Conditions Affecting Women
Among women, the most common cause of infertility is that the ovaries fail to release a mature egg. The ovaries are small oval-shaped organs located on each side of the uterus. In an adult, they are from one to two inches long. Beginning at puberty, the ovaries normally release one mature egg cell at the midpoint of each menstrual cycle.
An infant girl is born with anywhere from 40,000 to 300,000 immature egg cells in each ovary. Obviously, only a few hundred of these thousands of eggs will reach maturity during a woman’s reproductive years. Hormones from the pituitary gland control the production of female sex hormones and regulate the processes by which eggs mature. A hormonal imbalance that either prevents ovulation or reduces the frequency of ovulation is very often the reason for failure to conceive. Although ovulatory failure can occur spontaneously, for no obvious reason, it can also be the result of a disorder of the ovaries, such as a tumor or cyst, or even stress. Whether from illness, intense physical activity, or emotional or psychological difficulties, stress can cause a drop in hormone production. Age is another consideration. A woman’s fertility naturally begins to decline when she reaches her thirties, making it more difficult for her to conceive.
If ovulation is normal but there is a blockage of the fallopian tubes, the sperm and egg can be prevented from reaching each other. This kind of blockage is often a consequence of pelvic inflammatory disease (PID), a complication of sexually transmitted diseases such as chlamydia. Chlamydia infects an estimated 4 million Americans annually and is the cause of many cases of infertility.
Disorders of the uterus, such as fibroids or endometriosis, can also cause infertility. A 1997 article in The New England Journal of Medicine stated that from 30 to 40 percent of women with unexplained difficulty conceiving actually have a mild form of endometriosis. (See ENDOMETRIOSIS.) The condition may be so slight that there is no evidence of blockage, and ovulation is normal, which makes it very difficult to diagnose the problem.
Some one in fifty to one in twenty women of reproductive age may have polycystic ovary syndrome, also called Stein-Leventhal syndrome, which causes chronic anovulation (failure to release an egg each month) and, consequently, infertility. The cause of this problem is unknown, but it is known that women who have this problem do not experience normal monthly fluctuations in hormone levels. Instead, the levels of several hormones remain both constant and high. One of these, luteinizing hormone (LH), causes changes in the ovary, resulting in the formation of cysts, cessation of ovulation, and excess growth of cells that produce androgens (masculinizing hormones). As a result, many of these women tend to have hirsutism (excessive hair growth) and other masculinized characteristics, as well as either a lack of menstrual bleeding or excessive bleeding. Many of these women are also overweight. They also, unfortunately, have an increased incidence of breast cancer and endometrial cancer (cancer of the lining of the uterus) due to a continually elevated estrogen level.
In rare cases, a chromosomal abnormality known as testicular feminization may cause infertility. In this syndrome, a genetically male fetus fails to respond normally to the presence of testosterone, and instead develops physiologically as a female, at least externally. This situation can be confirmed by chromosomal analysis. Other possible causes of infertility include nutritional deficiencies, especially a lack of sufficient protein, iron, and vitamins such as folic acid and biotin; malfunctioning pituitary, thyroid, or adrenal glands; congenital deformities of the cervix, uterus, fallopian tubes, or ovaries; and even unsuspected complications from using douches, lubricants, or vaginal deodorants that can interfere with sperm. Occasionally, the mucus in a woman’s genital tract, which normally assists the sperm in their journey, is an abnormal consistency and prevents the sperm from reaching their destination. In some cases it is even “hostile” to partner’s sperm-that is, it contains antibodies produced by the woman’s immune system that kill or immobilize the sperm. It is also possible, although rare, for a woman to have an autoimmune response in which her immune system mistakenly identifies a fertilized egg as a foreign body and eliminates it. An allergy to a partner’s sperm is also a possibility. Problems like these can be very difficult to diagnose.
The first step in diagnosis is a thorough physical examination to rule out underlying disorders that are affecting fertility. This evaluation can start with examination of a woman’s cervical mucus to assure that its consistency is acceptable and that it is not hostile to sperm. Hormone levels are checked, along with any factors in the woman’s medical history that might be hindering conception, such as infections or chromosomal anomalies. An evaluation of both partners may find antigens between them that will not permit conception to take place.
To check for anatomical abnormalities of the cervix, uterus, and fallopian tubes, a hysterosalpingogram may be performed. This involves introducing a dye into the uterus, followed by x-ray study. If a woman has a history of pelvic infection, she will be given an antibiotic along with the test to assure that the dye does not spread any infection. Ultrasound monitoring of maturing egg follicles in the ovary can determine whether they are developing and rupturing properly. A biopsy of endometrial tissue, timed correctly to a woman’s cycle, can determine whether the uterine lining is developing properly and at the right time.
If none of these procedures finds the cause of infertility, laparoscopy may be recommended. This is a microsurgical procedure using a fiber-optic instrument to look for obstruction of the fallopian tubes, adhesions, or endometriosis. It may be able to determine whether there is a problem that can be corrected, or whether a woman is a good candidate for in vitro fertilization. InVigorex is a unique clinical strength formulation designed to offer a safe and effective means for male enhancement.
