The spontaneous loss of a woman’s pregnancy before the 20th week that can be both physically and emotionally painful.
Miscarriage is the most common type of pregnancy loss and often occurs because the foetus isn’t developing normally. Miscarriage can also be genetically.
Symptoms of miscarriage include:-
Miscarriage are both physically and mentally painful. In some cases female can’t have next pregnancy. Some of the symptoms include:
cramps
Abdominal pain
Bleeding which turn from low to high level
Weakness which some time cause faint
Back pain
Fever
Abdominal infection
Urinal problems
Can I get pregnant after miscarriage :
Yes. At least 85% of women who have miscarriages have subsequent normal pregnancies and births. Having a miscarriage does not necessarily mean you have a fertility problem. If you’ve had two miscarriages in a row, you should stop trying to conceive, use a form of birth control , and ask your health care .
Can a Miscarriage Be Prevented?
Usually a miscarriage cannot be prevented and often occurs because the pregnancy is not normal. If a specific problem is identified with testing, then treatment options may be available. Sometimes,treatment of a mother’s illness can improve the chances for a successful pregnancy. Basically to prevent miscarriage a female should take some basic medicine that helps in building up the baby Or foetus. sure to take at least 400 mg of folic acid every day, beginning at least one to two months before conception, if possible.
Exercise regularly.
Eat healthy, well-balanced meals.
Manage stress.
Keep your weight within normal limits.
Don’t smoke and stay away from smoke.
Don’t drink alcohol
Avoid illicit drugs.
Take proper rest
Make sure you are up to date on immunizations.
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In order to extract and fertilize the eggs during IVF, doctors generally follow the same process everytime. Once fertilization has occurred, there are a few different options available for embryo transfer:
Fresh embryo transfer: Once eggs have been fertilized, they are cultured for 1-2 days. The best embryos are chosen to transfer directly to the woman’s uterus.
Frozen embryo transfer: Any healthy embryos that were not used in the first transfer can be frozen and stored for future use. These can be thawed and transferred to the uterus.
Blastocyst embryo transfer: If many healthy embryos develop after the fertilization, it is common to wait to see if the embryos develop into blastocysts. According to a study in the Indian Journal of Clinical Practice, blastocyst embryo transfer has a higher success rate than the standard embryo transfer on day 3. However, another recent study suggests that it may pose risks later in pregnancy and should not always be recommended.
Assisted hatching (AH): A study in the Reproductive Biomedicine Online found that the process of assisted hatching – weakening the outer layer of the embryo before it is transferred to the uterus – does not improve pregnancy and implantation rates in women who are having fresh embryos transferred. The researchers noted, however, that women having frozen embryos implanted do benefit from having their embryos treated in this way.
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There’s no cure for endometriosis. Treatments usually include surgery or medication. You might need to try different treatments to find what helps you feel better.
Pain medicine. Your doctor may recommend an over-the-counter pain reliever. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) or naproxen (Aleve) work for many people. If these don’t relieve your pain, ask about other options.
Some other things you can do at home may help with pain:
Take warm baths.
Put a hot water bottle or heating pad on your belly.
Exercise regularly.
Some women find that alternative therapies like acupuncture, diet changes, or homeopathy work for them. Before starting one, talk to your doctor to be sure it won’t interfere with another treatment.
Hormones. Hormonal therapy lowers the amount of estrogen your body creates and can stop your period. This helps lesions bleed less so you don’t have as much inflammation, scarring, and cyst formation. Common hormones include:
Birth control pills, patches, and vaginal rings
Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists such as elagolix sodium (Orilissa) or leuprolide (Lupron)
Progestin-only contraceptives
Danazol (Danocrine)
Surgery. Your doctor might recommend surgery to take out as much of the affected tissue as possible. In some cases, surgery helps symptoms and can make you more likely to get pregnant. Your doctor might use a laparoscope or do a standard surgery that uses larger cuts. Pain sometimes comes back after surgery.
In the most severe cases, you may need a surgery called a hysterectomy to take out your ovaries, uterus, and cervix. But without them, you can’t get pregnant later.
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Endometriosis happens when the endometrium, the tissue that usually lines the inside of a woman’s uterus, grows outside it.
This tissue acts like regular uterine tissue does during your period: It will break apart and bleed at the end of the cycle. But this blood has nowhere to go. Surrounding areas may become inflamed or swollen. You might have scar tissue and lesions.
Endometriosis is most common on your ovaries.
