Materiały źródłowe

• #1 Female Infertility – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK556033/

  Infertility is a medical condition that can cause psychological, physical, mental, spiritual, and medical detriments to the patient. […] Although male infertility is an important part of any infertility discussion, this topic reviews the evaluation, management, and treatment of female infertility. […] To understand infertility, one must understand normal fecundability, the probability of achieving pregnancy in one menstrual cycle. […] The research community has established a fecundability rate multiple times, which has helped establish normal pregnancy rates to assist in diagnosing infertility. […] The largest study identified that 85% of women would conceive within 12 months. […] Based on this study’s findings, fecundability is 25% in the first 3 months of unprotected intercourse and then decreased to 15% for the remaining 9 months.

• #1 Female Infertility – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK556033/

  The World Health Organization (WHO) performed a large multinational study to determine gender distribution and infertility etiologies. […] In 37% of infertile couples, female infertility was the cause; in 35% of couples, both male and female causes were identified; in 8%, there was male factor infertility. […] In the same study, the most common identifiable factors of female infertility are as follows: Ovulatory disorders: 25%, Endometriosis: 15%, Pelvic adhesions: 12%, Tubal blockage: 11%, Other tubal/uterine abnormalities: 11%, Hyperprolactinemia: 7%. […] Ovulatory disorders make up 25% of the known causes of female infertility. […] Oligo-ovulation or anovulation results in infertility because no oocyte are released monthly. […] Without an oocyte, there is no opportunity for fertilization and pregnancy.

• #1 Pathophysiology of Female Reproduction and Clinical Management | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-031-11701-5_16

  The normal menstrual cycle is the result of the integration of the primary neuroendocrine complex (the hypothalamuspituitaryovarian axis) into a control system regulated by a series of peripheral mechanisms of feedback and nerve signals that result in the release of a single mature oocyte from a pool of hundreds of thousands of primordial oocytes. Alterations of these mechanisms can lead to pathological conditions and affect fertility of patients. […] Female factor infertility was reported in 37% of infertile couples in developed countries. The most common identifiable female factors, which accounted for 81% of female infertility, were: Ovulatory disorders (25%). Tubal abnormalities (20%). Endometriosis (15%). Pelvic adhesions (12%). Hyperprolactinemia (7%). […] An ovulatory dysfunction is responsible for approximately 20-25% of infertility cases. The history, including the onset of menarche, menstrual cycle length, and presence or absence of premenstrual symptoms, should be investigated. Signs and symptoms of systemic disease, especially of hypothyroidism, and physical signs of endocrine disease (i.e., hirsutism, galactorrhea, and obesity) should be focused on. The degree and intensity of exercise and a history of weight loss and of hot flushes are clinical clues of possible endocrine or ovulatory dysfunction.

• #1 Female infertility – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/female-infertility/symptoms-causes/syc-20354308

  Infertility results from female factors about one-third of the time and both female and male factors about one-third of the time. The cause is either unknown or a combination of male and female factors in the remaining cases. […] Female infertility causes can be difficult to diagnose. There are many treatments, depending on the infertility cause. Many infertile couples will go on to conceive a child without treatment. […] In women, a number of factors can disrupt this process at any step. Female infertility is caused by one or more of the factors below. […] Ovulating infrequently or not at all accounts for most cases of infertility. Problems with the regulation of reproductive hormones by the hypothalamus or the pituitary gland or problems in the ovary can cause ovulation disorders. […] Polycystic ovary syndrome (PCOS) causes a hormone imbalance, which affects ovulation. PCOS is associated with insulin resistance and obesity, abnormal hair growth on the face or body, and acne. It’s the most common cause of female infertility.

• #2 Female Infertility | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/23502

  The World Health Organization (WHO) performed a large multinational study to determine gender distribution and infertility etiologies. In 37% of infertile couples, female infertility was the cause; in 35% of couples, both male and female causes were identified; in 8%, there was male factor infertility. In the same study, the most common identifiable factors of female infertility are as follows: […] Ovulatory disorders make up 25% of the known causes of female infertility. Oligo-ovulation or anovulation results in infertility because no oocyte are released monthly. Without an oocyte, there is no opportunity for fertilization and pregnancy. […] The most common type of Normogonadotropic normoestrogenic anovulation is PCOS. PCOS accounts for 80% to 85% of all anovulatory patients and affects 8% of all reproductive-aged females.

• #2 Female Infertility – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK556033/

  The World Health Organization (WHO) performed a large multinational study to determine gender distribution and infertility etiologies. […] In 37% of infertile couples, female infertility was the cause; in 35% of couples, both male and female causes were identified; in 8%, there was male factor infertility. […] In the same study, the most common identifiable factors of female infertility are as follows: Ovulatory disorders: 25%, Endometriosis: 15%, Pelvic adhesions: 12%, Tubal blockage: 11%, Other tubal/uterine abnormalities: 11%, Hyperprolactinemia: 7%. […] Ovulatory disorders make up 25% of the known causes of female infertility. […] Oligo-ovulation or anovulation results in infertility because no oocyte are released monthly. […] Without an oocyte, there is no opportunity for fertilization and pregnancy.

• #2 Female infertility – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/female-infertility/symptoms-causes/syc-20354308

  Endometriosis occurs when tissue that typically grows in the uterus implants and grows in other places. This extra tissue growth and the surgical removal of it can cause scarring, which can block fallopian tubes and keep an egg and sperm from uniting. […] Endometriosis can also disrupt implantation of the fertilized egg. The condition also seems to affect fertility in less-direct ways, such as damage to the sperm or egg. […] Several uterine or cervical causes can interfere with the egg implanting or increase the risk of miscarriage. […] In some cases, the cause of infertility is never found. A combination of several minor factors in both partners could cause unexplained fertility problems. […] The quality and quantity of a woman’s eggs begin to decline with age. In the mid-30s, the rate of follicle loss speeds, resulting in fewer and poorer quality eggs. This makes conception more difficult, and increases the risk of miscarriage. […] Being overweight or significantly underweight may affect ovulation. Getting to a healthy body mass index (BMI) might increase the frequency of ovulation and likelihood of pregnancy.

