infertilidade
Causas de infertilidade feminina
The study of women involves, firstly, a medical history and a physical examination, with special emphasis on the gynecological component. In addition to the problem of infertility, situations that could compromise a future pregnancy can also be anticipated.
Fator ovulatório
Ovulation problems constitute the most common cause of female infertility, through various pathologies responsible for irregular menstrual cycles and anovulation. At the same time, they are also the cause in which the probability of therapeutic success is greatest.
• Polycystic ovarian syndrome (PCOS);
• Hyperprolactinemia (high levels of prolactin);
• Hypothalamic amenorrhea;
• Thyroid pathologies;
• Premature ovarian failure;
• Congenital or acquired absence of ovaries.
Fator tubário
Tubal problems are also a common cause of infertility:
• Pelvic inflammatory disease: can lead to the appearance of scars or pelvic adhesions that cause obstructions. One of the biggest causes is STIs, more specifically chlamydia and gonorrhea;
• Previous pelvic surgeries (appendectomy, tubal, abdominal or others);
• Previous ectopic pregnancy, history of repeated miscarriages or voluntary termination of pregnancy (IVG);
• Endometriosis: can cause scarring, adhesions or, in more serious cases, obstruction of the tubes.
The effects of these injuries can vary between the inability to capture the oocyte (due to damage to the fimbriae) and the inability of the sperm and oocyte to meet.
Fator uterino
Dysfunctions at the uterine level mostly lead to difficulties in implanting the embryo and maintaining the pregnancy, and may be associated with recurrent and spontaneous miscarriage.
Uterine anomalies include:
• Submucosal fibroids, endometrial polyps, intrauterine adhesions and synechiae, endometritis and congenital uterine anomalies.
Endometriose
Endometriosis is an extremely common benign disease in which cells similar to those lining the inside of the uterus develop in other locations. The most common areas are the pelvis, ovaries and tubes. Like endometrial cells, they also shed during menstruation, but as they have nowhere to escape, they end up causing adhesions and the formation of cysts.
Around 4 to 8% of infertility cases are due to endometriosis, however, the majority of women with this disease have no problems getting pregnant.
Although its existence may be suspected, diagnosis requires laparoscopy.
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