing fright or flight defensive mechanism, so to warn us from an impending danger.

Adrenaline and glucocorticoid (cortisol) are examples of such hormones, but their long-term secretion and effect create hormonal imbalances throwing the body into infertility.


6. Endometriosis
Endometriosis is a disease in which the endometrial tissues of the uterus are seen growing outside the uterine cavity (womb) and forming adhesions in the process.

Endometriosis occurring at certain sites in the reproductive organs leads to infertility, especially within the fallopian tubes and on the ovaries and they present with the following symptoms:

• Cyclical bleeding (heavy bleeding)
• Painful intercourse
• Low abdominal pain
• Vomiting


7. Thyroid Diseases:

Thyroid is a small butterfly-shaped organ surrounding the wind pipe, located in-front of your throat.

If you are trying to get pregnant and you suspect you have a thyroid issue, then I suggest you see your physician at once and get tested to find out your thyroid hormonal level.

Often this is neglected and has been shown to impact conception, negatively.

Hypothyroidism, occurs when the thyroid gland is producing very little thyroid hormones; triiodothyronine and thyroxine (T3 & T4), leading to amenorrhea and infertility.

On the other hand, Hyperthyroidism occurs when the thyroid gland is producing too much thyroid hormones, resulting to debilitating physical symptoms as listed below:

• Weight loss
• Excessive sweating
• Irritability
• Sleeping problems
• Muscle weakness
• Heat intolerance
• Fast heart rate
• Diarrhea
• Enlargement of the thyroid gland
• Menstrual irregularity
• Hyperprolactinemia
• Infertility

If you notice you have any of such symptoms, then do well and see your physician as soon as possible for thyroid gland screening.

By Dr Oyebade Obalola Jerry.


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