There are many reasons for female infertility, among them:
• absence of ovulation (release of the ovum from the ovary);
• violation of the passage of the egg through the fallopian tube (fallopian), as a result of which it is impossible to meet the sperm cell;
• aggressive influence of a woman's cervical mucus on the partner's sperm;
• violation of the process of implantation of a fertilized egg into the wall of the uterus.
Hormonal imbalance
The pathology of ovulation is responsible for about a third of all cases of female infertility. Most often this problem arises from the inadequate production of two hormones - follicle stimulating (FGP and luteinizing (LH)) that regulate the menstrual cycle and the process of ovulation.Hormonal imbalance may be a manifestation of a hypothalamic disorder that controls the production of hormones, or the pituitary gland responsible for their direct release In the pathology of the hormonal background, women are prescribed hormone substitution therapy or other drugs effective for infertility, for example, clomif The human chorionic gonadotropin drug (hCG) is also used to stimulate ovulation, which causes ovulation in more than 90% of cases, but for unknown reasons.
Pathology of ovulation
There are many other causes that lead to a violation of ovulation in women. These include:
• prolonged stress;
• excessive weight loss (for example, anorexia);
• obesity;
• Alcohol and drug abuse.
In addition, the depletion of egg cells in a woman due to ovarian damage during surgery (for example, removal of cysts), radiation damage (after radiotherapy), or as a result of menopause - physiological or premature. If the patient is unable to produce her own eggs, the only way out is the use of assisted reproductive technologies.
Pathology of the body and cervix
Implantation of a fertilized egg in the mucous membrane of the uterus may be hampered by the presence of nodes of myoma - a benign tumor of the muscular layer of the uterine wall. Infertility can cause and anomalies from the cervical (cervical) mucus. In some cases, an insufficient amount of mucus is noted in the cervical canal, in others - its increased viscosity; and both greatly complicate the passage of male sex cells along the cervical canal. In order for the fertilization to take place, the egg should be able to move freely through the uterine tube towards the uterine cavity.
Obstruction of the fallopian tubes can develop for various reasons:
• a birth defect;
• adhesion and scarring after surgery;
• infections such as salpingitis and postpartum infections;
• Sexually transmitted diseases, an ectopic pregnancy in history;
• endometritis;
• inflammatory disease of the pelvic organs.
The most common cause of damage to the fallopian tubes is inflammation of the pelvic organs - an infectious disease of the ovaries, fallopian tubes and uterus, which can be acute or chronic. The most common causative agent of this disease is the parasite Chlamydia trachomatis. Restoration of patency of the fallopian tubes is performed with the help of microsurgical technologies or laser surgery. If a woman can not become pregnant within a certain time, a clinical and laboratory study is performed to diagnose the cause of infertility.
Ovulation test
The most simple and accurate method of confirming ovulation is the use of a special test system that determines the increase in the level of luteinizing hormone in the urine just before ovulation. The test is conducted daily starting 2-3 days before the calculated middle of the menstrual cycle.
Ultrasonography
Ultrasound scanning is used to determine the status of the ovaries, as well as to monitor changes in the ovarian follicle before ovulation.