• #3 Pathophysiology of Female Reproduction and Clinical Management | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-031-11701-5_16

  The normal menstrual cycle is the result of the integration of the primary neuroendocrine complex (the hypothalamuspituitaryovarian axis) into a control system regulated by a series of peripheral mechanisms of feedback and nerve signals that result in the release of a single mature oocyte from a pool of hundreds of thousands of primordial oocytes. Alterations of these mechanisms can lead to pathological conditions and affect fertility of patients. […] Female factor infertility was reported in 37% of infertile couples in developed countries. The most common identifiable female factors, which accounted for 81% of female infertility, were: Ovulatory disorders (25%). Tubal abnormalities (20%). Endometriosis (15%). Pelvic adhesions (12%). Hyperprolactinemia (7%). […] An ovulatory dysfunction is responsible for approximately 20-25% of infertility cases. The history, including the onset of menarche, menstrual cycle length, and presence or absence of premenstrual symptoms, should be investigated. Signs and symptoms of systemic disease, especially of hypothyroidism, and physical signs of endocrine disease (i.e., hirsutism, galactorrhea, and obesity) should be focused on. The degree and intensity of exercise and a history of weight loss and of hot flushes are clinical clues of possible endocrine or ovulatory dysfunction.

• #3 Female Infertility | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/23502

  The World Health Organization (WHO) performed a large multinational study to determine gender distribution and infertility etiologies. In 37% of infertile couples, female infertility was the cause; in 35% of couples, both male and female causes were identified; in 8%, there was male factor infertility. In the same study, the most common identifiable factors of female infertility are as follows: […] Ovulatory disorders make up 25% of the known causes of female infertility. Oligo-ovulation or anovulation results in infertility because no oocyte are released monthly. Without an oocyte, there is no opportunity for fertilization and pregnancy. […] The most common type of Normogonadotropic normoestrogenic anovulation is PCOS. PCOS accounts for 80% to 85% of all anovulatory patients and affects 8% of all reproductive-aged females.

• #3 Female Infertility – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK556033/

  To help with treatment and further classification, the World Health Organization subdivided ovulatory disorders into 4 classes: Hypogonadotropic hypogonadal anovulation: Hypothalamic amenorrhea, Normogonadotropic normoestrogenic anovulation: Polycystic ovarian syndrome (PCOS), Hypergonadotropic hypoestrogenic anovulation: Premature ovarian failure, Hyperprolactinemic anovulation: Pituitary adenoma. […] The most common type of Normogonadotropic normoestrogenic anovulation is PCOS. […] PCOS accounts for 80% to 85% of all anovulatory patients and affects 8% of all reproductive-aged females. […] Infertility caused by PCOS is thought to be associated with a dysfunction in developing a mature follicle, leading to anovulation. […] The pathophysiology behind PCOS and infertility is not well understood; classically, abnormal pulsatility of GnRH is described as a possible underlying cause.

• #3 Pathophysiology of Female Reproduction and Clinical Management | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-031-11701-5_16

  Endometriosis decreases fertility due to anatomic distortion from pelvic adhesions, damage to ovarian tissue by endometrioma formation and surgical resection, and the production of substances such as cytokines and growth factors which impair the normal processes of ovulation, fertilization, and implantation.

• #4 Evaluation and Treatment of Infertility | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0301/p308.html

  Infertility is defined as the inability to achieve pregnancy after one year of regular, unprotected intercourse. […] Causes of infertility include male factors, ovulatory dysfunction, uterine abnormalities, tubal obstruction, peritoneal factors, or cervical factors. […] The etiology of female infertility can be broken down into ovulation disorders, uterine abnormalities, tubal obstruction, and peritoneal factors. Cervical factors are also thought to play a minor role, although they are rarely the sole cause. […] WHO categorizes ovulatory disorders into three groups: group I is caused by hypothalamic pituitary failure (10%), group II results from dysfunction of hypothalamic-pituitary-ovarian axis (85%), and group III is caused by ovarian failure (5%). […] Women with regular menstrual cycles are likely to be ovulating and should be offered serum progesterone testing at day 21 to confirm ovulation.

• #4 Female Infertility – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK556033/

  Correlating the high number of arrested follicles and polycystic-appearing ovaries is the elevation of the anti-Mullerian hormone (AMH). […] Hypergonadotropic hypoestrogenic anovulation is the category of premature ovarian insufficiency and ovarian resistance associated with females’ age. […] As mentioned before, a woman’s age affects fertility due to a well-studied phenomenon of a steady decline in the quality and quantity of the patients oocytes. […] The loss of the oocyte quality throughout a woman’s life is associated with meiotic nondisjunction, resulting in aneuploidy. […] This is thought to be related to accumulated damage throughout life and age-related changes in the granulosa cells. […] As women age, there is a significant increase in the number of meiotic nondisjunction events and corresponding aneuploid or chromosomally abnormal oocytes and embryos.

• #4 Evaluation and Treatment of Infertility | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0301/p308.html

  A high serum FSH level (greater than 30 to 40 mIU per mL [30 to 40 IU per L]) with a low estradiol level can distinguish ovarian failure from hypothalamic pituitary failure, which typically reveals a low or normal FSH level (less than 10 mIU per mL [10 IU per L]) and a low estradiol level. […] Women with no clear risk of tubal obstruction should be offered hysterosalpingography to screen for tubal occlusion and structural uterine abnormalities. […] Women with risk factors for tubal obstruction, such as endometriosis, previous pelvic infections, or ectopic pregnancy, should instead be offered hysteroscopy or laparoscopy with dye to assess for other pelvic pathology. […] Treatment of tubal obstruction generally requires referral for subspecialty care.

