Causes of Infertility in Women-It was proven by multiple researches that the ability for the woman to conceive decreases with increasing age

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2. Inability to conceive despite trying and
having regular intercourse for one year. The
causes could be due to female factors or
male factors
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3. Causes In
Women
Cervical
Tubal
Uterine
Ovarian
Endometriosis
Unexplained
Age
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4.  Laser conization- low secretion of mucous
 Anti-Sperm Antibodies
 Closed Cervix
Blockage of the vagina
Imperforate hymen
Extremely narrow vagina
Painful infections in the vagina
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5. Uterine Causes of
Infertility in
Women
Congenital
Asherman Syndrome
Fibroids
Fibrosis
Endometrial Polyps
Adenomyosis
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7. Treatment:
Hysteroscopic resection of these
adhesions can be done but it may
need multiple sessions, in addition
to giving steroids with estrogen for
three weeks after surgery to avoid
recurrence.
Asherman Syndrome:
 Intra uterine adhesion
(srepeated curettage, severe
endometritis, scars of uterine
surgery).
 Decreased amount of blood
loss during menstruation.
 Can be diagnosed easily using
hysterosalpingogram.
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8. Fibroids:
Benign uterine tumor .
“Adenomyosis They usually do not cause
infertility unless it affects the intrauterine cavity in
an obvious way, but if no other reason for infertility
can be found, it is better to do myomectomy
(excision of the fibroid ) and restore the
intrauterine cavity.
Myomectomy can be done either by Hysteroscopic
resection or by laparotomy ‘’
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9. Fibrosis may happen after Endometritis and can
be diagnosed using HSG, hysteroscopy can help in
treatment.
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10. Endometrial polyp: Its presence mimics IUCD, polyps can be diagnosed by
HSG, ultrasound or hysteroscopy then polypectomy (removing the polyp) can be done
easily.
Adenomyosis: Symptoms include secondary dysmenorrhea, some hormonal
treatments could be helpful e.g. GNRH analogues, or Danazol, the decision for this
treatment should be taken by the treating physician.
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11. Chronic Pelvic
Infections
Fimbral End
Destruction
Adhesions
Short tubes
Tubal Tumors
Tubal Cause Of Infertility
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12. Chronic Pelvic Infections:
 Cause tubal congestion.
 Obstruction (>3cm ) results in impeding of the oocyte
transfer,
 May result in pelvic adhesions that will affect tubal
movement.
 Slowing it so inappropriate time for oocyte transfer interferes
with fertilization.
 Tubal occlusion or pelvic adhesions that cause inability for
the fimbrial ends to catch the oocyte from the ovary or as
mentioned before abnormal movement of the tubes and
oocyte transfer.
 Causes for PID include infections with E.coli, or Gonococcus
infection (STD) PID affects ovarian function and tubal
movement
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13. Destruction of the fimbrial ends : Disabling its function
in catching oocytes into the tubes, PID or endometriosis
can cause this.
Adhesions: Caused by tubal surgery done for ectopic
pregnancy, pelvic surgery done to the tubes or due to
appendicitis.
Tubal Tumors affecting it's function.
Short tubes (less than 4cm).
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14. Polycystic Diseases
Functional Failure
Pituitary Failure
Endocrinopathy
Hypothalamic Failure
Ovarian Dysfunction
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15. Polycystic ovarian disease: 20% of females
have what is called polycystic ovary which
involves having follicles consisting of more
than the normal condition. In this case the
woman has normal fertility but if it is
associated with some conditions, it is called
polycystic ovarian syndrome and it is
pathological.
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16.  Women with e tubal occlusion
 Male abnormal semen analysis
 Women with PCOD will need IVF, should be individualized
 Treatment of hormonal imbalance is the best thing
Recurrent abortions in PCO:
 Increased LH level
 Control before starting induction of ovulation.
 Ovarian diathermy lowers LH
 lower recurrent miscarriages www.layyous.com

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18. Congenital: Genetic and chromosomal causes
 Ovarian agenesis.
 Hereditary causes for accelerated loss of ovarian
reserve.
 Familial premature ovarian failure.
 Chromosomal abnormalities (47XXX).
Exposure to certain factors:
 Large amount of radiation exposure.
 Chemotherapeutic agents as in cancer
treatment.
 Viruses such as mumps.
 Heavy smoking.
Congenital : enzymatic dysfunction
 17-α Hydroxylase Deficiency.
 Galactosemia.
Extras :
 Autoimmune causes: Presence of ovarian
antibodies.
 Lack of (or dysfunction) of LH, FSH
ovarian receptors.
 Idiopathic causes.
 Surgical oopherectomy.
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19. Secondary disorder of Gonadotrophin
Regulation:
1. High prolactine level
2. Pituitary adenoma
3. Idiopathic hypothyroidism
4. side effect to medication
5. Suprapituitary Tumors
6. Pituitary Tumors, trauma such as in RTA,
7. Radiation exposure to the pituitary.
8. Idiopathic causes.
LH and FSH gonadotrophin Deficiency due to:
1. Pituitary tumors.
2. Destructive pituitary lesion.
3. Pituitary ablation.
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20. Causes :
Rapid and sudden increase or decrease in body
weight.
Severe psychological and neurological stress
strenuous exercises.
Radiation exposure.
Medications that cause hypothalamic failure.
Tumors.
Unknown causes.
Endocrinopathy
 Adrenal gland dysfunction
 Thyroid gland problems.
 Hypothyrodism
 Pancreatic problems www.layyous.com

21. "Endometriosis Is Presence of Endometrial Tissues Outside Endometrial Cavity"
Affects pregnancy either by forming chocolate cyst
(endometrioma) or by causing adhesions.
Diagnos -Laparoscopy
Treatment:
Laparoscopic adhesiolysis,
Cauterization of endometriotic spots,
Salpingostomy and reanastomosis of fallopian tube problems.
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23. Hypotheses
Stress and worries changes in internal hormones ,decreased cervical
secretions or muscular spasm, including those lining fallopian tubes causing
its obstruction, or muscles lining the vagina causing dyspareunia.
Stress also has its effects on the hypothalamus and ovarian function.
Couple seeking pregnancy to try, as much as possible, to alleviate stress and
worries and have trust in god and trust their treating physician.
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24. Learn More
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World Class
Infertility IVF Gynecology and Obstetrics
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Dr Najeeb Layyous
Amman, Jordan
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