Introduction

Female factor problems are said to be present, either alone or in combination with male factor problems, in about 50% of infertile couples. These female factor problems arise following disturbance of function of the female genital organs. Thus a problem related to the vagina may prevent or limit sexual intercourse. Likewise, the cervix may not allow spermatozoa to reach the upper genital tract. There may be problems with ovulation or tubal pick–up of the ovulated oocyte. These and other female factor problems will be considered in this chapter. The incidence of each problem varies from place to place and even amongst different social classes in an area. This is because certain problems are related to the individual's environment and lifestyle factors. Thus the pattern of sexual activity will influence the incidence of pelvic infection and resulting damage to the tubes. Some ovulatory problems are associated with either overeating and obesity or starvation and underweight. It is therefore not possible to give an incidence of these problems that will hold true in all parts of the world. The example in Figure 5.1, however, gives an idea of the relative importance of the various female factor problems to be described below.

The vagina

The role of the vagina in infertility is poorly understood. There do not appear to be many vaginal conditions that can cause infertility per se unless they prevent or limit sexual intercourse.