FACTORS AFFECTING FERTILITY: MEDICAL PROBLEMS

Apr 23 2009

FACTORS AFFECTING FERTILITY: MEDICAL PROBLEMS

There are a number of medical conditions that can affect fertility. Some are directly linked to the reproductive process, such as blocked fallopian tubes. Some, like coeliac disease, are not obviously linked. However, many of these conditions can be treated. And, by improving your general health and fitness, you can do a great deal to help overcome these problems and regain your fertility.

Blocked Fallopian Tubes

The fallopian tubes are the route between the ovaries and the womb. The sperm swim along these tubes in order to reach the egg. The fallopian tube also provides a home for the fertilised egg for the first seven days of life, before it gets to the womb where it will implant itself. If the tubes are blocked then this is a major problem and medical intervention is needed.

Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is the main reason why some women stop ovulating. In its most extreme form, it can be a very distressing condition. Women affected by PCOS will tend to be overweight, prone to acne, menstruate seldom or not at all, grow unsightly body hair (often on the face, breasts and inside of the legs), and be susceptible to mood swings.

Fibroids

Fibroids are non-cancerous growths which grow in or on the wall of the womb. They are very common and many women never realize they have them, as they may not cause any symptoms. If they grow in a way that doesn’t exert pressure on neighboring organs, a woman can live with large fibroids for many years without needing medical help. They can, however, cause infertility and some fibroids can cause miscarriages. Fibroids can vary in number and size. If the fibroids grow significantly they can cause the uterus to enlarge and/or distort which makes it difficult for the embryo to implant properly. So you might conceive easily but miscarry unawares, at a very early stage, because the fertilised egg could not ‘hold on’ with the fibroid there. The size of a fibroid is usually compared to a foetus of that size (e.g. a 12-week fibroid) but some can be as small as a pea.

Endometriosis

Endometriosis is a condition where the lining of the womb (the endometrium) grows in places other than the womb. Sections of womb lining may grow in the fallopian tubes, ovaries, bowel and bladder. More uncommon places include the lung, heart, eye or knee. The womb lining, no matter where it is situated, then responds to the natural hormone cycle and will bleed when the period occurs. This can be extremely painful, especially in those sites where there is no natural escape route for the blood, and inflammation may occur. For instance, I have seen women who get a nose bleed during their period because the womb lining has migrated to the nasal passages and bleeds when they menstruate.

Endometriosis can affect female fertility because it can cause scarring and blockages inside the pelvic cavity, and it is thought that 50 per cent of women with endometriosis may have problems getting pregnant. It is more common in women over 30 who have not had children. So, as more women delay having children, the possibility of infertility being caused by endometriosis rises.

In some cases the endometriosis scars and obstructs the fallopian tubes so severely that the tubes cannot pick up the egg. And if the ovaries are scarred badly then ovulation may not occur. When the endometrial tissue implants on the ovary then cysts may form called ‘chocolate cysts’ because they are filled with dark, brown, old blood.

Coeliac Disease

This is a medical condition caused by intolerance to gluten which pre-vents food being absorbed properly. Symptoms can include foul-smelling greasy stools, weight loss, anaemia, bloating, fatigue, and signs of multiple vitamin and mineral deficiencies.

Unfortunately, coeliac disease can also cause fertility problems. A study in 1996 confirmed that women with coeliac disease were sub-fertile and had an increased risk of stillbirths and perinatal deaths.

Gluten is a major component of wheat; and other cereals, such as rye, barley and oats, can also be a problem. Rice and corn are fine. The gluten damages the villi, which are minute, hair-like projections lining the intestine, and this can stop the absorption of vital nutrients. The disorder is diagnosed by having a biopsy in which a sample of the small intestine is removed for examination.

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