Irregular or absent ovulation is the most common cause of female infertility.
This may be due to:
PCOS (the most common reason for irregular ovulation, explained in more detail below.)
Pituitary Gland Disorder
Signs of an ovulation disorder include a short or long menstrual cycle or history of irregular spotting. However, because menstruation may continue despite a lack of ovulation, many women do not realize they are not ovulating. Ovulation disorders are the most treatable form of infertility and ovulation can often be restored.
Endometriosis is a condition in which endometrial tissue, which makes up the uterine lining, is attached to tissues outside of the uterine cavity, typically inside the pelvis. These endometrial lesions build up and break down each month, just as the normal uterine lining does.
This often causes:
Severe menstrual pain
In severe cases, destruction of internal organs
Attaining pregnancy through infertility treatment often slows or reverses the progress of endometriosis, and sometimes minimally invasive surgery can improve a woman’s chances of becoming pregnant.
Polycystic Ovarian Syndrome
Polycystic Ovarian Syndrome, or PCOS, is the most common endocrine condition in women. Common problems with PCOS include excessive testosterone and insulin resistance. In turn, these abnormalities often effect reproduction, sexual function, metabolism, and even mood.
Common symptoms of PCOS often include:
Signs of excess testosterone including acne or abnormal hair growth
Irregular mensural cycles
polycystic appearance of ovaries (many small follicles) on ultrasound of pelvis
It is important to remember that PCOS can manifest in many ways and that not all Women with PCOS have the same symptoms. PCOS can be treated with dietary changes or medications to reduce insulin levels, and medications to improve ovulation. While serving as faculty at the University of Utah, Dr. Moore conducted research that showed that weight loss can improves odds of pregnancy in Women with PCOS.
Blocked or Damaged Fallopian Tubes
The fallopian tubes can be blocked because of inflammatory conditions such as endometriosis, infections or birth defects. If they are blocked, then sperm can’t get to the eggs and embryos are unable to arrive in the uterus.
Blockages of the fallopian tubes may be:
Bypassed with IVF
Surgically corrected, in some cases
In some cases, an abnormal fallopian tube may prevent pregnancy and may need to be removed surgically. Dr. Moore is a regional expert in robotic minimally invasive surgery and performed the first tubal reanastomosis at the University of Utah and in Utah county which resulted in baby’s born.
There are several uterine irregularities that may be the cause of infertility or recurrent miscarriage.
The most common irregularities of the uterus includes:
Congenital malformations (birth defects)
In some cases, we correct uterine irregularities by performing minimally invasive surgery. In severe cases, where the uterine damage is beyond repair, use of a gestational carrier is often recommended. A gestational carrier is also known as a surrogate carrier.
Low Ovarian Reserve
Women are born with a limited amount of eggs which, on average, are depleted around the age of 50. In some cases, they can be depleted much earlier. We test for ovarian reserve through ultrasound and blood tests.
During any given cycle, only one or two eggs are released but:
Several eggs will begin to ripen
Those that are not released will slowly disintegrate
Egg supply will gradually diminish over time
May eventually lead to infertility as the result.
Identifying low ovarian reserve can help identify how aggressive treatment should be. In some cases, when few eggs remain, adoption or IVF with donor eggs may offer the best chance for success.