Types of Endometriosis
There are three main types of endometriosis, based on where it is:
Superficial peritoneal lesion. This is the most common kind. You have lesions on your peritoneum, a thin film that lines your pelvic cavity.
Endometrioma (ovarian lesion). These dark, fluid-filled cysts, also called chocolate cysts, form deep in your ovaries. They don’t respond well to treatment and can damage healthy tissue.
Deeply infiltrating endometriosis. This type grows under your peritoneum and can involve organs near your uterus, such as your bowels or bladder. About 1% to 5% of women with endometriosis have it.
Endometriosis Symptoms
You might not notice any symptoms. When you have them, they can include:
Back pain during your period
Severe menstrual cramps
Pain when pooping or peeing, especially during your period
Unusual or heavy bleeding during periods
Blood in your stool or urine
Diarrhea or constipation
Painful sex
Fatigue that won’t go away
Trouble getting pregnant
Endometriosis Causes
Doctors don’t know exactly what causes endometriosis. Some experts think menstrual blood that contains endometrial cells may pass back through your fallopian tubes and into your pelvic cavity, where the cells stick to your organs. This is called retrograde menstruation.
Your genes could also play a role. If your mom or sister has endometriosis, you’re more likely to get it. Research shows that it tends to get worse from one generation to the next.
Some women with endometriosis also have immune system disorders. But doctors aren’t sure whether there’s a link.
Endometriosis Complications
Severe endometriosis pain can affect your quality of life. Some women struggle with anxiety or depression. Medical treatments and mental health care can help.
About 40% of women who have trouble getting pregnant have endometriosis. Researchers suspect that inflammation damages the sperm or egg or makes it harder for them to move. Or scar tissue might block your fallopian tubes. Surgery may boost your fertility.
Endometriosis may raise your risk of ovarian cancer or another cancer called endometriosis-associated adenocarcinoma.
Endometriosis Diagnosis
Your doctor might suspect endometriosis based on your symptoms. To confirm it, they can do tests including:
Pelvic exam . Your doctor might be able to feel cysts or scars behind your uterus.
Imaging tests. An ultrasound, a CT scan, or an MRI can make detailed pictures of your organs.
Laparoscopy. Your doctor makes a small cut in your belly and inserts a thin tube with a camera on the end (called a laparoscope). They can see where and how big lesions are. This is usually the only way to be totally certain that you have endometriosis.
Biopsy. Your doctor takes a sample of tissue, often during a laparoscopy, and a specialist looks at it under a microscope to confirm the diagnosis.
Endometriosis Stages
Doctors use the American Society of Reproductive Medicine’s four stages of endometriosis:
Stage I (minimal). You have a few small lesions but no scar tissue.
Stage II (mild). There are more lesions but no scar tissue. Less than 2 inches of your abdomen are involved.
Stage II (moderate). The lesions may be deep. You may have endometriomas and scar tissue around your ovaries or fallopian tubes.
Stage IV (severe). There are many lesions and maybe large cysts in your ovaries. You may have scar tissue around your ovaries and fallopian tubes or between your uterus and the lower part of your intestines.
The stages don’t take pain or symptoms into account. For example, stage I endometriosis can cause severe pain, but a woman who has stage IV could have no symptoms at all.
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In vitro fertilization (IVF) is a type of assistive reproductive technology (ART). It involves retrieving eggs from a woman’s ovaries and fertilizing them with sperm. This fertilized egg is known as an embryo. The embryo can then be frozen for storage or transferred to a woman’s uterus.
How Is In Vitro Fertilization Performed?
There are five steps involved in IVF:
stimulation
egg retrieval
insemination
embryo culture
transfer
Stimulation- A woman normally produces one egg during each menstrual cycle. However, IVF requires multiple eggs. Using multiple eggs increases the chances of developing a viable embryo. You’ll receive fertility drugs to increase the number of eggs your body produces. During this time, your doctor will perform regular blood tests and ultrasounds to monitor the production of eggs and to let your doctor know when to retrieve them.
Egg Retrieval- Egg retrieval is known as follicular aspiration. It’s a surgical procedure performed with anaesthesia. Your doctor will use an ultrasound wand to guide a needle through your vagina, into your ovary, and into an egg-containing follicle. The needle will suction eggs and fluid out of each follicle.
Insemination- The male partner will now need to give a semen sample. A technician will mix the sperm with the eggs in a petri dish. If that doesn’t produce embryos, your doctor may decide to use ICSI.
