Infertility

For pregnancy to occur, a specific sequence of events must occur, starting with ovulation, where your ovary releases an egg that progresses into the fallopian tube.

Sperm released during sex with your partner make their way through the cervix and uterus up to the fallopian tube, reaching the egg. One sperm penetrates the egg, fertilizing it before arrival in the uterus.

The lining of the uterus, called the endometrium, has thickened in preparation for this fertilized egg, which then embeds in the uterine wall. The fertilized egg has already started developing toward the formation of a fetus.

If any part of this process fails, then pregnancy doesn’t occur. If the failure occurs every month for about a year, infertility is diagnosed.

Infertility in women can be difficult to diagnose. Since neither ovulation nor fertilization is easy to observe, about one-third of all infertility issues can’t be attributed to either the woman or man, and the reason for infertility is never discovered.

Ovulation disorders are perhaps the most common female fertility issue, accounting for about 25% of all cases of infertility. If you’re not ovulating or ovulating in an unusual way, there may not be an egg present in the fallopian tubes when you expect it.

Depending on the underlying cause, your MOGA physician may recommend minimally invasive surgery to remove fibroids or endometriosis tissue.

This could include hysteroscopy or laparoscopic surgical techniques. Hormone therapy may be useful to restore balances that interfere with ovulation.

At MOGA, we can treat the most common causes of infertility and assist in the workup for both female and male issues.

We also offer medically assisted ovulation induction and intrauterine insemination (commonly known as IUI) for couples and can work with sperm banks for donor insemination.

Causes of irregular or absent ovulation include:

• Hypothalamic dysfunction: the pituitary gland produces two hormones every month to stimulate ovulation, so if this production is disrupted ovulation may not occur
• Polycystic ovary syndrome (PCOS): caused by an imbalance of hormones with elevated androgens, or male hormones, PCOS is the most common cause of female infertility
• Premature ovarian failure: ovaries stop producing eggs at an age that’s usually much younger than the typical onset of menopause.

Physical blockages may also cause infertility, such as those to the fallopian tubes caused by tissue damage and scarring from inflammatory diseases or sexually transmitted infections.

Endometriosis can cause several challenges to fertility, from blockages from scar tissue to disruption of the implantation process.