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Female infertility can be placed into several different categories.

Physical problems somewhere in the reproductive system represent one such category, alongside hormonal causes, medical problems elsewhere in the body indirectly leading to infertility, and unexplained causes. What are the physical causes of female infertility? 

Uterine malformations

Women who have a malformed uterus can encounter infertility, repeated miscarriages, or preterm labor. Uterine malformations are not very prevalent, and are estimated to affect between three and five percent of all women. Uterine abnormalities include a unicornuate uterus, a bicornuate uterus, and uterus didelphis. Respectively, they are a uterus that has not been fully formed, a heart-shaped uterus, and a uterus that splits into two smaller uteri. Uterine abnormalities come in degrees, and not all uterine abnormalities carry the same risks. Natural pregnancy is completely possible in many with with a bicornuate uterus, for example, while others suffer from repeated miscarriages. Women who have malformed uteri should ideally know about it and discuss their possibilities before attempting to get pregnant. In some cases, surgery prior to a planned pregnancy (either natural or with artificial reproductive techniques) is the best course of action. Many uterine abnormalities comes with a decreased chance of achieving pregnancy, higher miscarriage rates, higher pregnancy complications, and higher complication rates during labor and delivery. Informing yourself about the risks and possible treatments is therefore essential, if you know you have a uterine abnormality of any type.

Blocked fallopian tubes

Blocked fallopian tubes are another physical cause of female infertility. This problem is very common. Infections and reproductive diseases like endometriosis are the main culprits. Fallopian tube blockages and damage form the most common reason for which a woman seeks IVF. Blocked fallopian tubes physically obstruct the bridge between egg and sperm. The egg, which is released from the ovaries, cannot usually meet with the sperm, which have to get through the tubes to reach the egg. In the rare event that sperm does get through to the egg, even with the "road block", any fertilized egg will have a very slight chance of getting through the blockage and into the uterus. This means that any woman who does get pregnant naturally despite having blocked fallopian tubes has a very high chance of an ectopic pregnancy.

Uterine fibroids

Uterine fibroids are very common like blocked fallopian tubes. Unlike blocked fallopian tubes, uterine fibroids are not usually a problem. Fibroids are benign growths that come in various shapes and sizes. Most women who have fibroids can get pregnant without problems, and only a few of those who get pregnant with fibroids run into any pregnancy or birth complications. Some fibroids can get in the way of conception, however. If a fibroid is particularly large or awkwardly positioned, it can block either the opening to the fallopian tubes or the opening to the uterus (the cervix). Both will result in the inability of sperm to get through to the egg. In some cases, a woman with obstructive fibroids will get pregnant, but the fibroids still pose a miscarriage risk. After repeated miscarriages, surgery can be advised to remove the fibroids.

Problems with the endometrial lining

The endometrium is the tissue that covers the uterine wall, to create a healthy environment for a fertilized egg to implant into and to develop into a baby through pregnancy. There are several things that can go wrong with the endometrium. There can be polyps, cellular abnormalities, too thin a layer of the endometrium, or too tick a layer. In some cases, these abnormalities can certainly interfere with a woman's ability to either get pregnant or stay pregnant. Endometrial abnormalities, especially carcinoma, are also a common complication of Polycystic Ovary Syndrome. PCOS is a frequent cause of infertility all in itself. Endometrial problems should be on the list of things to investigate during infertility testing. If you have any endometrial abnormalities, they can sometimes be overcome with the help of medications. Talk to your healthcare team about this when you go in for fertility testing.

  • Infographic by SteadyHealth.com
  • Infographic by SteadyHealth.com
  • http://www.seattlefertility.com/diagnosis/uterineAnomalies.asp, http://www.ncbi.nlm.nih.gov/pubmed/12856518

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