What: The ovary is unable to release a mature egg because of hormonal dysfunction in the brain and ovaries. This may be caused by the growth of tumours, among other reasons.
Treatment: Ovulationstimulating drugs such as clomiphene are prescribed.
What: Benign tumours grow in the wall of the uterus for reasons that are not known. These may act as barriers that prevent the egg from implanting itself into the wall.
Treatment: Surgery can be performed to remove fibroids.
What: The uterine tissue grows outside the uterus, in places such as the ovaries, the Pouch of Douglas (the cavity between the rectum and the back of the uterus), and the peritoneum (the membrane covering the organs in the abdominal cavity). The cause is not known. It can distort the anatomy of the female reproductive organs. The chemicals produced also create an environment that is hostile to fertilisation.
Treatment: Laparoscopic surgery can be performed to remove the abnormal tissue.
POLYCYSTIC OVARY SYNDROME
What: The ovaries contain many small cysts, caused by hormonal dysfunction in the brain. It is not clear what leads to the hormonal dysfunction, which then results in irregular ovulation and menstruation.
Treatment: Ovulationstimulating drugs are used. In some patients, surgery is done to induce ovulation, in a process known as ovarian drilling.
BLOCKED OR DAMAGED FALLOPIAN TUBE
What: This is a result of scarring from previous surgery or pelvic inflammatory diseases that arise from sexually transmitted infections. It prevents the sperm from meeting and fertilising the egg.
Treatment: Laparoscopic surgery can be performed to unclog the tubes using instruments inserted through small incisions in the abdomen. A woman whose tubes are too badly damaged can consider in-vitro fertilisation, where the husband’s sperm is added to her eggs in the laboratory to produce embryos and then implanted in her uterus.
SOURCE: Dr Yong Tze Tein, a senior consultant at the department of obstetrics and gynaecology at Singapore General Hospital GRAPHICS: MIKE M DIZON