• #5 Female infertility | PPT

  https://www.slideshare.net/slideshow/female-infertility-142479256/142479256

  Luteal phase deficiency Luteinized unruptured follicle (LUF) syndrome. Hyperprolactinemia Occult infection. Immunological cause Psychological factors. […] The most common causes of female infertility are ovulatory and tubal factors, then endometriosis, the effect of age on female fertility is not a new concept, with the gradual decline in female fertility and an increase in the miscarriage rate being observed many years before the menopause. […] Anovulation is a frequent cause of infertility, -ve and +ve feedback mech allow the ovaries to interact successfully with hypothalamo-pituitary axis, causes can be divide into 3 main categories- 1 hypogonadotrophic hypogonadism, 2- normogonadotrophic anovulation and hypergonadotrophic hypogonadism. […] Polycystic ovary syndrome (PCOS) is a heterogenous group of disorders affecting 5-10% of women of reproductive age and is the most commonly encountered type of WHO Group II ovulation disorder. Common clinical features of PCOS include oligo- or amenorrhoea, anovulatory infertility, obesity and hyperandrogenism. Insulin resistance plays an important role in the pathogenesis of the disorder.

• #5 Female Infertility – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK556033/

  Primary ovarian insufficiency (POI) is defined as hypergonadotropic hypogonadism before the age of 40. […] This disease is characterized by a lack of folliculogenesis, a decrease in estrogen, loss of oocytes, and infertility. […] The most common cause of POI is Turner syndrome, monosomy of the sex chromosomes leading to a 45X karyotype. […] Prolactin causes suppression of hypothalamic GnRH secretion, leading to a low LH, resulting in anovulation, corresponding oligomenorrhea, or amenorrhea. […] Endometriosis is defined as endometrial tissue outside the uterine cavity. […] Endometriosis is known to cause infertility, but the pathophysiology is thought to change according to the stage. […] For stages I and II, infertility is believed to be associated with inflammation and increased production of prostaglandins and cytokines, macrophages, and natural killer cells.

• #6 Infertility in women Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/report/infertility-in-women

  Female infertility may be caused by an underlying medical condition that damages the fallopian tubes, interferes with ovulation, or causes hormonal complications. These medical conditions include: […] Most cases of female infertility are due to medical conditions that cause: Ovulation problems, Blocked fallopian tubes, Structural problems in the reproductive system, Problems with quality of cervical mucus or eggs. […] Problems that affect ovulation, and the hormones involved with ovulation, are the most common cause of female infertility. […] In PCOS, the ovaries produce excessive amounts of androgens (male hormones), particularly testosterone. Increased androgen production results in high levels of LH and low levels of FSH, so that follicles are prevented from producing a mature egg.

• #6 Female Infertility – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK556033/

  The inflammation impairs ovarian and tubal function, resulting in defective follicular formation, fertilization, and implantation. […] Stages III and IV are associated with pelvic adhesions or masses that distort pelvic anatomy; this inherently impairs tubal motility, oocyte release, and sperm motility. […] Pelvic and tubal adhesions, along with uterine and tubal abnormalities, account for a large portion of female infertility. […] Infectious processes within the abdomen are the leading cause of pelvic/tubal adhesions; the most common infectious process to affect infertility is pelvic inflammatory disease (PID). […] Hydrosalpinges, are a tubal abnormality caused by acute and chronic inflammation that damages the structural integrity of the fallopian. […] This damage leads to tubal obstruction, which blocks the distribution of physiologic fluid in the fallopian tube and results in fluid accumulation.

• #6 Infertility in women Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/report/infertility-in-women

  Premature ovarian failure, also called primary ovarian insufficiency, is when ovaries stop functioning normally before age 40. […] A blocked fallopian tube can prevent sperm from reaching and fertilizing the egg. […] Endometriosis is a condition in which cells that line the uterus grow in areas outside of the uterus. […] Structural problems in a women’s reproductive system may be caused by: Congenital Conditions, Uterine Fibroids, Adenomyosis. […] Low amounts of cervical mucus or poor quality cervical mucus can contribute to infertility by interfering with the sperm’s ability to reach and fertilize the egg. […] Ovarian reserve refers to the quality and quantity of a woman’s eggs. As a woman ages, the number and quality of her eggs diminish.

• #7 Common and Uncommon Causes of Infertility | Shady Grove Fertility

  https://www.shadygrovefertility.com/article/common-and-uncommon-causes-infertility/

  The womans body produces too much of some hormones and not enough of others. Women who are diagnosed with PCOS usually have low levels of follicle stimulating hormone (FSH), yet have high levels of luteinizing hormone (LH). FSH is the hormone thats responsible for stimulating the growth of follicles in the ovaries that contain maturing eggs. If a woman lacks FSH for a long time, her follicles will not mature and release their eggs, resulting in infertility. […] Another 10% of ovulatory dysfunction is caused by Hypothalamic Amenorrhea. Hypothalamic Amenorrhea is a condition in which ovulation stops due to a problem involving the hypothalamus. The hypothalamus is an area of the brain that produces hormones that control many bodily functions. Its function can be impaired by stress, being underweight or too much exercise.

• #7 Female Infertility – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK556033/

  The belief is that hydrosalpinges impair fertility through the retrograde flow of toxins and prostaglandins into the endometrium, creating a hostile environment for implantation by impairing endometrial receptivity. […] Uterine causes of infertility are associated with either space-occupying lesions or reduced endometrial receptivity. […] Congenital uterine abnormalities (CUA), although rare, are also associated with infertility. […] The most important aspect of fibroids is the location. […] Fibroids that impinge on the endometrium and distort the uterine cavity result in impaired implantation and increased miscarriage rates.

• #8 Infertility: Frequently Asked Questions | Reproductive Health | CDC

  https://www.cdc.gov/reproductive-health/infertility-faq/index.html

  Functional hypothalamic amenorrhea (FHA) is a condition that can affect ovarian function. […] Primary ovarian insufficiency (POI) is sometimes referred to as premature menopause. It occurs when a woman’s ovaries fail before age 40. […] Risk factors for fallopian tube obstruction include: History of pelvic infection, Ruptured appendix, Gonorrhea, Chlamydia, Endometriosis, Prior abdominal surgery. […] Problems that affect the physical characteristics of the uterus include: Intrauterine adhesions, Endometrial polyps, Adenomyosis, Congenital anomalies of the uterus, Fibroids. […] Female fertility is known to decline with: Age. Fertility declines with age primarily because egg quality declines over time.

