INFERTILITY PART 2 By Dr. Chin Akano

WHAT CAUSES INFERTILITY IN WOMEN


Let us first discuss some basic facts that will help us understand this topic.

For a woman to think of conceiving, first she needs to have normal reproductive anatomy.

What do I mean?

I am trying to say that she needs to be born with the following:

* a vagina ( Note that some women are born without one while some have issues with theirs)

* Womb (uterus)

* Fallopian tubes (tubes) left and right (2)

* Ovary (ovaries) left and right (2)

Even when she is born with all of these organs, they have to be normal and functional.

In a nutshell any problem with vagina, or womb or tubes or ovaries could lead to infertility.

Let me give some examples

* Vagina: absent vagina, or blocked vagina etc would lead to infertility

* Tubes: excessively long or blocked or diseased tubes could lead to infertility

* Ovaries: ovaries riddled with cysts, or not producing eggs or diseased are likely to lead to infertility
* Uterus: abnormally shaped or narrowed womb or one with abnormal linings or muscles or riddled with fibroids, masses or even diseased may lead to infertility.

Let me now go ahead and explain the importance of these reproductive organs


Vagina: This is the organ necessary for sexual intercourse to occur. Following intercourse the man deposits semen into the vagina and it swims through the vagina to the fallopian tube.

What is semen?
This is the fluid deposited by a man following ejaculation or masturbation. It contains spermatozoa (sperm), prostatic fluid, pre-ejaculate, fructose, amino acid , etc. Lesson to take away is that a man may produce semen without sperm in it and his semen will therefore be unable to fertilize the eggs ( ova). That a man ejaculated and produced semen does not mean the semen contains sperm or potent or enough sperm to fertilise the egg(s)
So for a man’s semen to be fertile, it must contact spermatozoa and other necessary components.

After semen is deposited in the vagina, the sperm swims through and gets to the fallopian tube and meet with the eggs waiting there and then fertilization occurs and an embryo is formed. This embryo then undergoes all necessary changes in the womb to become the baby we wish for.

Ovaries:

Every woman should have 2 ovaries, one on the left and another on the right. It is the ovary that produces the eggs (ova) and this happens once every month. This process is known as ovulation.
Both ovaries take their turn to produce eggs every month. So a woman does not need both ovaries to conceive but for obvious reason having both ovaries increase your chance of conceiving.
Ovulation usually takes place on the 14th day of a woman’s cycle if she has a regular cycle of 28 days. For those with cycles longer or irregular, it is difficult to time their ovulation.


Many women know when they ovulate as their cycle is like a clock and therefore easily predictable, however many women have irregular cycles and unpredictable ovulation.

So how can a woman know that she is ovulating?

There are a few features that can help a woman know when she is ovulating. They include the following

* marginal rise in base body temperature

* some vaginal discharge

* sharp one sided abdominal pain

* increased craving to have sex

* abdominal bloating

* breast engorgement among others



Fallopian tubes ( 2 in number)

After ovulation, egg(s) also known as ovum(ova) are released and they find their way to the fallopian tube to be fertilized by a sperm (champion sperm).

After ovulation, the next thing is fertilisation. What is this?

This is the process where a sperm and egg join together to form an embryo.

Where does it take place? In the fallopian tube

So the gist is that after ovulation the eggs move from the ovaries to the fallopian tube while the sperm migrates from the vagina to the tube as well to fuse with the egg to form the baby.

After fertilization in the fallopian tube, the fertilized egg or embryo stays there for a few days and then gradually finds its way into the womb ( uterus). If for any reason the embryo is not able to find its way into the womb, the baby starts developing in the tube. This is known as ectopic pregnancy. As the tube is not suited to accommodate the growing baby, after a while the tube burst causing some of the fatal emergencies associated with ectopic pregnancy.
In essence ectopic pregnancy means a pregnancy developing outside the womb. Please note that it is not only in the fallopian tube that ectopic pregnancy can occur, it can also occur in the ovaries, the cervix and even the abdomen.

Womb (Uterus)

When the fertilized egg (embryo) succeeds to get into the womb, it then gets attached to the lining of the womb. This process is known as implantation.
After implantation the embryo stays in the womb and undergo all necessary changes until the baby is born.

In conclusion for a woman to be fertile, first she has to anatomically normal and all the necessary reproductive organs have to be functional and normal.

Furthermore anything that affects the reproductive cycle ranging from depositing of the semen in the vagina, to the migration of the sperm to the fallopian tube, to ovulation, to migration of eggs to the tube, to fertilization, to movement of the fertilized egg to the womb, to implantation of the fertilized egg to the development of the baby in the womb would lead to infertility in a woman.