You need to ovulate. Achieving pregnancy
requires that your ovaries produce and
release an egg, a process known as ovulation.
Your doctor can help evaluate your menstrual
cycles and confirm ovulation.
Your partner needs sperm. For most couples,
this isn’t a problem unless your partner has a
history of illness or surgery. Your doctor can
run some simple tests to evaluate the health
of your partner’s sperm.
You need to have regular intercourse. You
need to have regular sexual intercourse during
your fertile time. Your doctor can help you
better understand when you’re most fertile
during your cycle.
You need to have open fallopian tubes and a
normal uterus. The egg and sperm meet in
the fallopian tubes, and the pregnancy needs
a healthy place to grow.
For pregnancy to occur, every part of the complex
human reproduction process has to take place just
right. The steps in this process are as follows:
One of the two ovaries releases a mature egg.
The egg is picked up by the fallopian tube.
Sperm swim up the cervix, through the uterus
and into the fallopian tube to reach the egg for
fertilization.
The fertilized egg travels down the fallopian
tube to the uterus.
The fertilized egg implants and grows in the
uterus.
In women, a number of factors can disrupt this
process at any step. Female infertility is caused by
one or more of these factors.
Ovulation disorders
Ovulation disorders, meaning you ovulate
infrequently or not at all, account for infertility in
about 25 percent of infertile couples. These can be
caused by flaws in the regulation of reproductive
hormones by the hypothalamus or the pituitary
gland, or by problems in the ovary itself.
Polycystic ovary syndrome (PCOS). In PCOS,
complex changes occur in the hypothalamus,
pituitary gland and ovaries, resulting in a
hormone imbalance, which affects ovulation.
PCOS is associated with insulin resistance
and obesity, abnormal hair growth on the face
or body, and acne. It’s the most common
cause of female infertility.
Hypothalamic dysfunction. The two hormones
responsible for stimulating ovulation each
month — follicle-stimulating hormone (FSH)
and luteinizing hormone (LH) — are produced
by the pituitary gland in a specific pattern
during the menstrual cycle. Excess physical
or emotional stress, a very high or very low
body weight, or a recent substantial weight
gain or loss can disrupt this pattern and affect
ovulation. The main sign of this problem is
irregular or absent periods.
Premature ovarian insufficiency. This disorder
is usually caused by an autoimmune response
where your body mistakenly attacks ovarian
tissues or by premature loss of eggs from
your ovary due to genetic problems or
environmental insults such as chemotherapy.
It results in the loss of the ability to produce
eggs by the ovary, as well as a decreased
estrogen production under the age of 40.
Too much prolactin. Less commonly, the
pituitary gland can cause excess production
of prolactin (hyperprolactinemia), which
reduces estrogen production and may cause
infertility. Most commonly this is due to a
problem in the pituitary gland, but it can also
be related to medications you’re taking for
another disease.
Damage to fallopian tubes (tubal infertility)
When fallopian tubes become damaged or blocked,
they keep sperm from getting to the egg or block
the passage of the fertilized egg into the uterus.
Causes of fallopian tube damage or blockage can
include:
Pelvic inflammatory disease, an infection of
the uterus and fallopian tubes due to
chlamydia, gonorrhea or other sexually
transmitted infections
Previous surgery in the abdomen or pelvis,
including surgery for ectopic pregnancy, in
which a fertilized egg becomes implanted and
starts to develop in a fallopian tube instead of
the uterus
Pelvic tuberculosis, a major cause of tubal
infertility worldwide, although uncommon in
the United States
Endometriosis
Endometriosis occurs 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 obstruct the tube and keep the egg and sperm
from uniting. It can also affect the lining of the
uterus, disrupting implantation of the fertilized egg.
The condition also seems to affect fertility in less-
direct ways, such as damage to the sperm or egg.
Uterine or cervical causes
Several uterine or cervical causes can impact
fertility by interfering with implantation or increasing
the likelihood of a miscarriage.
Benign polyps or tumors (fibroids or myomas)
are common in the uterus, and some types
can impair fertility by blocking the fallopian
tubes or by disrupting implantation. However,
many women who have fibroids or polyps can
become pregnant.
Endometriosis scarring or inflammation within
the uterus can disrupt implantation.
Uterine abnormalities present from birth, such
as an abnormally shaped uterus, can cause
problems becoming or remaining pregnant.
Cervical stenosis, a cervical narrowing, can
be caused by an inherited malformation or
damage to the cervix.
Sometimes the cervix can’t produce the best
type of mucus to allow the sperm to travel
through the cervix into the uterus.
Unexplained infertility
In some instances, a cause for infertility is never
found. It’s possible that a combination of several
minor factors in both partners underlie these
unexplained fertility problems. Although it’s
frustrating to not get a specific answer, this
problem may correct itself with time.
requires that your ovaries produce and
release an egg, a process known as ovulation.