• #9 Female Infertility | Article | GLOWM

  https://www.glowm.com/article/heading/vol-15–reproductive-medicine-for-the-obstetrician-and-gynecologist–female-infertility/id/421073

  Aging in female mammals is associated with reduced oocyte quantities in the ovary, reduced quality of the oocytes and higher chances of chromosomal anomalies. […] Considering reproductive aging is an aspect of overall aging, it has been propounded that the passing of time leads to the inability of the body to repair damage at the genetic level, thus accounting for the decline in the quality of oocytes as well as increased risk for chromosomal anomalies. […] Female fertility declines with age. The ovary contains a finite number of eggs, which decreases exponentially with age. […] The decline in ovarian reserve becomes more pronounced and accelerated, especially in the late 30s and early 40s. […] Poor ovarian response is associated with increased female age, a significant decline in the quality and quantity of oocytes in the ovary, and a reduced chance of spontaneous pregnancy or following IVF.

• #9 Female Infertility | Article | GLOWM

  https://www.glowm.com/article/heading/vol-15–reproductive-medicine-for-the-obstetrician-and-gynecologist–female-infertility/id/421073

  Ovarian reserve tests predict ovarian reserve reproductive potential and ovarian response to control ovarian stimulation COS. […] The lower the ovarian reserve, the lower the likelihood of achieving pregnancy spontaneously or with ART stimulation. […] Anti-Mullerian hormone belongs to the TGF- superfamily. […] It is secreted by the granulosa cells of the primary, preantral, and early antral follicles in contrast to inhibin B, which is secreted by the granulosa cells of the preantral follicles. […] Inhibin B is a heterodimeric glycoprotein released by the granulosa cells of the growing antral follicular pool responsive to FSH. […] The role of laparoscopy in assessing female infertility extends beyond tubal patency evaluation. It offers direct visualization of pelvic anatomy, enabling the diagnosis of conditions like peritubal adhesions and endometriosis, which may persist despite normal findings on HSG.

• #10 Female infertility – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/female-infertility/symptoms-causes/syc-20354308

  Endometriosis occurs when tissue that typically grows in the uterus implants and grows in other places. This extra tissue growth and the surgical removal of it can cause scarring, which can block fallopian tubes and keep an egg and sperm from uniting. […] Endometriosis can also disrupt implantation of the fertilized egg. The condition also seems to affect fertility in less-direct ways, such as damage to the sperm or egg. […] Several uterine or cervical causes can interfere with the egg implanting or increase the risk of miscarriage. […] In some cases, the cause of infertility is never found. A combination of several minor factors in both partners could cause unexplained fertility problems. […] The quality and quantity of a woman’s eggs begin to decline with age. In the mid-30s, the rate of follicle loss speeds, resulting in fewer and poorer quality eggs. This makes conception more difficult, and increases the risk of miscarriage. […] Being overweight or significantly underweight may affect ovulation. Getting to a healthy body mass index (BMI) might increase the frequency of ovulation and likelihood of pregnancy.

• #11 Female Infertility | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/23502

  Endometriosis is defined as endometrial tissue outside the uterine cavity. The diagnosis is based on the histological identification of endometrial glands or stroma outside the uterus. Endometriosis is most commonly found in the pelvis but can spread throughout the entire abdomen and affects 10% to 15% of reproductive-age women. Of women with endometriosis, 40% to 50% experience infertility. […] Pelvic and tubal adhesions, along with uterine and tubal abnormalities, account for a large portion of female infertility. Infectious processes within the abdomen are the leading cause of pelvic/tubal adhesions; the most common infectious process to affect infertility is pelvic inflammatory disease (PID). […] Uterine causes of infertility are associated with either space-occupying lesions or reduced endometrial receptivity. In regards to uterine leiomyomas (fibroids), 1 meta-analysis demonstrated that only submucosal or intracavitary fibroids impaired implantation and pregnancy rates compared to other infertile controls.

• #12 Infertility From Structural Causes | New Jersey Fertility ClinicInfertility From Structural Causes | New Jersey Fertility Clinic

  https://fertilitynj.com/infertility/female-infertility/structural-causes/

  A common cause of female infertility is a blockage of the fallopian tubes. A blockage of one or both tubes can prevent sperm from meeting and fertilizing an egg. […] Fallopian blockage may result from several possible causes: Hydrosalpinx, when a fallopian tube fills with fluid. […] Tubal scarring or adhesions from salpingitis, a previously undetected or untreated infection of the tubes, including infection from sexual transmissions. […] Endometriosis lesions within the uterine lining. […] In addition to preventing conception, blocked fallopian tubes can cause ectopic pregnancy, in which a fertilized egg is unable to move to the uterus for implantation and starts to grow within the tiny fallopian tube, ovary or abdominal cavity. […] Hydrosalpinx can create or worsen infertility, either by preventing ovulated eggs from meeting with sperm or by affecting embryos in the uterus. […] An abnormally shaped or positioned uterus is not likely to prevent fertilization but can interfere with uterine implantation or the ability to carry a pregnancy to term.

• #13 Causes of Female Infertility – Age – PCOS – Smoking

  https://www.dallasfertility.com/causes-of-female-infertility.html

  Hyperprolactinemia that cause the pituitary to release too much prolactin, a hormone that affects estrogen levels. […] Primary ovarian insufficiency in which menopause occurs before the age of 40. […] Endometriosis, a condition where endometrial tissue (the uterine lining) grows outside the uterus causing heavy and painful periods and is a culprit of recurrent miscarriage. […] Uterine Fibroids which are benign or non-cancerous growths of tissue in the muscular layer of the uterus that makes it difficult for an embryo to implant and grow. […] Uterine septum is a result of a congenital malformation, or uterine birth defect, in women where the uterine cavity is divided by a wedge-like partition of tissue. This condition is associated with a higher risk for miscarriage. […] Diseases of the Fallopian Tubes like pelvic inflammatory disease and endometriosis can cause the tube to be blocked or swollen, interfering with the tubes ability to transport a fertilized egg to the uterus.

