Embarking on the path to parenthood is a cherished dream for many women. However, for some , the journey may not unfold as smoothly as expected. Female infertility is a challenging reality faced by millions of women worldwide, causing emotional distress and raising countless questions. Infertility is a significant clinical problem today, affecting 8–12% of couples worldwide. In India, the overall prevalence of primary infertility lies in between 3.9% and 16.8%, as per WHO estimates. The majority of the women (39.3%) belonged to the 25–29 years of age group followed by 20–24 years (12.6%) and 30–34 years (13.6%). Understanding the factors contributing to infertility is crucial in guiding effective diagnosis and treatment options. By addressing female infertility through appropriate medical interventions, counselling and support, individuals and couples facing these challenges can often find hope in building a family.
Infertility is a condition in which the ability to get pregnant and give birth to a child is impaired or limited in some way. In couples 1/3rd of causes of infertility are due to a male problem, 1/3rd is due to a female problem, and 1/3rd is due to combination or unknown reasons. When the cause of the infertility is found to come from the female partner, it’s considered female infertility or female factor infertility (Source). Mostly commonly hormones are the cause of infertility.
What Are The Hormones Responsible For Infertility?
There are 4 main Hormones play a vital role in female reproductive system
- Follicle stimulating hormone (FSH) - Helps control the menstrual cycle, and stimulates the growth of the eggs in ovaries.
- Oestrogen - Much needed for puberty, menstrual cycle and pregnancy.
- Luteinizing hormone - Controls the menstrual cycle and triggers the release of egg from the ovaries.
- Progesterone - Main hormone for pregnancy and prepares the body for breastfeeding.
Risk Factors And Causes Of Infertility
1. Stress And Infertility
Prolonged or excessive stress can negatively impact the intricate hormonal balance required for successful reproduction. The heightened presence of stress hormones, such as cortisol, can disrupt the normal synthesis and release of reproductive hormones like estrogen and progesterone. These crucial hormones play a vital role in facilitating ovulation and supporting the implantation process.
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2. Weight Changes And Infertility
Ovarian dysfunction can be attributed to both weight loss and excessive weight gain, particularly when the body mass index (BMI) exceeds 27 kg/m². Obesity can lead to increased oestrogen production, which the body interprets as a form of birth control, thereby limiting the chances of pregnancy. On the other hand, weight loss can result in inadequate oestrogen production, leading to menstrual irregularities and anovulatory cycles. Adequate nutrition during early life has been identified as a significant factor for future fertility.
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3. Age Factor And Infertility
The decline in fertility is closely linked to age. Female fertility typically reaches its highest point between the ages of 18 and 24, demonstrating optimal conditions for conception. However, starting around the age of 27, fertility begins to gradually decrease, and this decline accelerates after the age of 35.
Additionally, ovulatory dysfunction, a condition that affects the release of eggs necessary for conception, is relatively more prevalent among younger couples compared to older ones.
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4. Lifestyle Choices And Infertility
Factors such as tobacco , smoking and alcohol consumption have been linked to infertility due to their association with elevated estrogen hormone levels. These elevated estrogen levels can negatively impact the secretion of other crucial hormones, such as follicle-stimulating hormones, leading to a reduction in ovum production and ultimately causing infertility.
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5. Hormonal Imbalance And Infertility
The pituitary gland plays a vital role as a central regulator for multiple hormonal glands in the human body, both through direct and indirect means. Consequently, any alterations in the chemical signals originating from the hypothalamus can have an impact on the pituitary gland, ovaries, thyroid, mammary gland, and result in hormonal abnormalities.
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6. Issues Related To The Uterus
Various conditions can impact the uterus, including the formation of polyps (small growths), fibroids (non-cancerous growths), or adhesions (tissue damage) within the uterine cavity. Polyps and fibroids can develop separately at any stage.
7. Conditions Involving The Fallopian Tubes
Infections of the female reproductive organs, often caused by common sexually transmitted infections and bacterial infections, significantly contribute to infertility, particularly when they affect the fallopian tubes.
8. Challenges Related To Ovulation
Multiple factors can disrupt the normal process of ovulation, which is the release of an egg in women. These factors include hormonal imbalances, a history of eating disorders, substance abuse, thyroid disorders, excessive stress, and the presence of pituitary tumors. These conditions have the potential to negatively affect the ovulation process.
9. Issues Concerning The Quantity And Quality Of Eggs
Women are born with a finite number of eggs, and this supply can gradually decrease over time, leading to menopause. Occasionally, some eggs may have an incorrect number of chromosomes, making them unable to successfully fertilize or develop into a healthy embryo (Source).
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- Prevalence: Infertility affects 8-12% of couples worldwide, and in India, the estimated prevalence of primary infertility ranges from 3.9% to 16.8%.
- Factors contributing to infertility: Several factors can contribute to female infertility, including hormonal imbalances, issues related to ovulation, conditions affecting the uterus or fallopian tubes, polyps, fibroids, adhesions & infections, challenges with egg quantity and quality, and lifestyle choices.
- Impact of stress: Stress can disrupt hormonal balance, affecting the production and release of reproductive hormones essential for ovulation and implantation.
- Weight changes: Both excessive weight gain and weight loss can impact fertility by causing ovarian dysfunction and hormonal imbalances.
- Lifestyle choices: Factors such as tobacco smoking and alcohol consumption can contribute to infertility by affecting hormonal secretions and ovum production.
It's important to remember that each individual's situation is unique, and the causes of infertility can vary. If you're experiencing difficulties in conceiving, it's advisable to consult with a healthcare professional who can provide personalized guidance and appropriate treatment options.
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