Monthly Archives: June 2011

Ovarian cancer

Ovarian Cancer Information

Ovarian cancer is one of the leading causes of women’s deaths. The peak incidence of ovarian cancer is in late 50′s, while malignant germ cell cancer (one type of ovarian cancer) occurs in early 30′s. When abnormal cells divides too fast a cellular mass or tumor is formed which doesn’t invade to surrounding and are within a cell, this is called benign tumors and if the tumor spread to surrounding tissue or organ it is called malignant or cancerous and the process in with this cells invade surrounding is called metastasis.

Types of Ovarian Cancer:
There are 3 main types of ovarian cancer; primary epithelial cancer, Germ cell tumors and Sex cord tumors. Primary epithelial cancers comprise of 80-90% of all ovarian cancer and are classified into six histological types, of which Serous and Endometrioids are more common.

  • Serous (fallopian tube) – 40%
  • Endometrioid (endometrium) -24%
  • Mucinous (cervix)
  • Clear cell (mesonephros)
  • Transitional cells
  • Undifferentiated carcinoma

Germ cell tumors include endodermal sinus malignancies, embryonal carcinoma (a rare ovarian cancer that appears in children), immature teratomas, and dysgerminoma.

Sex cord (stromal) tumors include granulosa cell tumors (that produce estrogen and may have feminizing effects), granulosa-theca cell tumors, and the rare arrhenoblastomas (that produce androgen and have virilizing effects).

Causes and Risk Factors of Ovarian Cancer:

It is still unknown the real cause of ovarian tumors. However studies suggest that several factors including, hormonal, environmental, and genetic variables may play a role in causing ovarian cancer. Some of the risk factors are discussed below:

Family history of ovarian cancer:
Woman has as high as a 50% risk of getting ovarian cancer if two or more first-degree relatives (mother, sister, and daughter) have history of ovarian cancer. However women have less risk for second-degree relatives (grandmother, aunt, cousin).

Age:
The risk of developing ovaries cancer increase with increase age. Its incidence is high in late 50′s. Over 50% of cancer occurs in women older than 60 years.

Menstrual history/pregnancy history:
The risk of developing ovaries cancer is high in early menarche (less than 12 yrs) and late menopause (greater than 50 yrs). Late first child birth(after 35 yrs) may also be associated with risk of developing cancer.

Personal history:
Women who have breast cancer or other cancer have high risk of ovarian cancer then women who had not any previous cancer.

Talcum powder:
Some have suggested that women who apply talcum powder to the genital area or sanitary napkins have higher risk of developing ovarian cancer.

High-fat diet:
High fat diet is also linked in causing cancer, especially obesity is involve in risk of causing cancer.

Hormone replacement therapy (HRT):
There are some evidence that women who receives HRT after menopause have slightly increase risk for cancer but only with high dose and long-term use.
Other Risk factors of ovarian cancer may be repeated radiography of pelvis, late menarche and artificial menopause.

Acquired genetic mutations:
Researcher have suggested that genetic mutations of DNA alter oncogenes (genes that promote cancer cell division) tumor suppressor genes(cancer preventing genes) and other genes may results in high risk for ovarian cancer. Acquired mutations of the HER2 oncogene or the p53 tumor suppressor gene may be associated with a higher risk of ovarian cancer.

Ovarian Cancer Symptoms and Signs
Despite the common beliefs that early stage ovaries cancer is with out symptoms most women with ovaries cancer have vague symptoms such as lower abdominal pain abdominal distention and epigastric discomfort. The important sign being, pressure of pelvic mass during physical examination. If the cancer has metastasis to surrounding or has advanced then other symptoms like anorexia, fatigue, nausea, weight loss may be seen. So signs and symptoms of ovarian cancer may include the following:

  • Abdominal or pelvic discomfort or pressure
  • Back or leg pain
  • Changes in bowel function or urinary frequency
  • Fatigue, nausea, vertigo
  • Gastrointestinal symptoms (gas, long-term stomach pain, indigestion)
  • Abnormal vaginal bleeding
  • Feeling of fullness after a light meal