• #14 Infertility pathophysiology – wikidoc

  https://www.wikidoc.org/index.php/Infertility_pathophysiology

  Disorders of ovulation make up at least 25% of the cases of infertility worldwide, according to a study done by WHO. Other pathologies such as genital tract infections, pelvic inflammatory disease, endometriosis make up the bulk of female infertility cases. […] A fertilized egg or embryo does not survive once it sticks to the lining of the womb (uterus). […] The fertilized egg does not attach to the lining of the uterus […] The eggs cannot move from the ovaries to the womb […] The ovaries have problems producing egg […] Hormonal imbalance such as hyperprolactinemia, hypothyroidism, diabetes mellitus, PCOS which interfere with fertility.

• #15 What Causes Female Infertility?

  http://web.stanford.edu/class/siw198q/websites/reprotech/New%20Ways%20of%20Making%20Babies/Causefem.htm

  The affected ovary often becomes surrounded with a smooth white capsule and is double its normal size. […] The increased level of oestrogen raises the risk of breast cancer. […] The hypothalamus is the portion of the brain responsible for sending signals to the pituitary gland, which, in turn, sends hormonal stimuli to the ovaries in the form of FSH and LH to initiate egg maturation. […] If the hypothalamus fails to trigger and control this process, immature eggs will result. […] This is the cause of ovarian failure in 20% of cases. […] The pituitary’s responsibility lies in producing and secreting FSH and LH. […] The ovaries will be unable to ovulate properly if either too much or too little of these substances is produced. […] This can occur due to physical injury, a tumor or if there is a chemical imbalance in the pituitary.

• #16 Research progress of ferroptosis in female infertility | Journal of Ovarian Research | Full Text

  https://ovarianresearch.biomedcentral.com/articles/10.1186/s13048-024-01508-y

  Ferroptosis is a novel type of programmed cell death dependent on iron and characterized by the accumulation of lipid peroxides in cells and is closely related to various diseases. […] With further investigation into the pathogenesis of infertility, a growing number of studies have demonstrated the close connections between infertility and ferroptosis. […] Iron overload increases the resistance to ferroptosis, and ferroptosis in some cells accelerates endometrial lesion growth. Moreover, iron overload may be hazardous to oocytes. […] As the pathogenesis of female infertility is being explored by more and more studies, it has been reported that programmed cell death (PCD) plays a key role in human reproduction. […] Ferroptosis is distinct from other forms of programmed cell death. Specifically, the former is dependent on intracellular irons, and nuclei in cells conserve their structural integrity.

• #16 Research progress of ferroptosis in female infertility | Journal of Ovarian Research | Full Text

  https://ovarianresearch.biomedcentral.com/articles/10.1186/s13048-024-01508-y

  The relationship between ferroptosis and female infertility has aroused academic interest. […] The mechanism of ferroptosis is illustrated in Fig. 1. […] Endometrial cells were harvested from patients with endometriosis-associated infertility and examined in some studies. However, it was found that estrogen did not inhibit reactive oxygen species(ROS). Iron overload in endometrial-like tissues outside the uterus finally resulted in a much higher ROS level than in normal in-situ endometrial tissues. […] Prolonged iron overload promotes sustained development of endometriosis, PCOS, and ectopic endometrial lesions, which may directly affect oocyte and embryonic development. […] Iron overload in the peritoneal fluid in infertile patients promotes the downregulation of GPX4 and hence induces lipid peroxidation, directly damaging embryo sac formation.

• #17 Research progress of ferroptosis in female infertility | Journal of Ovarian Research | Full Text

  https://ovarianresearch.biomedcentral.com/articles/10.1186/s13048-024-01508-y

  Ferroptosis and endometriosis show a bi-directional interaction. […] Numerous studies have indicated that ferroptosis in the uterus and placenta is closely related to PCOS. […] Several proteins related to ferroptosis, including acyl-CoA synthetase long-chain family member 4 (Acsl4), transferrin receptor (Tfrc), SLC7A11 (solute carrier family 7 member 1), and GCLC, were abnormally expressed. […] Ferroptosis is featured by iron-dependent ROS generation and accumulation of lipid peroxides and has close connections with placental dysfunction and trophoblastic damage. […] The pathogenesis of POI is complex and multifactorial and may be caused by defects in primordial follicle formation, follicle recruitment/distribution, follicle growth and development. […] Recent studies have shown that accelerated follicular atresia is one of the major pathogenic factors.

• #18 Research progress of ferroptosis in female infertility | Journal of Ovarian Research | Full Text

  https://ovarianresearch.biomedcentral.com/articles/10.1186/s13048-024-01508-y

  It has been shown that iron accumulation occurs in the early stage of follicular atresia, exhibiting abnormal GSH metabolism. […] The treatment of human umbilical cord mesenchymal stem cell-derived exosomes (hUMSC-Exos) reduced the ROS production, free iron ions and lipid peroxidation levels of granulosa cells. […] In conclusion, in the field of infertility treatment, cellular ferroptosis and its mechanism in infertility need to be studied systematically and in depth, with a view to providing a reference basis for the treatment of infertility-related diseases.