Your doctor can help evaluate your menstrual
cycles and confirm ovulation.
Your partner needs sperm. For most couples,
this isn’t a problem unless your partner has a
history of illness or surgery. Your doctor can
run some simple tests to evaluate the health
of your partner’s sperm.
You need to have regular intercourse. You
need to have regular sexual intercourse during
your fertile time. Your doctor can help you
better understand when you’re most fertile
during your cycle.
You need to have open fallopian tubes and a
normal uterus. The egg and sperm meet in
the fallopian tubes, and the pregnancy needs
a healthy place to grow.
For pregnancy to occur, every part of the complex
human reproduction process has to take place just
right. The steps in this process are as follows:
One of the two ovaries releases a mature egg.
The egg is picked up by the fallopian tube.
Sperm swim up the cervix, through the uterus
and into the fallopian tube to reach the egg for
fertilization.
The fertilized egg travels down the fallopian
tube to the uterus.
The fertilized egg implants and grows in the
uterus.
In women, a number of factors can disrupt this
process at any step. Female infertility is caused by
one or more of these factors.
Ovulation disorders
Ovulation disorders, meaning you ovulate
infrequently or not at all, account for infertility in
about 25 percent of infertile couples. These can be
caused by flaws in the regulation of reproductive
hormones by the hypothalamus or the pituitary
gland, or by problems in the ovary itself.
Polycystic ovary syndrome (PCOS). In PCOS,
complex changes occur in the hypothalamus,
pituitary gland and ovaries, resulting in a
hormone imbalance, which affects ovulation.
PCOS is associated with insulin resistance
and obesity, abnormal hair growth on the face
or body, and acne. It’s the most common
cause of female infertility.
Hypothalamic dysfunction. The two hormones
responsible for stimulating ovulation each
month — follicle-stimulating hormone (FSH)
and luteinizing hormone (LH) — are produced
by the pituitary gland in a specific pattern
during the menstrual cycle. Excess physical
or emotional stress, a very high or very low
body weight, or a recent substantial weight
gain or loss can disrupt this pattern and affect
ovulation. The main sign of this problem is
irregular or absent periods.
Premature ovarian insufficiency. This disorder
is usually caused by an autoimmune response
where your body mistakenly attacks ovarian
tissues or by premature loss of eggs from
your ovary due to genetic problems or
environmental insults such as chemotherapy.
It results in the loss of the ability to produce
eggs by the ovary, as well as a decreased
estrogen production under the age of 40.
Too much prolactin. Less commonly, the
pituitary gland can cause excess production
of prolactin (hyperprolactinemia), which
reduces estrogen production and may cause
infertility. Most commonly this is due to a
problem in the pituitary gland, but it can also
be related to medications you’re taking for
another disease.
Damage to fallopian tubes (tubal infertility)
When fallopian tubes become damaged or blocked,
they keep sperm from getting to the egg or block
the passage of the fertilized egg into the uterus.
Causes of fallopian tube damage or blockage can
include:
Pelvic inflammatory disease, an infection of
the uterus and fallopian tubes due to
chlamydia, gonorrhea or other sexually
transmitted infections
Previous surgery in the abdomen or pelvis,
including surgery for ectopic pregnancy, in
which a fertilized egg becomes implanted and
starts to develop in a fallopian tube instead of
the uterus
Pelvic tuberculosis, a major cause of tubal
infertility worldwide, although uncommon in
the United States
Endometriosis
Endometriosis occurs 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 obstruct the tube and keep the egg and sperm
from uniting. It can also affect the lining of the
uterus, disrupting implantation of the fertilized egg.
The condition also seems to affect fertility in less-
direct ways, such as damage to the sperm or egg.
Uterine or cervical causes
Several uterine or cervical causes can impact
fertility by interfering with implantation or increasing
the likelihood of a miscarriage.
Benign polyps or tumors (fibroids or myomas)
are common in the uterus, and some types
can impair fertility by blocking the fallopian
tubes or by disrupting implantation. However,
many women who have fibroids or polyps can
become pregnant.
Endometriosis scarring or inflammation within
the uterus can disrupt implantation.
Uterine abnormalities present from birth, such
as an abnormally shaped uterus, can cause
problems becoming or remaining pregnant.
Cervical stenosis, a cervical narrowing, can
be caused by an inherited malformation or
damage to the cervix.
Sometimes the cervix can’t produce the best
type of mucus to allow the sperm to travel
through the cervix into the uterus.
Unexplained infertility
In some instances, a cause for infertility is never
found. It’s possible that a combination of several
minor factors in both partners underlie these
unexplained fertility problems. Although it’s
frustrating to not get a specific answer, this
problem may correct itself with time.
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