Embryo Culture- Your doctor will monitor the fertilized eggs to ensure that they’re dividing and developing. The embryos may undergo testing for genetic conditions at this time.
Transfer- When the embryos are big enough, they can be implanted. This normally occurs three to five days after fertilization. Implantation involves inserting a thin tube called a catheter inserted into your vagina, past your cervix, and into your uterus. Your doctor then releases the embryo into your uterus.
However ivf involves these five most important procedure and this should be done under a best doctor. If you face any problem after and before ivf you must concern to your doctor. Ignore taking the medicine without recommendations.
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Infertility refers to the condition in which a female not getting pregnant, although by having carefully timed, unprotected sex for one year.
The cause of infertility may be difficult to determine but may include inadequate levels of certain hormones in both men and women, and trouble with ovulation in women. Smoking, alcohol and drug are the major problem of infertility in both male and female. The effects of smoking on male reproductive part (sperm) and female reproductive part (ovum) are affected.
Effect of smoking on MALE :
Sperm concentration: Sperm concentration refers to the number of sperm found in a measured quantity of semen. Studies have shown a 23 percent decrease in sperm concentration in men who smoke.
Sperm motility: Sperm motility refers to the swimming capabilities of the sperm. If sperm cannot swim properly, they may have trouble reaching the egg and fertilizing it.
Sperm morphology: Sperm morphology refers to the shape of sperm. Oddly shaped sperm may not swim well enough to get to the egg and may not be able to fertilize an egg. Male smokers have fewer healthy shaped sperm than non-smokers.
Harmful toxins are found in cigarettes are frequently to blame for bad health effects. Smoking exposes men to high levels of cadmium that have been linked to decreased fertility. Heavy smoker were found to have higher levels of cadmium in their semen.
But these toxins may not be the only factor. Zinc levels may play a role. Male smokers who had lower zinc levels in their semen also had poor sperm concentration, movement, and shape.
On the other hand, in smokers who had normal semen zinc levels, there were still issues with sperm concentration, motility, and morphology, but the degree of abnormality was less.
Effect of smoking on FEMALE :-
Women who smoke do not conceive as efficiently as non-smokers. The risk for fertility problems increases with the number of cigarettes smoked daily.
Even fertility treatments such as IVF may not be able to fully overcome smoking’s effects on fertility. Female smokers need more ovary-stimulating medications during IVF
Smoking damages the genetic material in eggs and sperm, miscarriage and offspring birth- defect rates are higher among patients who smoke. Smokeless tobacco ,drugs, drinks, alcohol and other harmful products also leads to increased miscarriage rates. Women who smoke are more likely to conceive a chromosomally unhealthy pregnancy than non-smoking mothers. Ectopic pregnancies also occur more often among female smokers.
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This includes a number of special technique which assist infertile couples to have children. Some prominent technique are :-
Test tube baby programme
Gamete intra fallopian tube (GIFT)
Intra cytoplasmic sperm injection (ICSI)
Artificial insemination technique (AIT)
Test tube baby programme :- this method involves in vitro fertilization (IVF) , fertilization of male gamete and female gamete outside the body in almost similar conditions as that in the body followed by zygote Or embryo transfer.
In some women normal conception is not possible because of blocked oviducts Or spermicidal secretions in the vagina pr low sperm count of the males. These are also cases wherein women cannot produce ova or men can’t produce sperm. In such cases, ovum from females is remove surgically after hormonal stimulation of the follicle. It is then fertilized by her donor male sperm in am laboratory dish containing a nutrient broth. The zygote up to eight blastomers is then transferred into fallopian tube or embryo with more than eight blastomers is transferred into the uterus.
The entire operations is carried out under the sterilised conditions.
The baby produced by conceiving in culture dish and nursing in the uterus is called a test tube baby. A scientific term for this procedure is In vitro fertilization.
Success rate of test tube babies :- The success rate of the technique of producing test tube baby is less than 20% . To increase the chance of success, the prospective mother given fertility drug which cause many ovarian follicle to mature at same time. This release many eggs simultaneously, there by increasing the chance of success. The additional embryo are transferred to surrogate mother for competition of development. They can also be frozen for later use.
Surrogate mother : a developing embryo can be inserted in the uterus of another female, provided her hormone are in the proper phases of reproductive cycle for implantation to occur. A woman who substitute or take place of the real mother to nurse the embryo is called as surrogate mother.