• #19 Female Infertility: Causes, Treatments and Nutrients – Life Extension

  https://www.lifeextension.com/protocols/female-reproductive/female-infertility?srsltid=AfmBOopSutrYKhpuJaIngQxzY1HLgqUBIfkShp0E4UtaiPlsWP0Gjj5w

  The causes of fertility problems in women can be categorized as ovulation dysfunction, tubal infertility, uterine and cervical issues, and diminished ovarian reserve. Ovulation disorders are caused by hormonal imbalance and account for approximately 25% of infertility cases, and may be caused by one or more of the following: Certain genetic mutations, particularly those affecting the X chromosome, can be an underlying cause of premature ovarian insufficiency, a condition in which menstrual cycles become irregular or cease and FSH levels are persistently high before the age of 40 years. Polycystic ovary syndrome (PCOS), a condition characterized by excess androgen production, ovarian structural and functional abnormalities, and metabolic disturbance, is a common hormonal cause of infertility. Endometriosis is the presence of endometrial tissue outside of the uterine cavity in any region of the pelvis or abdomen. Approximately 10-15% of reproductive-aged women have endometriosis and an estimated 30-50% of these women will experience infertility. Any type of fallopian tube abnormality can contribute to female infertility. Problems affecting the uterine cavity can interfere with implantation, leading to infertility. They also increase the risk of poor pregnancy outcomes, such as miscarriage and pre-term birth.

• #19 Female Infertility: Causes, Treatments and Nutrients – Life Extension

  https://www.lifeextension.com/protocols/female-reproductive/female-infertility?srsltid=AfmBOopSutrYKhpuJaIngQxzY1HLgqUBIfkShp0E4UtaiPlsWP0Gjj5w

  The number and quality of oocytes and follicles present in the ovaries diminish throughout a woman’s life, resulting in declining fertility. In addition to aging, ovarian reserve may be decreased due to ovarian surgery, chemotherapy, radiation therapy, and certain genetic factors. Age-related changes in cellular function, known as senescence, appear to be an important aspect of the connection between aging and decreased fertility. Ovarian senescence leads to decreased oocyte numbers and quality, and eventually to menopause. A number of overlapping genetic and environmental factors are believed to contribute to ovarian senescence, including oxidative stress, inflammation, mitochondrial and protein dysfunction, DNA damage, telomere shortening, and advanced glycation end products. […] Nutrients with free radical scavenging, anti-inflammatory, and mitochondrial supportive effects have the potential to slow ovarian senescence and the loss of ovarian reserve with aging. Vitamins E, C, and N-acetylcysteine are examples of well-known oxidative stress-reducing and anti-inflammatory nutrients that may potentially enhance fertility.

• #20

  https://link.springer.com/article/10.1007/s11033-023-08583-2

  According to the World Health Organization, infertility is a public health problem that affects around 48 million couples and 186 million individuals worldwide. Endocrine disruptors are one of the causes that raise more concern, given that it is a problem that has evolved with the progress of society. […] Endocrine disruptors have the capacity of interfering with the normal hormonal action, metabolism, and biosynthesis, which can lead to a variation of the normal hormonal homeostasis. Some of these endocrine disruptors are highly associated with diseases that are positively correlated with female infertility, such as polycystic ovary syndrome, endometriosis, irregular menstrual cycle and also disturbances on processes as steroidogenesis and development of the ovarian follicles. […] The present literature review covers various aspects of the possible relationship between endocrine disruptors and female infertility.

• #21 Pituitary P62 deficiency leads to female infertility by impairing luteinizing hormone production | Experimental & Molecular Medicine

  https://www.nature.com/articles/s12276-021-00661-4

  P62 deficiency led to female infertility at a young age through damaged luteinizing hormone (LH) synthesis and secretion in pituitary gonadotropin cells. […] P62 modulates LH via the mitochondrial oxidative phosphorylation (OXPHOS) signaling pathway, especially its complex I component Ndufa2, along with subsequent oxygen consumption. […] Our data demonstrate that p62 positively modulates pituitary LH in the regulation of female reproduction. […] P62 deficiency impaired LH production via mitochondrial OXPHOS signaling and led to female infertility, thus providing the GnRH-p62-OXPHOS(Ndufa2)-Ca2+/ATP-LH pathway in gonadotropic cells as a new theoretical basis for investigating female reproductive dysfunction. […] These results indicated that p62 deficiency might lead to female reproductive dysfunction, which was not secondary to obesity.

• #21 Pituitary P62 deficiency leads to female infertility by impairing luteinizing hormone production | Experimental & Molecular Medicine

  https://www.nature.com/articles/s12276-021-00661-4

  These data suggested that p62 deficiency might lead to female infertility at a young age. […] These results indicated that p62 regulated pituitary gonadotropic LH production, which might be the dominant aspect influencing female reproductive function. […] P62 loss damaged NADH dehydrogenase (mitochondrial complex I). […] Our results were consistent with these notions, since LH production was dependent on ATP and calcium, regardless of GnRH stimulation or p62 expression. […] In conclusion, p62-OXPHOS (Ndufa2)-ATP/Ca2+-LH signaling might be a basic signaling pathway in pituitary gonadotropin cells.

• #22 Infertility in Women | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/infertility-in-women

  Maternal age is the most significant factor related to a woman’s ability to conceive. […] The likelihood for successful pregnancy begins to decrease in women in their early 30s. […] Other factors, such as endometriosis and uterine fibroids can also play a role in infertility, though many women with these conditions conceive healthy children without trouble. […] Treatment for female infertility depends on the underlying condition. […] A woman’s age is probably the most significant factor related to her ability to conceive. In addition to age, there are a number of conditions that can interfere with a woman’s fertility, including endometriosis, polycystic ovarian syndrome, pituitary tumors and pelvic inflammatory disease. […] Endometriosis occurs when tissue from the membrane lining the uterus, called the endometrium, grows outside the uterus.

