CAUSES OF INFERTILITY
The problem may lie in one of these areas:
• The woman—70 to 75 per cent of infertile couples have a female factor.
• The man—30 to 35 per cent have a male factor.
• The couple—40 per cent of infertile couples have more than one factor. In some couples no cause will be identified.
However, the most common causes of infertility are:
• Anovulation (not producing an egg)—about 30 to 40 per cent of infertile couples have this problem.
• Having blocked fallopian tubes—about 20 per cent.
• Sperm problems—about 20 to 30 per cent.
Rarer causes include problems with the uterus, cervix, chromosomes and male anatomy.
Anovulation. A hold-up in egg production can arise for a variety of reasons. Making eggs requires a delicate balance of the right hormones in the right place at the right time, and an ovary capable of producing them.
Hormone imbalances can result from problems in the brain, specifically in the hypothalamus and pituitary gland, where the ‘stimulating’ hormones are produced. Too much or not enough hormone may be produced, for a variety of reasons, including (stress, weight, illness, etc.). Often there is no obvious cause.
One specific, though relatively uncommon, hormonal cause of anovulation is having too much prolactin, the milk-stimulating hormone. It is produced in the pituitary gland, and sometimes the gland will overgrow, causing what is known as an adenoma, a benign (non-cancerous) tumour. These prolactinomas account for 3 to 5 per cent of cases of infertility, and can be treated with medication or surgery.
The ovaries may not respond to the signals sent to them by the brain for various reasons. Polycystic ovary syndrome is one condition in which the messages don’t result in an egg being produced. Instead the ovaries produce heaps of little cysts. The hormone imbalance related to this condition can also lead to increased weight and hairiness, and acne. It is usually diagnosed by ultrasound and can be treated with hormones.
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