With only the symptoms it is not possible to diagnose the disease. There are more clinical lab, radiology and cytology findings which helps to confirm the disease. It requires detailed patient history, clinical evaluation, surgical exploration and some histological studies. Any enlargement of the ovary in post menopausal women is regarded as malignant cancer until proved. Laboratory tumor marker studies, such as Ca-125, human chorionic gonadotropin and carcinoembryonic antigen may be helpful to differentiate between benign or malignant process, although the marker may be negative in half of early stages of ovarian cancer. Abdominal and pelvic Ultrasonography or CT may help to determine the size of tumor. It may still be difficult to determine the benign or malignant nature of cancer until laparotomy.

Surgical exploration with biopsy will confirm the diagnosis of the disease. Abdomen is opened and explored and the tissue from the site is taken out for pathology studies.

Treatment of Ovarian Cancer:
Accurate pathologic evaluations and thorough surgical staging are essential to the management of early stage disease. In girls or young women who have unilateral encapsulated tumors and wish to maintain their fertility, resection of the ovary involved with consideration of later removal of another ovary after child bearing is suggested

For the patient who doesn’t like to have more child, Total Abdominal Hysterectomy with Bilateral Salpingo Oophorectomy can be done. Patients with stage Ia grade 1 or grade 2 tumors have very good prognosis and may not require additional chemo therapy.
Chemotherapy is very effective in ovarian cancer as adjuvant therapy and in achieving clinical remission. The current regimen for advance epithelial ovarian cancer is a combination of taxane and carboplatin and for germ cell tumors is cicplatin, etoposide and bleomycin.

Ovarian Cancer Prevention and Screening

The most important is by avoiding the risk factors which we have discussed above. Bilateral salpingo-oophorectomy at the time of hysterectomy in women over age 50 and after child bearing function has completed in younger women is advocated by many in prevention of development of ovarian cancer. No effective screening test for ovarian cancer is applicable to general population though women with strong family background should be considered for genetic counseling.

Known protective factors for ovarian cancer includes, child bearing and use of oral Contraceptive pills. Even 6 months of pills use seems to decrease the relative risk for ovarian cancer and the effect remains protective for up to 10 years. For patient with genetic mutation predisposing them to increase risk, prophylactic oophorectomy may be performed with or without prophylactic mastectomy for breast as well.

Prevent Sunburn From Peeling

How to Prevent Sunburn From Peeling

We all love to spend few times relaxing on sunny days, enjoying our self in beach, lakes and other out door activities like swimming, fishing and so on. But do you know, it only takes 20-30 minutes to burn your skin in the sun. Have you prepared for that? After few hours of sunburn your skin starts peeling. You must have been worried about how to prevent sunburn from peeling. Here are few tips you might want to try.

  • The first measure is to avoid the sun immediately. Don’t be exposed to sun for at least 48 hours.
  • Apply soothing lotions like calamine lotion to the burn area.
  • Oatmeal bath is also a good option. You can also take Apple cinder vinegar bath.
  • Don’t use any oil, perfumes or bath salts; this may give rise to sensitivity reaction.
  • Don’t scratch or scrub the skin.
  • Don’t use any creams or lotion which has anesthetic effect.
  • Use a cold compress on the affected area. Remember not to leave the cold compress for more then 10-15 minutes.
  • Take plenty of water to keep you well hydrated.
  • Use some moisturizing cream and lotions containing aloe vera. Don’t use any fatty cream.
  • Take some drugs like aspirin and ibuprofen it will ease the pain. Never take this drug on empty stomach and child below 12 years.

If the above options are not helping you to Prevent Sunburn from Peeling or you have any other related symptoms, visit the doctor immediately. To learn more visit:
How to Prevent Sunburn From Peeling

Menstrual cramps

How To Relieve Menstrual Cramps

Menstrual cramps or dysmenorrhea may occur just before or at the beginning of menstrual cycle and continue for 1-2 days. Menstrual cramps are often caused by hormonal changes or sometimes secondary to systemic diseases in old age. So be sure to follow up with your doctor to rule out any secondary cause.

