Silvia Azaña, embryologist at inviTRA, tells us in this video about the possible causes of infertility in women:
When talking about female infertility, the issue could be found at several different levels or indeed be caused by a variety of factors. Thus, we can talk about ovarian factor, tubal factor, cervical factor, and uterine factor.
Concerning the ovarian factor, hormonal changes during the woman's menstrual cycle can impact ovulation. The endocrine or hormonal system is responsible for controlling the ovarian cycle. An alteration caused by stress, obesity, low weight, specific thyroid problems, the use of certain medications, etc. can affect the normal functioning of the ovary. In order to assess the ovary and ovulation, ultrasounds and hormonal blood tests are performed. Regarding the tubal factor, it refers to any alteration, damage, or significant problem in the woman's fallopian tubes. This part of the female reproductive system has two fundamental roles: allow the meeting of the egg and the sperm so that fertilization can occur and helping the embryo to reach the uterus, which is the location where implantation and gestational development occur.
Therefore, if the fallopian tubes do not perform these functions correctly, the woman can have fertility problems. This happens especially when there is a blockage in both tubes, as can occur in cases of salpingitis, malformations, hydrosalpinges, or even endometriosis, among others. In order to diagnose a tubal problem, a hysterosalpingography is usually carried out. This test allows us to assess whether the fallopian tubes are permeable. If at least one of the tubes is permeable, that is, it is not obstructed, pregnancy could occur. Conversely, if both fallopian tubes are blocked, the necessary meeting between the ovum and the spermatazoon for fertilization will not take place. Given this situation, it will be necessary to resort to in vitro fertilization to seek a pregnancy. Regarding the cervical factor, if the sperm are unable to pass through the cervix or the neck of the uterus, they will not be able to reach the egg to fertilize it. For this reason, abnormal growths that develop in the cervix, such as polyps, as well as alterations in cervical mucus, infections, or inflammation of the cervix, might be a reason for female infertility. Tests like a hysteroscopy or microbiological cultures are requested in this case, for example. Finally, we will discuss the uterine factor. Alterations in the uterus, whether uterine malformations or problems in the endometrium, could definitely be a cause of infertility in women. The implantation or the development of a pregnancy to term might be made more difficult. The most common alterations include conditions such as endometriosis, myomas, and polyp.
