When pregnancy has not been achieved after twelve months of attempts through intercourse (six months if the woman is over 35 years old), we may be dealing with a case of infertility.

Statistics show that almost 55% of these cases have a feminine factor. The causes of female infertility can be multiple. In addition, there may be several simultaneous factors. The main ones have to do with ovulation, oocyte quality, the uterus and the fallopian tubes and the maternal environment.

Ovulation and fertility according to a woman's age

Women are born with a limited number of antral follicles and over time the number of follicles decreases, especially after the age of 35.  This decline is more pronounced around the age of 40.

It is therefore important to assess the woman's menstrual cycle and see if there may be a problem of anovulatory cycles (e.g. polycystic ovarian syndrome) and to carry out a count of antral follicles by ultrasound and the anti-Mullerian hormone.

 

Tubal factor

The tubal factor is determined as the alteration of the fallopian tubes, the area where fertilisation (union of egg and sperm) takes place.

Alterations in tubal patency may be due to infections, endometriosis, tubal malformation, hydrosalpinx, surgical interventions or pelvic inflammatory disease, among others.

 

Uterine factor

The alterations in the uterine cavity are differentiated into:

- Cervical factor: alterations of the cervical mucus, infections...

- Uterine factor: Congenital uterine malformations, myomas, polyps...

 

Immunological sterility

This is when the immune system attacks normal body tissues that it would otherwise ignore. Autoimmune disorders, such as antiphospholipid syndrome or lupus, can affect fertility.

 

Genetic factor

Genetic and chromosomal alterations that can hinder or prevent conception and also affect the normal course of pregnancy, causing miscarriages.

 

Implantation failure

The rooting of the embryo in the endometrium is a decisive moment in gestation, so that if it does not happen correctly, pregnancy will not take place. The presence of pathologies such as endometrial polyps, myomas (submucous or deforming the cavity or in contact with the endometrium, etc.), hydrosalpinx (the accumulation of fluid in the fallopian tubes) or endometritis (infection that causes inflammation of the endometrium) can prevent the embryo from implanting.


As we can see, there are various factors that cause infertility in women, so if you think that this may be your case, the first step is to find the problem in order to find a solution. Usually, those cases that require surgery and/or medication are solved with surgery and/or medication, and the following treatments, from less to more complex, are resorted to:

1- Programmed coitus.

2- Artificial insemination. 

3- In vitro fertilisation.

4- Oocyte donation.

Our recommendation is that you put yourself in expert hands as soon as possible, making an appointment at a specialised centre to carry out an appropriate study to determine the possible causes.  At IGIN our consultations are free of charge and can be carried out by videoconference.