What is normal female fertility?

At the beginning of every menstrual cycle, the pituitary gland in the brain releases a hormone which acts through stimulating your ovaries into producing several (usually from 6 to 10) follicles. One of these follicles will then develop more quickly than the others do, thus becoming the dominant follicle. This dominant follicle releases the egg when a woman ovulates.

During your monthly menstrual cycle, the ovaries produce, in varying amounts, several different hormones, such as oestrogen and progesterone. Oestrogen promotes follicle growth, whereas progesterone, which is released after you ovulate, prepares your womb (your uterus) for a possible pregnancy.

After the ovulation phase is complete, the egg passes down through the fallopian tube, which is when it can meet any sperm cells that are swimming towards your egg. If one of the sperm cells manages to penetrate the outer layer of your egg, then fertilisation takes place, and the fertilised egg then moves into your womb to implant itself into your endometrium (your womb lining); pregnancy has now begun.

If your egg is not fertilised or if your embryo doesn’t develop properly, then your period begins (which is when your endometrium is shed) about 14 days after you have ovulated.

What causes infertility?

Ovulation disorders
Infertility is most commonly caused by problems with ovulation (the monthly release of an egg). Some problems stop women releasing eggs at all, and some cause an egg to be released during some cycles, but not others.

Ovulation problems can occur as a result of many conditions, such as:
polycystic ovary syndrome (PCOS) – a condition that makes it more difficult for your ovaries to produce an egg

thyroid problems – both an overactive thyroid gland (hyperthyroidism) and an underactive thyroid gland (hypothyroidism) can prevent ovulation

premature ovarian failure – where a woman’s ovaries stop working before she is 40

Womb and fallopian tubes
The fallopian tubes are the tubes along which an egg travels from the ovary to the womb. The egg is fertilised as it travels down the fallopian tubes. When it reaches the womb, it is implanted into the womb’s lining, where it continues to grow.

Submucosal fibroids
Fibroids are benign (non-cancerous) tumours that grow in, or around, the womb. Submucosal fibroids develop in the muscle beneath the inner lining of the womb wall and grow into the middle part.
Submucosal fibroids can reduce fertility, although exactly how they do this is not yet known. It is possible that a fibroid may prevent an embryo from implanting itself in the womb.

Endometriosis is a condition where pieces of the endometrium, begin to grow in other places, such as the ovaries.

This leads to female infertility because the new growths result in the formation adhesions (sticky areas of tissue) or cysts (fluid-filled sacs) that can block or distort the pelvis. These make it difficult for an egg to travel to the womb and get itself implanted.
It can disturb the way that a follicle (fluid-filled space in which an egg develops) matures and releases an egg.

Pelvic inflammatory disease
Pelvic inflammatory disease (PID) is one of the causes of female infertility. It is an infection of the upper female genital tract, which includes the womb, fallopian tubes and ovaries. It can result from sexually transmitted infection (STI). PID can damage and scar the fallopian tubes, making it virtually impossible for an egg to travel down into the womb.

At your IPSA Medical Clinic, we help you to understand the critical areas. A series of tests is carried out followed by recommending you the best treatment.

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