Ovulation is a phenomenon orchestrated by a conjunction of hormonal changes involving ovaries, hypophysis and the hypothalamus. Although; the woman’s body bears these changes and she is stable, there are many factors which can alter the dynamics of this process. When ovulation takes place and the egg is released it reaches the fallopian tube where it has to meet the sperm for conception to occur. For fertilisation to occur it is very important that the spermatozoids with greater mobility are not obstructed on its way to the uterus. The phenomenon of implantation is the one that will determine if everything has been done in an adequate way and this is when pregnancy occurs.
For pregnancy to take place in a natural way a series of events are required to happen in a precise and coordinated way. Nevertheless; there are factors that can interpose to successfully reach this objective.
What are they?
We can classify the causes of female infertility according to the level in which the dysfunction takes place, being able to distinguish;
Ovarian Failure
This includes women who have minor functional disturbances which do not hinder ovulation as well as women who have totally lost ovarian function.
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Women with Ovarian function:
We refer to women who although still menstruate could present; a reduced ovary function due to age (35 years or over) and their eggs are no longer in the optimum maturation ambience, women with a lower ovary reserve, women with hormonal disorders such as the Polycystic Ovary Syndrome (POS) or those women who go for long periods without menstruating (amenorrhea). Occasionally; women with severe endometriosis affecting ovarian function could be included in this group.
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Women without Ovarian function:
These are women who have totally lost their ovarian function due to age or premature ovarian failure if menopause takes place before the age of 40. In some cases this can be due to a certain damage, infection, Oncologic treatment or surgery affecting the ovarian function. Although less frequent a genetic pre disposition or chromo sonic alterations leads to the loss of ovarian function.
Tubal Factor
In the fallopian tubes is where the oocytes fertilization by the sperm takes place and later the transportation of the zygote to the uterus. That’s why; any kind of alteration which obstructs the passing of the spermatozoids and zygote will have its implications on the fertility potential of the couple. Inflammatory processes, infections or previous surgery can trigger the obstruction of the tube. The tissues of the uterus and tubes are closely united to the extent that any damage can facilitate cicatrisation and create adherence which provokes the partial or total obstruction through this cavity. Some malformations constitutes and obstruction and a lack of permeability between the tube and uterine cavity.
Uterine or Endometrial Factor
Certain uterine anomalies affect the embryonic implantation. The endometrium is the mucus which covers the interior of the uterus and is in charge of establishing a molecular dialogue directly with the embryo during implantation. Some malfunctions of the uterine anatomy, presence of tumours (fibroids or polyps) can drastically affect the possibilities of pregnancy.
