Reproductive Factors That Affect Your Fertility. Part 1

A thorough infertility work-up evaluates five fertility factors: The Cervical Factor, the Male Factor, the Ovulatory Factor, the Uterine Factor, and the Pelvic Factor. Once these factors are correctly assessed, a fertility treatment plan can be chosen. Typically, a systematic evaluation of all the fertility factors can be completed in three menstrual cycles. A complete evaluation is important to prevent unnecessary procedures, and to avoid wasting precious time. The following section describes each of the factors important for women:

The Cervical Factor

The ability of the cervix to nurture and transport sperm into the upper female reproductive tract is known as the cervical factor. In the “normal” female, the cervix produces large amounts of clear watery mucus just prior to ovulation. After ovulation, the mucus thickens and inhibits sperm from reaching the fallopian tubes, and hence, the egg.

A simple procedure to assess the cervical factor is the postcoital test. Just before ovulation occurs, the couple has intercourse. Six to ten hours later, the female partner is examined in the office. A small portion of the cervical mucus is taken for examination. The clarity and texture of the mucus is examined under the microscope to determine if there is a reasonable number of sperm swimming freely. Although the postcoital test has been performed for years, it is still somewhat controversial, because there is no universally accepted number of swimming sperm seen under the microscope to be called a normal test.

The quantity and quality of the mucus can be negatively affected by in utero exposure to DES, previous cone biopsy, or infection. Repeated use of clomiphene citrate (Clomid® or Serophene®) can also affect the mucus. If the postcoital test is inadequate, mucus cultures, test for sperm antibodies, and a semen analysis may reveal the nature of the problem. Treatment is based on these collective findings.

The Ovulatory Factor

Simply put, the ovulatory factor refers to the ability of a woman to release a healthy egg each cycle (ovulate). Problems with ovulation or inconsistent ovulation are very common causes of female infertility. In fact, the ovulatory factor accounts for about one fifth of all causes of infertility.
Ovulation prediction kits can help you determine when (and if) you are ovulating. Intended especially for couples first trying to concieve, Stadtlanders’ First Step Kit is a comprehensive package that includes an instructional video, Ovulation predictor kit, chart, basal thermometer, and instructional booklets.

Each month, a normally ovulating female develops one egg as a result of the carefully synchronized secretion of pituitary hormones from the pituitary gland in the brain. During ovulation, the egg is released from the ovary into the fallopian tube. Many factors may interfere with this process, and cause either abnormal ovulation or ovulatory failure. Abnormal ovulation is typically caused by hormonal irregularities, and can usually be treated with medications. Ovulatory failure can be due to abnormal pituitary function, polycystic ovarian syndrome (PCOS), premature ovarian failure (menopause), or overactive secretion of the hormone prolactin. In PCOS, the ovaries secrete abnormally high levels of male hormones called androgens. Androgens can cause premature wasting of the follicles, which contributes to anovulation. Women with premature ovarian failure may not ovulate because their ovaries no longer respond to hormonal stimulation.