Here are few tips on how to relieve Menstrual Cramps

  • Provide heat to the abdominal area or lower back with a heating pad or warmth bath.
  • Eat food high in vitamins B6(bananas,broccoli,lentis)and vitaminc C(citrus fruits,green peppers)and magnisium(whole grains,soybeans,spinach,fish).
  • Lie down with a heating pad on your abdomen.Witn youe fingertips,lightly massage your benny in circular motion.
  • Drink warm,noncaffeinated beverages.
  • Take a warm shower.
  • Do waist-bending exercise or take a walk.

When to Call the doctor.??
You know your body best. If you develop unusual health changes, including any of the following symptoms beside menstrual cramps, please call your physician.

  • Severe abdominal pain,nausea or vomiting that lasts several days.
  • Fever lasting more than a few days.
  • Frequent dizziness,nausea or headache.
  • Changes in vision.
  • Unexplaned changes in weights.
  • Abnormal bleeding or blood in urine,stool or phlegm.
  • Cough or pain more than a week.
  • Extreme fatigue.
  • Excessive thirst.
  • Persistent bloating,a feeling of fullness or gas.
  • Menstrual disorder(heavy and/or prolonged menstrual bleedinf,skipped periods,bleeding in between periods)
  • Pain during intercourse.
  • Any unusual breast syptoms(discharge,redness,swelling or changes in shapes and sizes)
Laparoscopic Sleeve Gastrectomy

Laparoscopic Sleeve Gastrectomy

Laparoscopic Sleeve Gastrectomy is an operation in which around 2/3rd of the left side of stomach is removed laparoscopically. The stomach thus takes the shape of a tube, a banana or sleeve. It works by restricting the food intake and therefore it is known as restrictive form of weight loss surgery. Laparoscopic Sleeve Gastrectomy leaves a stomach capacity ranging from 60cc to 150cc. In addition, it also removes that part of stomach that contain appetite stimulating hormone “Ghrelin” thereby decreasing your appetite significantly.

In this procedure the function of the stomach is preserved while the stomach size is reduced drastically. Laparoscopic Sleeve Gastrectomy is not reversible unlike Gastric Banding. It can be performed as a single stage procedure for not extremely obese patients. In extremely obese individual (BMI>60) is can be performed as two stage procedure, where it can be followed by gastric bypass after initial weight loss. About 70%-80% of excess weight is lost at the end of 1.5 years with improvement in obesity associated medical conditions. In addition to weight loss quality of life improves considerably.

Sleeve Gastrectomy Procedure
Patients are expected to get some investigations done before the surgery. These tests include cholesterol levels, blood sugar, vitamins, minerals, and sonography and sleep study in case of patients suffering from sleep apnea. Once the surgery date has been decided, patients are required to go on a high protein, low carbohydrate and low fat diet. This diet has to be started 7-10 days prior the surgery date. It helps in term of decreasing the liver swelling and making the operation easier.

As Laparoscopic Sleeve Gastrectomy is done with minimally invasive technique (Laparoscopy) the hospital stay doesn’t exceed 2-3 days. There are about 4-5 tiny incision on the stomach which heal quickly and with time the scar becomes invisible. The stitches dissolve on its own and so they do not hamper daily activities like sleeping on the stomach, turning around, bathing, walking, driving and so. If the surgery is done by a skillful doctor patients can resume work within a couple of days Patients are advised to walk around from the day of the surgery as it fastens the healing process. Post surgery patients are advised on their diet and exercise.

