Fertility issues can arise in many ways. Problems with ovulation mean that eggs do not develop correctly or on time. Chemicals or even stress can cause hormone imbalances. And then there are physical problems with the reproductive system. As tough as a woman’s body is, the ovaries, fallopian tubes, and uterus are also delicate. If they become damaged through injury or disease, fertility can suffer. We’re taking a look at a few structural causes of infertility, their symptoms and possible causes, and ways to deal with them.
Structural Cause 1: Uterine Fibroids
Uterine fibroids are noncancerous growths in the uterus. Symptoms include heavy menstrual bleeding, periods lasting longer than a week, and pelvic pain. Many women develop uterine fibroids at some point in their lives. Of the conditions we discuss here, uterine fibroids are least likely to interfere, but some can cause infertility, pregnancy loss, or complications.
We don’t know exactly what causes fibroids, but they may be related to genetic changes, hormone levels, or bodily compounds like insulin-like growth factor. Risk factors include a family history of fibroids, obesity, vitamin D deficiency, a diet high in red meat, and race – fibroids are more common among African-Americans.
Many fibroids are not harmful and can be waited out – they will typically shrink after menopause. Medications like Gonadotropin-releasing hormone agonists treat fibroids by temporarily putting your body in a postmenopausal state. To eliminate fibroids, a surgeon could use non-invasive ultrasound to shrink them, starve them by cutting off their blood flow, or simply remove them.
Structural Cause 2: Damage To The Fallopian Tubes
To transport the egg to the uterus, the fallopian tubes must be clear and intact – so if they become damaged, fertility can be compromised. Abdominal or pelvic surgery can unintentionally harm the tubes. Diseases like chlamydia can scar and block the tubes. Abnormalities in the pelvis – including birth defects, scar tissue, and the other conditions in this article – can block the tubes and impair fertility.
Damaged fallopian tubes can sometimes be repaired with surgery. Other conditions that block the tubes may be treated in their own ways. But most often, in vitro fertilization is recommended for women with fallopian tube damage.
Structural Cause 3: Endometriosis
Endometriosis is a condition in which tissue of the uterine lining grows outside of the uterus itself. The tissue thickens and breaks down according to the menstrual cycle, but since it can’t exit the body, it stays behind and irritates the surrounding tissue. This can cause scarring and adhesions that make the ovaries, uterus, and other nearby organs stick to one another.
Endometriosis is painful, especially during your period. Fertility issues result from the scarring and adhesions interrupting the normal function of the reproductive system. Possible causes include retrograde menstruation, where menstrual blood flows in the wrong direction and deposits endometrial cells outside the uterus; pieces of the endometrium being dislodged following surgery; and immune system disorders that prevent the body from breaking down misplaced endometrial tissue.
Most doctors recommend conservative treatments for endometriosis at first. These include painkillers or hormone treatments to reduce the symptoms of the condition. If you are trying for a baby, surgery to remove the misplaced endometrial tissue is often required. In the most severe cases, endometriosis may require a complete hysterectomy and removal of the ovaries.
Structural problems can cause fertility issues, but in many cases, these issues can be overcome through medication or surgery. Talk to your doctor if you are concerned about any of these conditions.