- Cervical polyp is a tumor-like formation that grows from the wall of the cervical canal into its lumen, with a leg or wide base;
- scar deformation of the cervix, which occurs mainly after childbirth or surgery on the sexual organs;
- abnormal position of the uterus (sharp bend at the back or front);
- immunological causes (spermatozoa loses mobility in the canal mucus).
From the uterus sperm penetrates into uterine (fallopian) tubes. The obstruction of uterine tubes determines the tubal infertility factor. The main cause of obstruction of fallopian tubes – adhesion process after inflammatory diseases.
Sperm cells seek to fertilize a mature ovum, which comes out of the dominant follicle in one of the ovaries. Ovulation disorder and the absence of a ripe egg is called anovulation. This condition is the cause of endocrine infertility.
The reasons for the lack of ovulation:
- Disturbance of the organs that produce hormones (pituitary gland, hypothalamus, ovaries, thyroid, adrenal glands);
- Premature ovarian exhaustion (aging) – absence of primordial follicles (small follicles, which are in the initial stage of their development) from which the ovary matures.
Fertilization of the ovum occurs in the lumen of the fallopian tube. Then, the fertilized ovum moves along the fallopian tube towards the uterus. If the uterine tubes are impassable, the movement of the egg to the uterus is difficult or becomes impossible.
After ovulation, the ovaries begin to produce progesterone. Under the influence of the hormone thickens the inner mucous membrane of the uterus (endometrium), and the fertilized ovum is completely immersed in it. Chronic inflammatory diseases (endometritis, infections, endometriosis, hormonal dysfunction, uterine myoma) and other pathological processes interfere with the promotion of the egg and its implantation in the endometrium. This can lead to the attachment of blastocyst (early embryo development) to the fallopian tube and the development of ectopic pregnancy.
Improper attachment of the egg to the endometrium may lead to a halt in embryo development and an abortion. Mutations of genes in the sperm, the ovum or already in the fertilized egg can also cause undeveloped pregnancy.
Classification and stages of development of female infertility.
According to recommendations of WHO and the Ministry of Health of the Russian Federation, female infertility is classified according to ICD-10 as “N97 Female Infertility (inability to get pregnant, sterility of women)”. It is subdivided into “N97 Female Infertility (inability to get pregnant, female sterility)”:
(N97.0) Female infertility due to lack of ovulation.
Ovulation is an egg output from the ovary into the uterus tube with the possibility of subsequent sperm fertilization. Without ovulation, conception is impossible by natural means. Ovulation may be absent due to disruption of the hormone secreting organs (hypothalamus, pituitary gland, ovaries, thyroid, adrenal glands). This form is called “endocrine infertility”, it accounts for about 25% in the structure of all causes of infertility. Endocrine infertility occurs against the background of diseases caused by various causes. For example, functional hypothalamic amenorrhea occurs due to nervous shocks, loss of body weight or under heavy physical stress.
(E28.2) Polycystic Ovarian Syndrome (POSC) is characterized by an excess of male sex hormones (testosterone, androstendon, dehydroepiandrosterone and others) and the lack of ovulation. Sometimes the body weight is increased and the menstrual cycle is broken. SPKJA is inherited, its frequency in the population is 8-13%.