So if you are obese or have obese friends and family member and planning to get Laparoscopic Sleeve Gastrectomy done contact the doctor for further suggestions and advice.

stomach fat loss

A Short Guide To Fat Loss Effectively

It is a misconception of people that dieting can reduce fat loss but there are some other effective ways through which one can lose fat in very short time. One should use healthy foods in order to reduce fat effectively. The belly fat on the body looks ugly and it is important to look in shape to enhance inner confidence. Accumulation of body fat may be due to bad eating or lack of exercise. Losing fat is entirely different from loosing weight, so one need to implement some essential measures to get in shape soon.

However, there are different types of supplements available in the market but one cannot trust all those supplements. It is essential to cut out junk foods, soda, fast foods or other foods which have deprived nutritional value. Apart from these types of junk foods, it is always recommended to eat fresh leafy vegetables, lean meats, whole grains and fruits.

The body comprises of 70 percent water and thus one should drink at least eight glasses of water everyday to keep the digestion system well. Cardiovascular exercises are also essential for fat loss because to keep the system healthy and working. Some general exercises such as running, biking, swimming, walking, playing sports and running.

Work out is the best exercise to lose fat and everyone should reserve some time to do workouts. Aerobic exercises can strengthen the cardiovascular system resulting in calories burn. Everyone should walk for 30 minutes to maintain regular fitness and to get in shape soon. Make use of protein, healthy fats and fiber in daily diet. Having fit and perfect shape of body is an exceptional experience, this is why various celebrities or leading actors have exceptional body figure.

As far as diet habits are concerned, again there are some useful measures which should be used in practice for fat loss. One should always avoid less natural foods or preservatives to keep the immune system healthy.

Protein powder and fruits like apples, pomegranate and oranges should be on the list. Alcohol is the main root of bulkiness and it can lead to belly fat. According to recent survey several people who drink daily are more prone to heart problems, so try to avoid it.

The calorie graph should be on the mind of each and every one. It is the right way to keep fit and people who are completely fit should also follow these measures to avoid furthering convenience. So, if still, there is any type of problem persists always consult the physician to determine the exact cause.

Whip Your Tummy into Shape

Exercises to Whip Your Tummy into Shape

If you’re one of the many millions of women who suffer from the dreaded belly bulge, there is hope for your stomach. While a good diet and exercise can provide you with the most beneficial solution, there are other measures you can take towards achieving a firmer midsection without having to break out your jogging shoes.

For those that can afford it, many women flock to masseuses who specialize in firming massages in order to tighten up their bellies. The method is not exactly cost-free in time or money. There is even a difference of opinion about the effectiveness of massages without exercise for this figure problem. If you’re one of the millions of women who can’t afford this procedure, you can instead opt for spot reduction exercises.

Weak muscles trigger the trouble with the area around your stomach, but toning up the weakness requires consistent treatment. You can’t expect to workout sporadically and receive stellar results. However, working out doesn’t have to be synonymous with strenuous exercises in order to get your belly in shape. Because it is a woman’s prerogative to change her mind, perhaps she might be persuaded to do spot routines instead of spending hours at the gym. Spot routines take less than fifteen minutes daily. Performed to music they become an aesthetic kind of play, rather than boring work. If the exerciser is in good health, the fatigue angle is a myth.

For the easiest program on record try this to get your stomach in tip top shape today:

Stand with your feet ten inches apart, and your arms stretched overhead. Swing forward from the waist and touch all fingers to right knee; rise and repeat to left. Alternating sides, continue for thirty counts. Now, from the same starting position, bend and reach left, repeating this motion to right twenty times.

Lastly, to begin shaping your belly, pull in your waist and abdomen and hold? All day! Practice this movement for the remainder of the day when standing, sitting, shopping, etc. Ensure that you are stretching, reaching, and pulling in these areas as it will ensure that you reap the benefits of a smooth, curvy line.

These spot reduction exercises help you achieve a curvy, more proportioned figure while exercise serves as the means to get rid of that unsightly belly bulge. Combined, they make an awesome team and can catapult you to your weight loss success if performed on a consistent basis.

