Which of the following is the ovarian factor that affects female fertility?
A. Tubal adhesions
B. Endometrial tumours
C. Endometriosis
D. Increase prolactin level
Correct Answer: D. Increase prolactin level
Explanation
Ovarian factors that affect female fertility are conditions that interfere with the ovary’s ability to produce healthy eggs or release them normally. Common ovarian factors include:
- Polycystic Ovary Syndrome (PCOS):
- Hormonal imbalance leading to irregular or absent ovulation.
- Often causes infertility due to lack of egg release.
- Premature Ovarian Insufficiency (POI) / Premature Menopause:
- Early loss of ovarian function before age 40.
- Reduces egg quantity and quality.
- Ovulatory Dysfunction:
- Irregular ovulation or anovulation due to hormonal issues (e.g., thyroid disorders, hyperprolactinemia).
- Ovarian Tumors or Cysts:
- Certain cysts or tumors can disrupt normal ovary function.
- Age-related decline in ovarian reserve:
- Egg quality and number decrease with age, affecting fertility.
Key Point: The ovarian factor specifically refers to issues with the ovaries themselves, not the uterus, tubes, or hormonal regulation outside the ovary.
Other Options Details
Here’s a detailed explanation of the options you provided, all of which are potential causes of female infertility or reproductive issues:
A. Tubal adhesions
- Definition: Tubal adhesions are bands of scar tissue that form inside or around the fallopian tubes.
- Cause: Often result from infections (like pelvic inflammatory disease), surgery, or endometriosis.
- Effect on fertility: They can block or partially obstruct the fallopian tubes, preventing the egg from meeting the sperm, which may lead to infertility or ectopic pregnancy.
- Symptoms: Sometimes asymptomatic; may have chronic pelvic pain.
B. Endometrial tumours
- Definition: Abnormal growths in the lining of the uterus (endometrium). Examples include polyps or malignant tumours like endometrial cancer.
- Effect on fertility: They can interfere with implantation of the embryo, cause irregular bleeding, or distort the uterine cavity.
- Symptoms: Abnormal uterine bleeding, pelvic pain, or sometimes no symptoms until advanced.
C. Endometriosis
- Definition: A condition in which endometrial tissue (normally lining the uterus) grows outside the uterus—commonly on the ovaries, fallopian tubes, or pelvic lining.
- Effect on fertility: Can cause inflammation, adhesions, and scarring, which may block the fallopian tubes or interfere with ovulation and implantation.
- Symptoms: Chronic pelvic pain, painful menstruation (dysmenorrhea), pain during intercourse, and sometimes infertility.
D. Increased prolactin level (Hyperprolactinemia)
- Definition: Excess production of the hormone prolactin by the pituitary gland.
- Effect on fertility: High prolactin can disrupt the menstrual cycle by inhibiting ovulation, leading to irregular periods or amenorrhea (absence of menstruation).
- Causes: Pituitary tumors (prolactinomas), hypothyroidism, certain medications, stress.
- Symptoms: Irregular or absent periods, galactorrhea (milk production outside of breastfeeding), infertility.
All four options can impair fertility, but through different mechanisms—tubal blockage, uterine environment issues, tissue overgrowth, or hormonal imbalance.
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Writer: Vandita Singh,Lucknow (GS India Nursing Group