Although a healthy reproductive system is not essential to staying alive, diseases of the reproductive system that cause infertility are significant because they can reduce the quality of life for people who want to have children. For example, in their 2007 study published in the "Journal of Clinical Endocrinology," Dr. H.L. Ching and colleagues reported that women suffering from polycystic ovarian syndrome (PCOS), a common multi-symptom condition that can cause infertility, reported a poor quality of life.
Endometriosis
The cells lining the uterus are shed and replenished monthly with the menstrual cycle. Sometimes, these cells are not completely shed and remnants grow abnormally on the ovaries, fallopian tubes and other pelvic organs, causing inflammation, periodic bleeding and often pain. Severe endometriosis can cause infertility by blocking or scarring the ovaries and fallopian tubes, preventing normal release of the egg (ovulation) and fertilization. Patches of abnormally growing cells can be found and removed using laser treatments during outpatient surgery. Difficulty conceiving may be the first indication that the patient could have endometriosis, since pain symptoms may be absent even with advanced endometriosis. According to the Mayo Clinic, endometriosis is often diagnosed in women who are seeking medical treatment for infertility and is a common cause of female infertility.
Polycystic Ovarian Syndrome
Polycystic ovarian syndrome (PCOS) is a disease of the ovaries. Women with PCOS typically have multiple small cysts on their ovaries which contain immature eggs. The normal ovary responds to monthly hormones and grows a structure called a follicle, which helps the egg contained within it to grow and become mature and fertilization-ready. At the time of ovulation, this mature egg is released from the follicle so that it can be fertilized. In PCOS, instead of one normal follicle, a hormonal imbalance creates multiple small cysts containing immature eggs that cannot be fertilized. Women with PCOS typically have abnormally low levels of follicle stimulating hormone (FSH) and abnormally high levels of androgen, a male hormone. Women with PCOS tend not to ovulate, leading to infertility. According to the National Institute of Health (NIH), in addition to infertility, some other symptoms of PCOS related to abnormally high androgen levels include absent or irregular periods; persistent, treatment-resistant acne; increased facial hair and metabolic problems causing diabetes and obesity.
Hypogonadism
Low levels of testosterone are a primary symptom of hypogonadism. Low levels of testosterone can be due to genetic causes, trauma or infection of the testicles. The root cause of hypogonadism can be at the level of the testicle, called primary hypogonadism. Alternately, secondary hypogonadism can be caused by a problem with the hypothalamus or pituitary, organs in the brain which release the hormonal signals that the testicles need to function normally. If hypogonadism occurs in the fetus before birth, it can disrupt the normal development of the testicles, preventing the normal body changes that occur with puberty. After puberty, abnormally low levels of testosterone will inhibit normal sperm production, resulting in no sperm or few sperm being produced, depending on the severity of the condition. According to the Mayo Clinic, hypogonadism can also cause infertility by causing erectile dysfunction.
Reproductive System Cancers
Cancer can cause infertility in one of two ways. First, cancers in reproductive organs, including the testis and ovary, directly damage the function of these organs, so that sperm, eggs and steroid hormones cannot be produced. Furthermore, treatment of testicular or ovarian cancer usually involves surgical removal of the gonad, which is the site of gamete and hormone production. Likewise, uterine and cervical cancers often require removal of these organs as part of the treatment plan, causing infertility. Finally, chemotherapy and radiation treatments used to treat cancer anywhere in the body often have the side effect of causing temporary or permanent infertility.
References
- Endometriosis
- Polycystic Ovarian Disease
- Hypogonadism
- Impact of Infertility on Quality of Life, Marital Adjustment, and Sexual Function
- Quality of Life and Psychological Morbidity in Women with Polycystic Ovary Syndrome: Body Mass Index, Age and the Provision of Patient Information Are Significant Modifiers