Breast Cancer

Breast Cancer Information

Breast cancer is the most common cancer in women who do not smoke. It is malignant neoplasm of the breast. It is estimated that one woman in nine will develop breast cancer in her lifetime and will have 3.5% chance dying from it.

How is Breast Cancer Diagnosed?

About 90% of the cases of breast cancer are discovered by breast self examination by patient them self. Screening is the method of diagnosing cancer at early stages before it produces any signs or symptoms which reduce the mortality by 50%. Positive diagnosis can be made by obtaining tissue for microscopic examination. The American cancer society recommends that all women should perform breast self examination monthly. In addition women from 20-40 years ages should visit the clinician every 3 years and women above 40 years every years. The risk of developing breast cancer increases with age.

Breast Self Examination:

  • Observe for symmetry, lumps, dimpling, nipple discharge or failure of nipple erection.
  • Gently squeeze nipple and observe for secretion and nipple erection after each nipple is gently stimulated.
  • While leaning forward, observe breast as they are reflected in mirror to detect irregularities, retracted areas especially one side only.
  • Feel for nodes irregularities and tenderness both in breast and axillaries nodes.

Symptoms of Breast Cancer:

Most women present with painless increasing mass which may also be associated with nipple discharge, ulceration and in inflammatory cancer edema and Erythema may be seen. There may be some non-specific symptoms such as weight loss, fatigue, anorexia, back or bone pain. This usually indicated more advanced stage of breast cancer.

Advanced Breast Cancer:

When breast cancer has advanced edema, redness, nodularity, ulceration of skin, presence large primary tumors which are fixed to chest wall, enlargement, shrinkage or retraction of the breast, marked axillary lymph nodes supra clavicular lymph nodes enlargement, edema of same sided hand or distant metastasis may be seen. 1-2 movable non-tender less than 5mm nodules are not suggestive of metastasis but nodules greater than 7mm usually contains metastasis. Axillary lymph nodes that are fixed to skin or deep structure indicates advanced disease.

What other disease you should consider?
There are several other diseases which may also gives same symptoms and signs as breast cancer. So these diseases can be excluded by obtaining a tissue biopsy of the site. Some other diseases to consider are:

  • Mammary dysplasia (cystic disease of the breast)
  • Fibro adenomas
  • Intraductal papilloma
  • Lipoma
  • fat necrosis

Risk factors of Breast Cancer

Breast is the most common site of cancer in women and accounts for second cause of death in women, first being lung cancer. Some risk factors of breast cancer are followings:

  • The most important being dietary factors especially high fat content (eg. red meat which have high saturated fat and protein content)
  • Women with previous cancer of uterine
  • It is more common in whites than non whites
  • Early menarche (less than 12 years) and late natural menopause (greater than 50 years are at high risk.
  • Late menarche and artificial menopause are at lower risk.
  • Women who had cancer of one breast are high risk of developing the other.
  • There is some evidence that administration of estrogen to post menopausal women has slightly increase risk of cancer but with higher dose and long term use.
  • Late first child birth (after 35 yrs) may also increase risk of developing breast cancer.

Treatment of Breast Cancer:

The type of treatment whether surgical, chemotherapy or combination of both therapies is determined by the extent of disease, patient age and her decision.

Early Breast Cancer Treatment:
Surgery with wide local excision and breast conservation or mastectomy with or with out re-construction is done. Amount of breast tissue to be removed still remains controversial. At one time radical mastectomy was done routinely although still performed, modified radical mastectomy, simple mastectomy or lumpectomy. Lumpectomy only removes cancerous portion of breast and axillary nodes. Radio therapy is given to conserve the breast after wide local excision to reduce local recurrence.

Adjuvant Systemic Treatment:
Tamoxifen adjuvant therapy immediately following surgery is beneficial for estrogen-progesterone receptor positive disease and has reduced the relative risk of women dying from breast cancer by 25%. Most commonly therapy with cyclophosphamide and 5-Flurouracil plus methotrexate for 5 months reduces the absolute by 10% and relative risk of death by 20%.

