What are the causes of ovarian infertility?

When women experience infertility, it is undoubtedly a very painful thing, and some women cannot find out why they cannot get pregnant. The main causes of female infertility are problems with the uterus and ovaries. The causes of ovarian infertility include oophoritis, congenital abnormalities, ovarian tumors, ovarian endometriosis, etc.

1. Congenital abnormalities

There are Turner syndrome and true hermaphroditism, which are not within the scope of infertility treatment.

2. Ovarian inflammation

It can be divided into tuberculous and non-substantial ovarian parenchymal inflammation and peripheral inflammation. For inflammation, anti-inflammatory treatment should be the main treatment; for those with surrounding fibrous adhesions, laparotomy or laparoscopic adhesion lysis can be considered; for tuberculosis patients, anti-tuberculosis treatment can be performed.

3. Abnormal ovarian position

Ovarian sagging changes the anatomical position of the fallopian tube fimbria and the ovary, thus affecting the entry of the egg into the fallopian tube. Ovarian ligament shortening surgery can be considered to shorten or fix the ovarian mesentery to the posterior wall of the uterus. Adhesive uterine malposition is often caused by inflammation and endometriosis, both of which can cause infertility. Surgery or laparoscopic adhesion lysis may be considered.

4. Ovarian tumor

Ovarian cysts are sometimes associated with infertility. Multiple follicular cysts that secrete too much estrogen can cause persistent anovulation. Ovarian solid tumors such as various hormone-secreting tumors, granulosa cell tumors that secrete female hormones, and ovarian cystic cell tumors. Symptoms of female masculinization, such as testicular blastoma, adrenocortical tumor, and hilar cell tumor, which secrete male hormones, are all associated with infertility. Except for ovarian tumors with a tendency to malignant transformation, normal ovarian tissue should be preserved as much as possible when the tumor is removed.

5. Ovarian endometriosis

In infertility caused by endometriosis, the most common cause is invasion of the ovaries by the lesions. Danazol (a derivative of 17-α-ethynyltestosterone) can be used for drug treatment; conservative surgery can be performed, and visible lesions should be removed as much as possible while preserving normal ovarian tissue. Smaller lesions can also be cauterized under laparoscopy, and mild adhesions in the pelvic cavity can be loosened, or the contents of the endometrial cyst can be extracted through the attached needle of the laparoscopic tube.

6. Ovarian amenorrhea

Patients with ovarian amenorrhea may be divided into two categories: those who are ineffective and those who are effective after gonadotropin treatment. Therefore, the examination of patients with ovarian amenorrhea should be carried out in the following order: ① determination of FSH and LH in urine or blood; ② gonadotropin stimulation test; ③ LH-RH pituitary stimulation test if conditions permit; ④ chromosome and sex chromatin examination; ⑤ laparoscopic examination; ⑥ laparotomy if necessary

7. Folding local factors

For example, congenital absence of ovaries or immature ovaries, premature ovarian failure, polycystic ovaries, certain ovarian tumors such as granulosa-thecoma cell tumor and testicular blastoma can affect ovarian hormone secretion and ovulation; systemic diseases such as severe malnutrition, or lack of certain important nutritional factors in the diet can affect ovarian function and cause infertility; chronic diseases, metabolic diseases such as hypothyroidism or hyperthyroidism, diabetes, adrenal dysfunction and other diseases can also lead to infertility; central influences: endocrine imbalance between the hypothalamus, pituitary gland, and ovaries, pituitary tumors or scars can cause ovarian dysfunction and lead to infertility: mental factors such as mental stress or excessive anxiety can affect the hypothalamus-pituitary-ovarian axis and inhibit ovulation.