Problem in producing test tube baby : the production of test tube baby involving the surrogate mother raises some ethical and legal problem such as right over child.
U. S. Government has proposed the following guidelines :-
No embryo should be left outside the mother.
Only married person should contribute egg and sperm for producing test tube baby.
Cost of embryo transplants in surrogate mother will not be funded by the Federal Government
Gamete Intra Fallopian Transfer (GIFT) :- this method is used in female who can’t produce ova but can provide suitable environment for fertilization and further development of embryo in the oviduct. In such case, ovum from the donor female is surgically removed and is them introduced into the Fallopian tube of such female. Such women then accept sperm from male during copulation.
Intra Cytoplasmic Sperm Injection (ICSI) :- it is another specialized technique to form an embryo in the laboratory in which a sperm is directly injected into the ovum placed in a nutrient broth.
Artificial insemination technique (AIT) :- this technique is used in those female where the husband either is unable to insemination the female or has very low sperm count in the ejaculates. In such case, the semen of the husband is first collected and then is artificial introduced either into the vagina or into the uterus of the female.
All the above mentioned technique require extremely high precision handling by specialized professional and expensive instrumentation.
Such facilities are presently available in all IVF centre.. This may lead to complications such as pelvic inflammatory disease PID, abortion, still birth, ectopic pregnancy, infertility or even cancer of the reproductive tract. Sexually transmitted diseases STD are a major threat to a healthy society Under such programmes., Adolescence are specially targeted to follow some principles given below :
Avoid sex with unknown partner or multiple partner
Always use condoms during coitus
If you doubt for an reproductive infection.., go to doctor immediately.
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Semen freezing is the procedure whereby spermatozoa are exposed to cryoprotectants and then cooling them to subzero temperature using liquid nitrogen. Frozen semen samples can be stored for many years while maintaining reasonable parameters of semen. Semen freezing helps in storage, supply or reserve of the human sperm for future use.
Sperm freezing is widely used and established method in humans and other species, it is very effective in Assisted Reproductive technology (ART) and fertility preservation in patients with cancer, before initiation of radiotherapy or chemotherapy. Semen freezing can be done by two methods 1. Noncontrolled rate cryopreservation and 2. Controlled rate cryopreservation.
CLINICAL APPLICATION OF SPERM FREEZING :-
1.Assisted Reproductive Technologies (ART)
2. Fertility Preservation with Cancer Therapy
3. Non- malignancy systemic diseases and other conditions
4. Surgical procedures involving male genitalia
5. Social and other reasons
ART – Assisted reproductive technologies – IUI/IVF/ICSI:
In ART, the most common use of sperm freezing is in artificial insemination, in vitro fertilization (IVF), or intra cytoplasmic sperm injections (ICSI) for various infertile couples. One of the ART options usually offered to infertile couples is intrauterine insemination using fresh or frozen sperm. Although the technique is used preferably with a fresh semen sample, the availability of freezing sperm samples is an option usually offered by infertility clinics in case the male partner cannot produce semen. In case of severe male factor infertility, the samples can be frozen for later use.
Fertility Preservation with Cancer Therapy:
Another application of sperm freezing is for cancer patients before initiation of cancer therapy. The option of sperm freezing should be offered to any male undergoing chemotherapy or radiotherapy as these treatments can have long-term or permanent cytotoxic side effects on testicular function. One of the advantages of semen freezing is here is that the frozen sperm can stand multiple freezing thawing cycles with no effect on the sperm quality; this is beneficial in cases where patients might have testicular cancer and require surgical removal of the whole testis, with no future possibility of obtaining sperm again. For young males before puberty , cryopreservation of testicular tissue may be an option for fertility preservation in future, improved chemotherapy regimens may give hope to patients in terms of maintaining their sexual and fertility potential after therapy, but at present all male patients diagnosed with cancer who wish to have children should consider sperm freezing or cryopreservation of testicular tissues for further ART use.
Non- malignancy systemic diseases and other conditions:
Cryopreservation of sperm or testicular tissue can also be used in patients prior to cytotoxic therapy for non malignant conditions, such as autoimmune diseases, kidney diseases, inflammatory bowel disease and heart transplant procedures. Most of these conditions are not fatal and the patients should be offered freezing of their sperm or testicular tissue prior to the cytotoxic therapy in order to preserve their fertility for the future.
