Causes of infertility in women

Here you will find an overview of possible causes of infertility in women - from hormonal disorders, including polycystic ovary syndrome and the decline in fertility from 40, all the way up to rare disorders of the immune system.

Hormonal disorders
A variety of hormones interfere with the growth of the oocytes in the ovary, as well as the events surrounding the fertilization and implantation of the embryo in the uterus. If respective hormone levels are out of balance, oocyte maturation and ovulation, the growth of the uterine lining or the formation of the corpus luteum may be adversely affected.

PCO-Syndrome (Polycystic Ovarian Syndrome)

This is the most common hormonal disorder among women of reproductive age. In Europe, about 5 to 10 % of all women are affected. Thus PCO syndrome is the most frequent cause of hormonally induced female infertility. Cycle irregularities are common (in women), oftentimes skipping the monthly period altogether.

The diagnosis is made using a combination of ultrasound examination and conventional hormonal screening. Recent research has shown that polycystic ovary syndrome is often associated with irregular glucose metabolism, especially if the patient is also overweight. In recent years new treatment strategies have been developed on the basis of these results, often helping fulfill your wish for a child in a natural way – with only slight hormonal assistance or through minor surgery. 

Fertility over 40

In women, the probability of becoming pregnant declines significantly with age, especially from the age of 40 on. Key factors for the decline in fertility from that age and onward are hormonal causes that lead to impairment of oocyte maturation. Additionally, genetic disorders – such as aneuploidy (too many or too few chromosomes) – have more recently emerged as leading causes. Medical prerequisites run counter to societal development, so the wish to give birth to a child later in life is becoming increasingly common.

Basically, from age 40 on a variety of hurdles in treating fertility patients are becoming more difficult to clear. Initially it is advised to harvest as many eggs as possible through individual stimulation treatment. These eggs can be fertilized by the sperm of the partner and must then implant in the uterine lining. Because of an increased risk of miscarriage these patients require special attention during the drug treatment of the luteal phase, in which the embryo implants in the lining of the uterus, thus allowing the pregnancy to occur.

We incorporate all of these experiences in the individual stimulation and treatment planning, with the greatest attention to a cost-saving approach where possible. We have particularly addressed this problem and are proud to have made a substantial increase in the number of happy mothers over the age of 40

Other possible causes

Infertility due to problems with the fallopian tubes

Fallopian tubes are the “conveyor belt” that takes the sperm cells to the egg cell and the fertilized egg cells (embryos) toward the cavity of the uterus. If the fallopian tubes are partially or fully blocked, it is harder or impossible for the sperm cells to reach the egg or the embryo to reach the uterus (risk of a tubal pregnancy). Blocked tubes can be caused by inflammations, previous tubal pregnancies, surgery or endometriosis (where tissue from the lining of the uterus forms and grows outside the uterus).

Endometriosis

Endometriosis is a disease in which endometrial tissue grows outside the uterine cavity , for example in the abdominal cavity, on or in the ovaries, bladder or intestines, but also deeply infiltrating into the muscle layer of the uterus itself. It is believed that about 5 to 10% of all women suffer from endometriosis. Among women with impaired fertility, however, endometriosis is much more common, namely in 30 to 40 % of cases. Severe pain during menstruation can be a symptom of endometriosis. Very often, however, this disease remains undetected, since in many cases it can only be diagnosed by the use of laparoscopy.

The cause of this disease is still unknown, but it may adversely affect fertility in a variety of ways. In the case of severe endometriosis, adhesions of the fallopian tubes and / or ovaries are very commonly the cause of infertility. But even mild endometriosis, which is often diagnosed only as an incidental finding or as part of an infertility screening, can often result in anomalies that lead to infertility. The main difficulties lie with oocyte maturation and subsequently also implantation of the embryo in the uterus.

For more than 20 years our team members have been researching the causes and the development of possible treatments for this disorder. Currently, artificial insemination offers the best chance to become pregnant, especially in combination with ICSI and/or assisted hatching.

Structural changes of the uterus/endometrium

Muscle knots in the uterus (myoma or uterine fibroids) are very common. Sometimes, especially if they sit near the mucosa, they are the reason for persistent infertility or recurrent miscarriages. In such cases, the problem can often be resolved through surgery. The cervix in design is , similar to a bottle-neck, the narrowest point for the sperm towards the egg. Scarring post surgery, inflammation or obstructions in this area can severely hinder reproductivity.

In rare cases - usually congenital - abnormalities in the reproductive organs represent the reason for infertility. These conditions are surgically remedied relatively easily.

Sometimes the cause of the non-occurrence of pregnancy is the mucous membrane not developing properly, thus not allowing the embryo to implant. In addition to the non-response of the mucosal cells to the various hormones and growth factors, diseases such as endometriosis and chronic infections may adversely affect the complicated process of implantation of the embryo in the uterine lining. The causes of such problems and the evaluation of possible therapeutic approaches are a significant focus of our current research activities.

Disorders of the immune system

In rarer cases an immune response disorder is the cause of infertility in a woman. In women suffering from this dysfunction, the immune system sees the egg cell or the sperm as a foreign body which it then attacks.