• #23 Female infertility as a result of stress-related hormonal changes – GREM – Gynecological and Reproductive Endocrinology & Metabolism

  https://gremjournal.com/journal/0203-2022/female-infertility-as-a-result-of-stress-related-hormonal-changes/

  Female infertility as a result of stress-related hormonal changes […] Contemporary civilization provides a number of stress factors, and exposure to these factors disrupts the functioning of many systems of the human body. […] Chronic stress that breaks homeostatic mechanisms, may lead to many changes, including the hormonal ones, responsible for fertility problems. […] Stress-related hormonal changes may negatively affect the mechanisms ensuring successful female reproduction. […] Hormonal responses observed during chronic stress due to permanent activation of the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system, may lead to different disfunctions, especially when homeostatic mechanisms are broken. […] High levels of circulating stress hormones can interfere with the timing of ovulation and shorten the luteal phase. […] Additionally, the changed levels of hormones observed during stress could directly influence the quality of egg cells, thickness of the endometrial layer or other structures engaged in the reproductive process.

• #24 Female infertility as a result of stress-related hormonal changes – GREM – Gynecological and Reproductive Endocrinology & Metabolism

  https://gremjournal.com/journal/0203-2022/female-infertility-as-a-result-of-stress-related-hormonal-changes/

  The involvement of chronic stress in the pathogenesis of a variety of diseases has been well documented. […] It may also negatively affect the mechanisms assuring successful female reproduction such as ovulation, ovarian steroidogenesis, endometrial development, follicular maturation or implantation.

• #25 Female infertility – Wikipedia

  https://en.wikipedia.org/wiki/Female_infertility

  Tobacco smoking is harmful to the ovaries, and the degree of damage is dependent upon the amount and length of time a woman smokes or is exposed to a smoke-filled environment. Nicotine and other harmful chemicals in cigarettes interfere with the body’s ability to create estrogen, a hormone that regulates folliculogenesis and ovulation. […] Smoking reduces the chances of IVF producing a live birth by 34% and increases the risk of an IVF pregnancy miscarrying by 30%. […] Sexually transmitted infections are a leading cause of infertility. They often display few, if any visible symptoms, with the risk of failing to seek proper treatment in time to prevent decreased fertility. […] Twelve percent of all infertility cases are a result of a woman either being underweight or overweight. […] A review from 2010 concluded that overweight and obese subfertile women have a reduced probability of successful fertility treatment and their pregnancies are associated with more complications and higher costs.

• #26 Female Infertility | Reproductive Science Center of New JerseyFemale Infertility | Reproductive Science Center of New Jersey

  https://fertilitynj.com/infertility/female-infertility/

  It is important for hopeful parents to practice a healthy lifestyle while trying to conceive. […] When it comes to female fertility, a woman’s weight can greatly impact her hormone production. […] Being significantly overweight or underweight can inhibit normal ovulation. […] Women who are obese can have a harder time getting pregnant and can take longer to achieve pregnancy than a woman of normal weight. […] Conditions caused by food intake, including celiac disease (gluten sensitivity), can also affect a woman’s fertility. […] Effects of STDs, specifically chlamydia and gonorrhea, can lead to infertility in women. […] In addition to other health concerns, smoking ages a woman’s ovaries and depletes her eggs prematurely. […] An increase in ovulation disorders is associated with heavy drinking. […] Excessive physical activity can inhibit ovulation and reduce production of progesterone, which are essential in becoming pregnant. […] Exposure to toxins can affect hormones and the health of a woman’s eggs.

• #27 Infections as a Cause of Infertility | GLOWM

  https://www.glowm.com/section-view/heading/Infections%20as%20a%20Cause%20of%20Infertility/item/327

  Approximately 35% of women with an infertility problem are afflicted with postinflammatory changes of the oviduct or surrounding peritoneum that interfere with tuboovarian function. […] Most of these alterations result from infection. […] Infection is also a major factor in male infertility, second only to oligospermia. […] The best hope for reducing the incidence of infertility related to infection lies in prevention and early detection and treatment of newly acquired asymptomatic or mildly symptomatic infections. […] Despite the current focus on sexually transmitted diseases (STDs), infertility may also follow bloodborne infections such as tuberculosis, mixed aerobic and anaerobic infections of other pelvic sites, inflammatory complications of surgical trauma, postabortal and puerperal sepsis, and appendiceal rupture.

• #28 Infections as a Cause of Infertility | GLOWM

  https://www.glowm.com/section-view/heading/Infections%20as%20a%20Cause%20of%20Infertility/item/327

  The pathways of spread of genital tract infections are shown in Figure 2. In gonococcal and chlamydial salpingitis, the microorganisms ascend by surface extension from the lower genital tract through the cervical canal by way of the endometrium to the fallopian tubes. […] The sequelae of PID that are responsible for infertility include chronic interstitial salpingitis, hydrosalpinx, salpingitis isthmica nodosa, and periadnexal adhesions. […] Early recognition and proper treatment of upper genital tract infection are mandatory to prevent permanent damage to the female reproductive tract and subsequent infertility. […] After C. trachomatis or another pathogen ascends to the fallopian tubes and establishes a persistent infection, infertility can be induced by at least two mechanisms: fallopian tube occlusion and immune rejection of the embryo. […] The role of genital mycoplasmas in infertility is unresolved. […] The higher frequency of antibodies to M. hominis in infertile women with a history of pelvic infection than in other women suggests that this organism may contribute to tubal pathology.

• #29 Molecular Mechanism of Resveratrol and Its Therapeutic Potential on Female Infertility

  https://www.mdpi.com/1422-0067/25/7/3613

  Resveratrol is a polyphenol present in various plant sources. Studies have reported numerous potential health benefits of resveratrol, exhibiting anti-aging, anti-inflammatory, anti-microbial, and anti-carcinogenic activity. Due to the reported effects, resveratrol is also being tested in reproductive disorders, including female infertility. Numerous cellular, animal, and even human studies were performed with a focus on the effect of resveratrol on female infertility. In this review, we reviewed some of its molecular mechanisms of action and summarized animal and human studies regarding resveratrol and female infertility, with a focus on age-related infertility, polycystic ovary syndrome, and endometriosis. […] Infertility is a global healthcare problem, affecting around 8–12% of couples. It is estimated that the female factor contributes to around 50% of couples’ infertility and can be classified as primary (no previously achieved pregnancy) or secondary (previously achieved pregnancies) infertility. The leading cause of female infertility was reported to be due to polycystic ovarian syndrome (PCOS). Other causes include endometriosis, tubal obstruction due to sexually transmitted infections, uterine fibroids, and endocrine and uterine anatomical abnormalities. However, in 10–17% of females, no cause is identified (idiopathic infertility). Despite that, some studies have reported that idiopathic infertility could be a consequence of imbalanced adaptive immunity or genetic abnormalities.