Surgical procedures involving male genitalia:
Sperm freezing can also be used prophylactically before, during, or after certain surgical procedures as these may have serious adverse effects on male genital structure and functions. An example is the varicocele ligation procedure or reconstructive surgery (e.g. vasovasectomy or vasoepididmostomy). Sperm freezing may also be used postoperatively to insure against subsequent loss of patency of the vas deferens
Social and other reasons:
Sperm freezing could be a mean of preserving fertility in men with social reasons to preserve their rights to have children bearing their names, for example soldiers being deployed to combat missions in war. Other reasons for sperm freezing might be immediately pre and postmortem where relatives of a person wish to ensure that the person can have a legal heir.
CONCLUSION:
Applications of sperm freezing now days are diverse and include humans, animals and insects. Despite the undeniable morphological and functional adverse effects that cryopreservation exerts on sperm, it still remains one of the core methods of fertility preservation for patients and healthy volunteer donors. Future studies are expected to concentrate on advancing technology to achieve the goal of “damage free” sperm after freezing. Encouragingly, recent advances in ART suggest that it will be possible eventually to achieve a healthy pregnancy and live birth from freezing of a single sperm or frozen semen sample. Nevertheless, it has proved to be boon in the era of modernization helping childless couples to embrace parenthood. Sperm freezing has become an accepted modality for fertility preservation and childless couples.
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Oligospermia is a male fertility issue characterized by a low sperm count. Other aspects of the sexual health of men with this condition are typical. This includes the ability to get and maintain an erection, as well as produce ejaculation at orgasm.
Sperm count in your ejaculate can vary throughout your life. A healthy sperm amount is often necessary for fertility. The World Health Organization (WHO) classifies sperm counts at or above 15 million sperm per milliliter (mL) of semen as average. Anything below that is considered low and is diagnosed as oligospermia.
Mild oligospermia is 10 to 15 million sperm/mL.
Moderate oligospermia is considered 5 to 10 million sperm/mL.
Severe oligospermia is diagnosed when sperm counts fall between 0 and 5 million sperm/mL.
Some men with oligospermia can still conceive despite lower sperm counts. Fertilization may be more difficult, however. It may take more attempts than couples without a fertility issue.
Other men with oligospermia may have no problem with conception, despite the low sperm numbers.
Some of the most common causes of oligospermia also increase a man’s risk for other fertility issues. This includes sperm motility problems.
Sperm motility refers to how “active” sperm are in a man’s semen. Normal activity allows sperm to swim toward an egg for fertilization easily. Abnormal motility may mean the sperm don’t move enough to reach an egg. The sperm may also move in an unpredictable pattern that would prevent them from reaching an egg.
Causes of Oligospermia
There are many possible causes of oligospermia, including the following:
Varicocele – a swelling of the veins that drain the testicle
Infection that interferes with sperm production or sperm health
Ejaculation problems such as retrograde ejaculation (ejaculation backward into the bladder)
Certain medications (alpha blockers, finasteride, antiandrogens)
Hormonal imbalance (low testosterone, high prolactin levels)
Undescended testicles
Medical issues such as multiple sclerosis, diabetes or thyroid disorders
Heat exposure (hot tubs, baths, saunas)
Recreational drugs (Alcohol, cocaine, marijuana)
Anabolic steroid use
Chronic stress
How to diagnose a Oligospermia case
Doctor will take a detailed medical history and perform a general physical examination of your genitalia. He will also order a semen analysis and reproductive hormones that include testosterone, FSH and LH.
Low sperm count can be a biomarker of current and future health. If tests show you have a low sperm count, you should seriously consider undergoing a thorough medical evaluation with a specialist to rule out any underlying health conditions. You should also see your doctor annually to stay on top of your overall health and catch anything troubling early, when it is more easily treated.
Treatment
Oligospermia does not mean you have untreatable infertility. Docotr may recommend one of several approaches to improve semen quality.
Home remedies
1- Track ovulation 2-Have sex more frequently 3- Don’t use lubricants
Treatment may include:
Surgery. For example, a varicocele can often be surgically corrected or an obstructed vas deferens can be repaired. Prior vasectomies can be reversed. In cases where no sperm are present in the ejaculate, sperm can often be retrieved directly from the testicles or epididymis using sperm retrieval techniques.
Treating infections. Antibiotics can cure an infection of the reproductive tract, but this doesn’t always restore fertility.
Treatments for sexual intercourse problems. Medication or counseling can help improve fertility in conditions such as erectile dysfunction or premature ejaculation.