Advanced Breast Cancer Treatment:
Patient with establish metastasis disease may require endocrine therapy, chemo therapy or radiotherapy. The treatment is not curative but may be of great palliate benefits and consistent often with many years of good quality life. Recently addition of anti HER2 antibodies to chemo therapy has produced a modest survival advantage.

Endocrine Therapy for Advance Breast Cancer:
Women who have high level of estrogen receptor and progesterone in their tumor have greater chances of responding to endocrine therapy. A range of hormonal manipulations are as follows:
For premenopausal patients

  • Suppression of ovarian function by means of oophorectomy, radiation-induced ovarian ablation
  • Anti-oestrogen, Tamoxifen
  • Progesterone

For post menopausal women

  • Tamoxifen
  • Progesterone
  • Aromatase inhibitors (anastrozole)

Chemotherapy for Breast Cancer:
Patient who are unlikely to respond to hormonal therapy or who fail to respond to endocrine therapy or who requires rapid response  are given chemo therapy. The most common regimen used is:

  • CMF (cyclophosphamides, Methotrexate, 5-fluorouracil)
  • MM (mitoxantrone and methotrexate)
  • Doxyrubicin and cyclophosphamide
  • Paclitaxel or docetaxel used as single agent or in combination with an antracycline where initial therapy has failed or is inappropriate.

Side effect of Chemotherapy

  • Nausea, vomiting
  • Hair loss
  • Fatigue
  • Mucositis (eg. oesophagitis, diarrhea)

Drugs Specific Side Effects:

  • Anthracyclines causes cardio toxicity
  • 5-fluorouracil causes skin dermatitis

Poor Prognostic Factors for Breast Cancer

  • Young age
  • Pre-menopausal women
  • Tumor size
  • Metastasis of tumor
  • Oestrogen and progesterone receptor negative
  • Positive nodes.

Should I see the doctor after my treatment?
After primary therapy, patients with breast cancer should be followed for life for at least two reasons:

  • To detect recurrences and to observe the positive breast for secondary carcinoma.
  • Local or distant metastasis occurs frequently with in the first 3 years. So during this period patient is examined every 6 months. Thereafter, every 6-12 months for 5 years, then after every 12 months.
problems-during-pregnancy

Common Problems During Pregnancy

Your pregnancy is going smoothly, we all wish that. It is normal that during pregnancy you may have few discomfort that you can manage yourself and are not any life threatening. Here we would like to focus on some of the common problems that you might face during pregnancy and their management. If you think something might be going wrong, contact your doctor immediately.

Back Pain: Low back pain during pregnancy is quite common, especially after 28 weeks. Mild exercise, particularly stretching may relief pain. Massage, gentle heating pad and Tylenol can be used for mild pain. For severe pain muscle relaxants can be used.

Constipation: Some pregnant women complain of constipation during pregnancy. Taking more fluids particularly water should be taken. About 10-14 glasses of water per day may be taken. In addition stool softeners or bulking agents may help. Laxatives are usually avoided after 28 weeks due to premature labor.

Contraction: Irregular contraction may occur several times over days, but these may be normal. Dehydration may cause increase contraction so taking plenty of water and juice may help. Regular contraction occurs every 10-15 minutes and is sign of preterm labor and if it happens you should contact the doctor immediately.

Dehydration: Dehydration may occur as a result of less fluids intake, so excessive fluids diets are recommended.

Edema: Edema of feet and ankles may occur as a result of inferior vena cava and pelvic vein compression. Elevation of feet above the heart may help. This may be done by putting a pillow on the legs during sleep. Severe edema of face and hand may suggest pre-eclampsia and immediate visit to doctor is recommended.

Gastro esophageal reflux disease: Relaxation of lower esophageal sphincter and increase tone in stomach can lead to reflux and nausea. In this situation you may take some antacids or eat multiple small meals per day rather than taking large meals once. If your symptoms continue for days taking omeprazole may help.

