Women’s age is important prognostic factor for pregnancy and livebirth. The ovaries in puberty contain about 400 000 oocytes. After puberty ovulation occurs every month. Ovulation is condition when mature oocyte-egg is releasad from the ovary ant it occurs about 350-400 times during the women’s life. The quality of the eggs is worsened after 35 years of age.
Ovulation happens after coordinated action of hyppothalamus, pituitary gland and ovary. Each disturbance of this delicated process and imbalance in hormone secretion results in ovuation disturbance and inability to achieve pregnancy.
Causes of ovulation disorders:
- weight loss and eating disorders;
- hard physical training;
- psychological stress;
- policystic ovarian syndrome(PCOS).
PCOS is hormone imbalance when elevetad androgens disturb ovulation. PCOS affects about 10 % of female population. The symptoms of PCOS are unregular periods, acne, excess of body and facial hair, obesity and infertility. Infertility treats by ovarian stimulation and in vitro fertilization (IVF).
Tubal factor infertility
Fertilization occurs in fallopian tubes after ovulated egg meets the spermatozoa. Tubal factor of infertility occurs when Fallopian tubes are obstructed and damaged that egg and sperm can’t meet. Chlamidya and gonnorhea infections are two common sexually transmited diseases that cause tubal infertility. Adhesion, previous surgery and endometriosis can also influence tubal function. IVF is established treatment for this kind of infertility. Surgery can be performed in selected cases.
Uterine factor infertility
Fibroids are diagnosed in about 8 % of women between 33-40 years of age. Submucosal (located in uterine cavity) and possibly intramural (located in uterine wall) fibroids affect fertility. Some uterine malformations and uterine adhesions may also cause infertility. Further, 1 out of 4000 women is born without the womb and some women remove uterus due to cancer, fibroids and complications after delivery.
Endometriosis is condition when endometrium (tissue that normally lines the inside of uterus) grows outside of the uterus. The clinical signs of endometriosis are pelvic pain, painful periods, pain with intercourse and defecation, and infertility. Endometriosis may disturb ovulation and fertilization as well as it can provoke adhesions that affect fallopian tube function.
High level of prolactine and high/low level of thyroid gland hormones affect ovulation that results in infertility.