Hormone treatments and medications. Your doctor might recommend hormone replacement or medications in cases where infertility is caused by high or low levels of certain hormones or problems with the way the body uses hormones.
Assisted reproductive technology (ART). ART treatments involve obtaining sperm through normal ejaculation, surgical extraction or from donor individuals, depending on your specific situation and wishes. The sperm are then inserted into the female genital tract, or used for IVF or intracytoplasmic sperm injection.
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Infertility is defined as the inability to conceive within 12 months. If you are infertile, then you cannot get pregnant naturally and have children Approximately 85% of couples will achieve pregnancy within one year of trying, with the greatest likelihood of conception occurring during the earlier months. Additional 7% of couples will conceive in the second year and the couples who are enable to conceive even after trying this long defined as infertile.
Until recently, it was usually the women who were assumed to be the origin of any fertility issues. However, recent studies as conducted by the International Committee for Monitoring Assisted Reproductive Technology, World Health Organization, show that nearly 50% of infertility is related to the reproductive anomalies or disorders in the male.
WHAT IS REQUIRED FOR A COUPLE TO BECOME PREGNANT:
In order for a couple to become pregnant, at least four things have to happen:
OVULATION -A woman must produce and release a healthy egg from one of her ovaries.This is known as ovulation.
FERTILIZATION-A man must produce viable sperm which can successfully fertilize the woman’s egg. This procedure is known as fertilization.
TRANSPORTATION-The egg must travel through a fallopian tube toward the uterus.
IMPLANTATION-The fertilized egg must attach to the inside of the uterus.
What are the causes of low sperm count or abnormal sperm function in men?
Low sperm count or abnormal sperm function may be caused by:
Undescended testicles
If there is any Genetic defects/DNA damage
When a man is suffering from Diabetes
If a man had a Prior bacterial or viral infections such as mumps or adenovirus
Had a history of trauma or prior surgeries on the testicles or inguinal region
If a person has enlarged veins (varicoceles) in the testes that can increase blood flow and heat, both of which affect the number and shape of the sperm
If a man is exposed to chemicals like pesticides, radiation, and chemotherapy
If a man is an Alcohol user, marijuana user, and uses tobacco smoke
If a man is on Steroid
There is overexposure to heat (such as in saunas and hot tubs)
If surgical removal of one of the testicles due to cancer
In addition, there can be problems with the delivery of sperm and subsequent fertilization due to any of the following:
Premature ejaculation
Damage or injury to the reproductive organs
Semen entering the bladder instead of emerging through the penis during orgasm (retrograde ejaculation)
Certain genetic diseases (such as cystic fibrosis)
Men who have previously had a vasectomy and wish to father a child have two choices. They either need to have the vasectomy reversed or have sperm retrieved through a surgical procedure as part of assisted reproductive techniques.
What are the causes of infertility in women?
The causes of infertility in women can include many of the following:
Hormonal issues: These can be due to the lack of the necessary synchronized hormonal changes leading to the release of an egg from the ovary.
Hormonal issues: These can be due to the lack of the necessary synchronized hormonal changes leading to the release of an egg from the ovary.
Disorders of the thyroid gland: Either too much thyroid hormone or too little thyroid hormone can interfere with the menstrual cycle or cause infertility
Gland disorders: These hormonal disorders may include polycystic ovarian syndrome (PCOS), or problems with the hypothalamus, pituitary gland, adrenal gland (such as Cushing’s syndrome or congenital adrenal hyperplasia)
Structural issues: Benign growths (such as polyps and fibroids) in the uterus, blocked fallopian tubes, abnormal anatomy of the cervix or uterus, endometriosis, scar tissue
Fallopian tube damage can include scarring from prior surgery and/or pelvic infections. These include pelvic inflammatory disease (PID). Problems with transportation of the egg(s) can occur due to damaged or blocked fallopian tubes.
Diminished ovarian reserve, premature menopause or cessation of ovulation (primary ovarian insufficiency); changes in egg quality or quantity can affect fertility
Additional factors:
Poor diet that is lacking in nutrients
Athletic overtraining
Stress
Too much exposure to certain chemicals and toxins (for example, tobacco smoke, alcohol, marijuana, pesticides, radiation, and chemotherapy)
Certain medications (the effect usually is temporary)
Sickle cell disease
Kidney disease
Celiac disease
Diabetes
Women who have had a tubal ligation or an Essure® device (forms of permanent birth control) should speak with a gynecologist about their options.
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