Endometriosis
In some women, the cells of the uterine lining that shed during the menstrual period can be found in other parts of the body such as the uterine wall, the ovary, and on the surface of the organs in the stomach. This condition is called endometriosis. Endometriosis tissue can cause pain and difficulties getting pregnant. Sometimes endometriosis doesn’t have obvious symptoms but can still adversely affect your fertility. About 10 % of women of their reproductive age have endometriosis.
The most prominent and common symptom of endometriosis is severe menstrual pain that lasts several days and occurs every cycle. Symptoms can also occur at other stages of the cycle. Menstrual pain that prevents you from going to school or work is not a normal part of life. So if you have pain this severe, you should see a doctor. Endometriosis can cause difficulties getting pregnant.
PCOS (polycystic ovary syndrome)
In PCOS, the ovaries contain more follicles that are visible by ultrasound. Women and girls with PCOS might have ovulation problems and other issues such as too much weight gain, acne, and excess hair growth. They might also have problems getting pregnant and have a higher risk for diabetes and high blood pressure. This however is different in each woman with PCOS. This condition affects about 8-13 % of women of their reproductive age.
Ovulation problems
Sometimes the ovaries do not release eggs regularly, or the eggs are not of good quality. While it is normal not to ovulate every now and then, this can become a problem if a lack of ovulation occurs frequently, causing the cycles to become too long or too short or irregular. Sometimes, in more difficult cases, the periods can stop altogether. When there is no ovulation, the woman cannot get pregnant without medical help.
Fallopian tube problems
Some infections and sexually-transmitted diseases, such as chlamydia, damage the inner layers of the fallopian tubes. This might lead to several negative consequences. Either the sperm can not meet the egg preventing fertilisation or – if it occurs – the fertilised egg might get stuck in damaged tubes resulting in ectopic pregnancies. This can be life-threatening by bursting and catastrophic bleeding! Smoking also changes the way the fallopian tubes function and could lead to extrauterine pregnancies.
Uterine problems
The most common uterine problems are fibroids (also called myomas) and polyps. Fibroids are made of muscle cells that form balls in the wall of the uterus. Polyps are tongue-like growths on the inside of the uterus. Both fibroids and uterine polyps can cause heavy periods or spotting, and pain, and can sometimes make it harder to get pregnant.
In rare cases, the irregularities in the uterus such as a wall that divides it in two halves, or a missing right or left part can lead to fertility problems. In yet rarer cases, the uterus or a fallopian tube can be missing altogether.
Other diseases
Treatments of some diseases such as cancer can affect the way the ovaries and the uterus function. In some cases, these effects stop after the end of treatment but in some cases, the changes cannot be reversed.
It is important to remember that while we know a lot about our bodies and about infertility, sometimes, doctors cannot find the cause of infertility.