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Female fertility begins to decline many years prior to menopause despite regular ovulatory cycles. A woman’s fertility peaks in her mid-20’s and drops off more steeply after age 35. There are many different reasons why a woman may not conceive a baby. Examples are listed below and indicate when you should seek a Fertility Specialist for consultation.
Ovulation disorders – This accounts for approximately 25 percent of women who are having difficulty conceiving. These can be caused by disregulation of reproductive hormones by the hypothalamus or the pituitary gland, or by problems in the ovary itself. You may have an ovulation dysfunction if you menstruate irregularly, ovulate infrequently or not at all.
Damage to fallopian tubes (tubal infertility) – When fallopian tubes become damaged or blocked, they prevent the sperm from reaching the egg to fertilize it. Causes of fallopian tube damage or blockage may include:
- Inflammation of the fallopian tubes (salpingitis) due to prior infection such as chlamydia or gonorrhea
- Previous ectopic pregnancy in which a fertilized egg becomes implanted and starts to develop in a fallopian tube instead of in the uterus
- Previous surgery in the abdomen or pelvis resulting in scar tissue
Endometriosis – When tissue that normally grows in the uterus implants and grows in other locations, this extra tissue growth — and the surgical removal of it — can cause scarring, which may impair fertility. Researchers suggest endometriosis may create a hostile environment by potentially producing inflammatory reactions that interfere with conception.
Cervical narrowing or blockage – Also called cervical stenosis, this can be caused by an inherited malformation or damage to the cervix. The result is that the cervix can’t produce the best type of mucus for sperm mobility and fertilization. In addition, the cervical opening may be closed, preventing any sperm from reaching the egg.
Uterine causes – Benign polyps or benign tumors (fibroids or myomas) in the uterus, not uncommon in reproductive women, can impair fertility by blocking the fallopian tubes or by disrupting implantation. However, many women who have fibroids can become pregnant. Scarring within the uterus also can disrupt implantation, and some women born with uterine abnormalities, such as an abnormally shaped (bicornuate) uterus, can have problems becoming or remaining pregnant.
Unexplained infertility – In some instances, a cause for infertility is never found. It’s possible that combinations of minor factors in both partners underlie these unexplained fertility problems. This may occur in up to 20% of couples.