Hemorrhoids: Due to compression of inferior vena cava and pelvic vein and increase abdominal pressure hemorrhoids may occur. These hemorrhoids are treated symptomatically for pain and swelling. Prevention of constipation with increase fluids and fiber diets and stool softeners may help suppress hemorrhoids.

Lower abdominal pain: Usually between 18-32 weeks you may have lower abdominal pain. This pain is due to rapid expansion of uterus and stretching of ligaments. This is often self limiting but may be relieve with heating pad or Tylenol. If you have severe pain there may also be other factors. In such case immediately contact your doctor.

Urinary frequency: During pregnancy the uterus compress the bladder as uterus grows resulting in urinary frequency. Urinary tract infection may also cause but is often accompanied by dysuria. Urine culture should be done. Remember to take plenty of fluids despite urinary frequency.

Varicose veins: In lower extremities or vulva may seen Varicosities during pregnancy. Elevation of lower extremities or use of pressure stockings may help reduce varicose veins. If they do not resolve after 6 months of delivery you must consult for surgical therapy.

infertility in women

Causes of Infertility in Women

Infertility refers to inability of a couple to conceive and have offspring after 12 months of unprotected sex. Infertility is on the rise in many countries. The increasing age of conception versus the decrease in the probability of conception with age makes it a critical issue. Some of the infertility problems may be due to several health problems. So what causes infertility in women? We’ll review few causes of infertility in women here.

Ovulation disorders:
A decline balance of sex hormone (estrogen, progesterone, luteinizing hormone (LH) and follicle stimulating hormone (FHS) is needed for timely growth and release of the eggs from the ovary (ovulation). Hormone imbalance can cause ovulation disorder in women and are the leading causes of infertility in women.

Fallopian tube damage:
The fallopian tube is where fertilization takes place, after egg is released from the ovary into the tube and is met by sperm. Full or a partial blockage of the fallopian tube may prevent fertilization. Damage to the fallopian tubes can be caused by a host or factors including inflammation as result of viral or bacterial infections, some types of sexually transmitted diseases, or complications of surgery such as adhesion or scarring.

Uterus and Cervical disorder:
Benign growth on the uterine wall, such as fibroids or polyps can contribute to infertility as they interfere with the attachment of the embryo to the wall of the uterus.
Abnormalities in the shape of the cervix (lowest part of the uterus) or changes in the texture of the cervical mucus can make it difficult for sperm to move from the vagina into the uterus.

Endometriosis:
Endometriosis is a condition where the lining of the uterus forms at inappropriate places within and outside of the reproductive tract. It can block the fallopian tubes and/or disrupt ovulation. It occurs in about 10% of women.

Immunological factors:
The presence of antibodies to sperm in cervical mucus can cause infertility. In other cases, the mother’s immune system prevents the embryo from attaching to the wall of the uterus and so causes a miscarriage.

Polycystic ovaries:
Polycystic ovaries contain lots of small cysts, making the ovary larger than normal. The condition, known as polycystic ovarian disease (PCOD), is also associated with high levels of androgen and estrogen. Women with PCOD have irregular periods and may not ovulate resulting in infertility.

Ovarian failure:
Ovarian failure can be a consequence of medical treatments such as surgical removal of ovarian tumors or the complete failure of ovaries to develop or contain eggs as in the case of Turner Syndrome. The treatment of ovarian tumors may involve surgical removal of all or part of the ovary. Ovarian failure can also occur as a result of treatment such chemotherapy and pelvic radiotherapy for cancers in other body areas. These therapies destroy eggs in the ovary.

Aging:
Reproductive function declines as women ages, particularly after the age of 35. Women are born with a finite number of eggs, unlike men who produces sperms most of their adult life. With the years approaching menopause, there are fewer and fewer eggs left in the ovary. The quality of eggs also diminishes, as women gets older.

Aging can also affect other reproductive organs and function, such as uterus, hormone production and ovulation. There is also higher incidence of miscarriage in women in their late 30′s.