• #30 Molecular Mechanism of Resveratrol and Its Therapeutic Potential on Female Infertility

  https://www.mdpi.com/1422-0067/25/7/3613

  The role of COX-2 is, however, not only limited to inflammation processes. In terms of reproduction, it was shown that mice deficient in COX-2 were infertile, displaying ovulation, fertilization, and implantation abnormalities. […] Resveratrol has been observed to mediate an inhibitory effect on the TNF-induced activation of NF-κappaB, activator protein-1 (AP-1), and caspase-induced apoptosis. The generation of reactive oxygen intermediates and lipid peroxidation influenced by it was therefore suppressed in myeloid, lymphoid, and epithelial cells, as was the expression of matrix metalloproteinase expression (MMP-9) in smooth muscle cells. […] Resveratrol has also been observed to improve ovarian function in infertile women, as lower concentrations of resveratrol (1 μM and 10 μM) decreased the apoptosis of human granulosa cells. This was confirmed on the molecular level as Bcl-2 was increased and transforming growth factor-β (TGF-β), Bax, and caspase 9 were decreased upon resveratrol treatment.

• #31 Female Infertility: Causes, Treatments and Nutrients – Life Extension

  https://www.lifeextension.com/protocols/female-reproductive/female-infertility?srsltid=AfmBOopSutrYKhpuJaIngQxzY1HLgqUBIfkShp0E4UtaiPlsWP0Gjj5w

  The importance of the vaginal microbiome has long been recognized, and more recent evidence indicates the upper reproductive tract, including the uterus, fallopian tubes, and ovaries, also harbors a microbial ecosystem with a critical role in gynecologic health and fertility. Imbalance, or dysbiosis, of the female reproductive microbiome has been implicated in conditions that can contribute to infertility and poor pregnancy outcomes, such as bacterial vaginosis, sexually transmitted infections, pelvic inflammatory disease, endometriosis, and gynecologic cancers. […] Mesenchymal stem cells (MSCs) are cells that have the ability to give rise to many types of cells, given the appropriate conditions. Emerging research suggests MSCs may be able to restore fertility to women with ovarian dysfunction, possibly by supporting the growth of immature ovarian follicles or generating new follicles. Early human clinical trials have yielded promising findings. In an uncontrolled trial, nine women with premature ovarian failure had MSCs derived from their own adipose tissue transplanted into their ovaries and were monitored for one year. Some participants experienced sporadic or short-term resumption of menstrual cycles and reduction in FSH levels.

• #32 Azthena logo with the word Azthena

  https://www.news-medical.net/news/20240918/Newly-discovered-mechanism-could-revolutionize-infertility-care-by-promoting-embryo-implantation.aspx

  A team from Kumamoto University has uncovered a new mechanism that could revolutionize infertility care by promoting embryo implantation. The discovery focuses on prostaglandin (PG) receptors in the uterus that enhance the critical process of decidualization, which is necessary for a successful pregnancy. […] A research team led by Professor Yukihiko Sugimoto and Assistant Professor Tomoaki Inazumi found that two types of prostaglandins – PGD2 and PGE2 – produced in the uterus during the early stages of pregnancy, activate specific receptors, DP and EP4, to promote the formation of the decidual tissue that supports embryo implantation. […] This groundbreaking discovery suggests that boosting these pathways with specialized drugs, called DP/EP4 agonists, could help women struggling with infertility due to implantation issues. […] This novel understanding of how prostaglandin receptors aid in implantation paves the way for innovative infertility therapies, potentially transforming reproductive medicine by improving the chances of pregnancy for many individuals.

• #33 Infertility – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/infertility/symptoms-causes/syc-20354317

  Causes of female infertility can include: […] Ovulation disorders. These conditions affect the release of eggs from the ovaries. They include hormonal problems such as polycystic ovary syndrome. High levels of a hormone needed to make breast milk, called prolactin, also may have an effect on ovulation. Either too much thyroid hormone, called hyperthyroidism, or too little, called hypothyroidism, can affect the menstrual cycle or cause infertility. Other underlying causes may include too much exercise, eating disorders or tumors. […] Conditions of the uterus. These include growths called uterine polyps, issues with the shape of the uterus or problems with its lower end, called the cervix. Tumors in the wall of the uterus, called uterine fibroids, also may cause infertility but they aren’t cancer. Fibroids can block the fallopian tubes, where an egg and sperm unite. They also can stop a fertilized egg from attaching to the uterus, which needs to happen for an unborn baby to develop.

• #33 Infertility – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/infertility/symptoms-causes/syc-20354317

  Fallopian tube damage or blockage. Often, these issues are caused by swelling of the fallopian tube, called salpingitis. The swelling can happen due to an infection of the female reproductive organs called pelvic inflammatory disease. […] Endometriosis. With this condition, tissue that’s similar to the inner lining of the uterus grows outside of the uterus. It may affect how well the ovaries, uterus and fallopian tubes work. […] Primary ovarian insufficiency. This happens when the ovaries stop working as they should, and menstrual periods end before age 40. The cause is often unknown. But some factors linked with primary ovarian insufficiency include immune system diseases, genetic conditions such as Turner syndrome, and radiation or chemotherapy treatment. […] Pelvic adhesions. These are bands of scar tissue that bind organs. They can form after a pelvic infection, appendicitis, endometriosis, or surgery of the abdomen or pelvis. […] Cancer and its treatment. Certain cancers especially ones that affect the reproductive organs often reduce female fertility. Both radiation and chemotherapy may affect fertility as well.

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