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Female Factor

Sieviešu faktors

Cause of infertility – always a female factor?

Contrary to popular belief that only women can be infertile, now it is known that female infertility is the reason of difficulty conceiving in about 35% of the cases. In approximately 35% of the cases it may be caused by changes in a man’s heath, but for every fifth couple the cause of infertility is a common factor with both the man and the woman having fertility problems. In 10% of the cases the cause cannot be identified.

Are there any female factors that increase infertility risk?

Many factors can contribute to infertility:

  • Hormonal (underactive thyroid, metabolic syndrome, hyperprolactinaemia, use of hormonal or contraceptive drugs without medical supervision, etc.)
  • Genetic (mosaic Turner syndrome, fragile X chromosome, BRCA1/BRCA2 gene mutations, etc.)
  • Uterine abnormalities (various myoma types)
  • Endometrial abnormalities (adenomyosis, refractory endometrial hypoplasia, polyps, endometrial hyperplasia)
  • Implantation window variations – in such event ERA test helps calculate the best time for embryo implantation for each woman individually:
  • Blood circulation and coagulation disorders (thrombophilia, etc.)
  • Immune factors
  • Various infections of reproductive organs or sexually transmitted diseases, chronic inflammation of uterine appendages, ovarian cysts and cystadenomas, consequences of legal or spontaneous abortions, bad habits.

Moreover, we cannot ignore a growing number of infertility cases in recent years due to adverse environmental factors, emotional stress and a fast pace of life, which are common in urban areas.

Egg reserve diminishing with age

Ageing is the number one enemy for women’s reproductive life, which begins with their first period and continues until menopause.

Nowadays, women think more about their careers and self-improvement and postpone settling down until they are confident in their partner and ready to get married and to have kids. Undoubtedly, it is possible to plan having a child at some point later, but we must not forget that our biological clock cannot be stopped and it will not wait until a woman is ready or it is the ‘right’ time.

Ovarian tissues age the quickest, that is why women’s reproductive age is not as long as men’s.

When ovaries begin to lose their reproductive potential, it may lead to infertility. Ageing process affects both the number and the quality of eggs, which over time reduces until creation of an offspring is no longer possible.

There are women whose bodies can still produce hormones ensuring regular periods, but it is not an indicator of the quantity of eggs in the ovaries, which may be low nonetheless.

Reduced ovarian function – poor ovarian response

We know that with age ovarian reserve diminishes, but it is not the only reason. Our experience shows that a poor or no response to ovarian stimulation may occur at a relatively young age and, vice versa, women of upper reproductive age (from 38 years of age) may have a normal egg reserve and good response to stimulation. It means that not only ovarian reserve diminishing with age can be the reason for poor response, but also possible genetic disorders, medical treatment or environmental factors that have caused ovarian insufficiency at a younger age.

One of the ovarian reserve diminishing assessment criteria is AMH (Anti-Mullerian hormone). Normal AMH level is 0.4-4.0 ng/m. If AMH level is higher, it means that ovaries are not working properly due to multifollicular ovary or polycystic ovary syndrome (PCOS). If AMH is below normal, it is a sign of diminished ovarian reserve.

The second criterion is FSH, a hormone that stimulates follicle growth. If FSH is lower than 12, ovaries poorly respond to commands of the body and stimulation drugs.

There are many other things that ultimately affect the number of eggs collected during the IVF. In any event, if you have poor ovarian response to stimulation, do not worry, iVF Riga can help. We have developed our own treatment tactics for patients with poor response, we create and follow individual treatment plans for each patient and we have achieved very good results.

Comprehensive female fertility genetic tests

iVF Riga Genetics Centre recommends patients to have comprehensive fertility tests before their first artificial insemination cycle to find the answer to the question why pregnancy does not occur. The results will help to avoid potential risks of pregnancy loss and to refine further tactics to achieve the desired result –


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